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The paper shows that membership inference risk in medical AI is concentrated in a stable set of patients, even though cohort-wide averages look negligible. Stronger weight decay cut the number of exposed patients substantially, but the same individuals stayed most at risk across architectures, training recipes, and foundation-model initializations. The authors also propose a lightweight screening tool that flags high-risk records before full training, which is a practical step toward per-patient privacy assessment. Readers should note that the evidence comes from controlled experiments on six clinical datasets, so how well the screening generalizes to production settings remains to be tested.
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Automated screening of privacy risks in medical AI

arXiv3 min read

arXiv:2610.30229v1 Announce Type: new Abstract: Medical artificial intelligence (AI) models are often shared without their training data, assuming this protects the patients who contributed them. However, a model can reveal whether a patient's records were used in training, a privacy breach known as a membership inference attack. This risk is usually reported as a cohort average, which can appear negligible while individual patients are almost certainly exposed. Identifying potentially vulnerable records before developing a production model could make privacy assessment more practical. We measured each patient's vulnerability to membership inference attack, across 7,789 models trained on six clinical datasets in four modalities, including two adapted pretrained medical models. Training choices changed how many patients had high attack scores, but the patients who ranked highest by risk largely stayed the same across the configurations we tested. Stronger weight decay reduced the exposed cohort up to threefold, yet largely the same patients remained most at risk across training recipes, architectures and initializations, including foundation models. Therefore, we developed a lightweight screening tool that uses four small models to identify patients with high risk of exposure before production-model training. We also assessed if flagged patients could be protected without removing their data. Privacy screening should become incorporated into data preparation for clinical AI.

Abstract:Medical artificial intelligence (AI) models are often shared without their training data, assuming this protects the patients who contributed them. However, a model can reveal whether a patient's records were used in training, a privacy breach known as a membership inference attack. This risk is usually reported as a cohort average, which can appear negligible while individual patients are almost certainly exposed. Identifying potentially vulnerable records before developing a production model could make privacy assessment more practical. We measured each patient's vulnerability to membership inference attack, across 7,789 models trained on six clinical datasets in four modalities, including two adapted pretrained medical models. Training choices changed how many patients had high attack scores, but the patients who ranked highest by risk largely stayed the same across the configurations we tested. Stronger weight decay reduced the exposed cohort up to threefold, yet largely the same patients remained most at risk across training recipes, architectures and initializations, including foundation models. Therefore, we developed a lightweight screening tool that uses four small models to identify patients with high risk of exposure before production-model training. We also assessed if flagged patients could be protected without removing their data. Privacy screening should become incorporated into data preparation for clinical AI.

Machine Learning (cs.LG); Artificial Intelligence (cs.AI); Cryptography and Security (cs.CR)

arXiv:2610.30229 [cs.LG]

(or arXiv:2610.30229v1 [cs.LG] for this version)

https://doi.org/10.48550/arXiv.2610.30229 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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Full text under the publisher's open licence · 306 words

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