For sharing privacy-sensitive data, de-identification is commonly regarded as adequate for safeguarding privacy. Synthetic data is also being considered as a privacy-preserving alternative. Recent successes with numerical and tabular data generative models and the breakthroughs in large generative language models raise the question of whether synthetically generated clinical notes could be a viable alternative to real notes for research purposes. In this work, we demonstrated that (i) de-identification of real clinical notes does not protect records against a membership inference attack, (ii) proposed a novel approach to generate synthetic clinical notes using the current state-of-the-art large language models, (iii) evaluated the performance of the synthetically generated notes in a clinical domain task, and (iv) proposed a way to mount a membership inference attack where the target model is trained with synthetic data. We observed that when synthetically generated notes closely match the performance of real data, they also exhibit similar privacy concerns to the real data. Whether other approaches to synthetically generated clinical notes could offer better trade-offs and become a better alternative to sensitive real notes warrants further investigation.
This study explored the usability of prompt generation on named entity recognition (NER) tasks and the performance in different settings of the prompt. The prompt generation by GPT-J models was utilized to directly test the gold standard as well as to generate the seed and further fed to the RoBERTa model with the spaCy package. In the direct test, a lower ratio of negative examples with higher numbers of examples in prompt achieved the best results with a F1 score of 0.72. The performance revealed consistency, 0.92-0.97 in the F1 score, in all settings after training with the RoBERTa model. The study highlighted the importance of seed quality rather than quantity in feeding NER models. This research reports on an efficient and accurate way to mine clinical notes for periodontal diagnoses, allowing researchers to easily and quickly build a NER model with the prompt generation approach.
This study aimed to utilize text processing and natural language processing (NLP) models to mine clinical notes for the diagnosis of periodontitis and to evaluate the performance of a named entity recognition (NER) model on different regular expression (RE) methods. Two complexity levels of RE methods were used to extract and generate the training data. The SpaCy package and RoBERTa transformer models were used to build the NER model and evaluate its performance with the manual-labeled gold standards. The comparison of the RE methods with the gold standard showed that as the complexity increased in the RE algorithms, the F1 score increased from 0.3-0.4 to around 0.9. The NER models demonstrated excellent predictions, with the simple RE method showing 0.84-0.92 in the evaluation metrics, and the advanced and combined RE method demonstrating 0.95-0.99 in the evaluation. This study provided an example of the benefit of combining NER methods and NLP models in extracting target information from free-text to structured data and fulfilling the need for missing diagnoses from unstructured notes.