arXiv:2605. 03301v2 Announce Type: replace-cross Abstract: De-identification of clinical text is a prerequisite for the secondary use of electronic health records.
The study evaluates an auditable patient‑timeline reconstruction system that tracks provenance, records revisions, and refuses to answer when evidence is missing. Using a synthetic corpus of 1,000 patients and 3,353 notes, two provenance‑aware Evidence Graph operators reduced graph size by 33–37% while preserving all answers across 6,813 query points; a fixed‑window baseline failed to answer over half of the points. The system’s evidence‑gating mechanisms (BioClinicalBERT and a zero‑shot LLM) responded appropriately to evidence‑unavailable controls, but performance varied on marker‑free controls, with BERT maintaining high accuracy but the LLM’s coverage dropping sharply. "whyItMatters":"The results demonstrate that provenance‑aware evidence graphs can significantly reduce data complexity while maintaining answer integrity, highlighting a practical approach to building auditable clinical NLP systems."
The paper presents a method for extracting key information from OCR‑digitized clinical reports, addressing challenges posed by heterogeneous documents and noisy OCR output. It introduces an open key space that is iteratively mined, normalized, clustered, and verified to build a canonical key inventory, and defines key coverage as a metric for inventory completeness. Experiments on reports from over 20 hospitals using a 0.2B BERT model show that performance improves steadily with key coverage, achieving high F1 scores when the top 90 keys are covered and outperforming a fine‑tuned Qwen3‑0.6B baseline.
The paper introduces a clinically grounded privacy evaluation framework for medical language models, assessing leakage across a spectrum of adversarial access levels—from publicly inferable demographics to leaked note fragments. Using this framework on an LM pretrained on 378,000 clinical notes, the authors find that routine encounter metadata leads to high verbatim memorization and significant recovery of sensitive diagnoses (e.g., AUROC 0.91 for abortion, 0.82 for HIV). They also note that exact-match memorization can overstate disclosure, with 36% of memorized tokens being templated documentation, underscoring the risks of training on longitudinal clinical data and offering a reusable evaluation tool.
The paper introduces a source‑grounded integrity gate for AI‑assisted personal health records, ensuring that data generated by large language models remains provisional until a deterministic monitor verifies it against the source document. The monitor only accepts candidates that contain a unique supporting quotation, appear within the same laboratory row, and preserve provenance, preventing the model from approving its own output. In Medical DataCloud, the system passed all 22 conformance and mutation tests and, in a replay of nine historical lab reports, admitted 72 of 97 numeric candidates while retaining 25 for human review.
MedDeID is an on‑premises framework that combines in‑house annotation, synthetic‑note generation, model training, inference, pseudonymisation and evaluation to de‑identify clinical text. On a Dutch hospital benchmark, a hospital‑trained transformer detected 98.9 % of identifying text while redacting only 0.24 % of non‑identifier text; a synthetic‑only model achieved 96.1 %. In primary‑care notes, the synthetic‑trained model outperformed the hospital‑trained model in recall and robustness to identifier‑format changes, and an English version trained without real text reached 99.7 % and 98.9 % detection on synthetic benchmarks.
INDRA is a research platform that integrates multiple archival collections—such as UCSF’s Industry Documents Library, Columbia and CUNY’s ToxicDocs, and Stanford’s SRITA—into a single, LLM‑readable corpus. It employs three safeguards: a closed evidentiary sandbox, real‑time provenance tagging, and a deterministic system‑level protocol to ensure that model outputs are clearly distinguished from archival evidence and from the model’s own inferences. The platform enables large‑language‑model‑powered investigations across these archives while keeping the conditions of knowledge production transparent and auditable.
The study evaluates whether large language models (LLMs) with in‑context learning can better identify institution‑specific protected health information (PHI) in electronic health records than existing de‑identification systems. Using 100 pediatric oncology notes from Texas Children’s Hospital, eight LLMs were compared to two purpose‑built systems and pattern‑based baselines under three progressively specific prompts. The best LLM achieved an F1 score of 0.918, recovering 79% of previously missed PHI categories and reaching a recall of 0.981 after iterative prompt refinement, demonstrating that calibrated single‑pass prompting can close the institutional PHI gap while balancing precision and recall.
arXiv:2606. 09500v1 Announce Type: new Abstract: Objective.
arXiv:2608. 07796v1 Announce Type: new Abstract: Large language models perform strongly on medical knowledge benchmarks, but reliable clinical deployment requires agents to conduct defensible investigations over heterogeneous, longitudinal records: determining what evidence is needed, retrieving and reconciling structured and free-text data, grounding conclusions in verifiable evidence, and deferring cases that cannot be resolved reliably.
The paper introduces TRACE, a method that removes duplicated text—known as note bloat—from clinical notes by leveraging EHR metadata and frequency-based de‑duplication. Across 5.3 million notes from diverse patient cohorts, TRACE eliminated 47.3 % of chart text while preserving information extraction and prediction performance, with only 0.3–6.6 % of removed content being author‑generated. The authors project that applying TRACE could yield net savings of $1.00 M to $13.58 M over three years at a large academic center, depending on model pricing schemes.
arXiv:2608. 09393v1 Announce Type: cross Abstract: We identify and quantify temporal misgrounding: the systematic retrieval and citation of the currently in-force version of a legal article when the applicable version is an earlier or future one.