Privacy-Preserving Generation of Clinical Narratives from Medical Terminologies

Synthetic data is increasingly used to enable the development and evaluation of AI systems in domains where access to real-world data is restricted. In healthcare, clinical documentation presents particular challenges due to its sensitivity. This work introduces a synthetic clinical notes pipeline and dataset designed to support the development of clinical AI tools while avoiding the privacy risks associated with real patient data. The dataset is generated using a modular pipeline that combines structured patient generation, semi-structured patient journey simulation, and unstructured clinical note generation using large language models. The pipeline is designed to prioritise internal consistency across longitudinal patient records, while also capturing variation in writing style, note structure, and clinical detail. Additional mechanisms, including LLM-based validation and augmentation steps, are used to improve faithfulness, realism, and diversity of the generated notes. We release a dataset of 70 synthetic patients, each associated with 20-50 clinical notes spanning a full hospital journey. The dataset is provided at multiple levels of validation, enabling users to balance realism and scalability depending on their use case. This dataset supports the development, testing, and evaluation of clinical AI systems, including summarisation tools, coding models, and decision support systems, without reliance on real patient data.

Large language models (LLMs) have emerged as a powerful tool for synthetic data generation. A particularly important use case is producing synthetic replicas of private text, which requires carefully balancing privacy and utility. We propose Realistic and Privacy-Preserving Synthetic Data Generation (RPSG), which uses private seeds and integrates privacy-preserving strategies, including a formal differential privacy (DP) mechanism in the candidate selection, to generate realistic synthetic data. Comprehensive experiments against state-of-the-art private synthetic data generation methods demonstrate that RPSG achieves high fidelity to private data while providing strong privacy protection.

The development of medical AI is constrained by limited access to high-quality clinical data due to institutional silos and strict privacy regulations such as HIPAA and GDPR. Synthetic data generation offers a potential solution, but existing methods lack principled mechanisms to explicitly manage the privacy-utility trade-off, often degrading clinically meaningful patterns or risking patient re-identification. We present PSyGenTAB, a privacy-preserving generative framework that formulates synthetic healthcare data generation as a constrained optimization problem solved using the Augmented Lagrangian Method. By embedding configurable privacy constraints directly into model training, PSyGenTAB enforces minimum privacy thresholds while maximizing clinical data utility. Across multiple clinically motivated benchmarks, PSyGenTAB preserves inter-feature clinical relationships and minority-class diagnostic patterns essential for reliable health AI. Downstream evaluation using Train-on-Synthetic, Test-on-Real and Train-on-Real, Test-on-Synthetic protocols shows that models trained on synthetic data achieve performance comparable to those trained on real patient records. Privacy auditing further demonstrates reduced exact record reproduction and strong resilience to membership inference attacks. These results establish PSyGenTAB as a principled framework for balancing privacy protection and clinical utility in synthetic healthcare data, supporting secure cross-institutional AI development.