# Learning to Diagnose Privately: DP-Powered LLMs for Radiology Report Classification

arXiv: https://arxiv.org/abs/2506.04450 · HTML: https://mlsanity.com/paper/2506.04450/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 21 of its 40 references that are in the map.
- First posted on arXiv 4 Jun 2025.

## Builds on (most cited first, 21 of 21)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [ALBERT: A Lite BERT for Self-supervised Learning of Language Representations](https://mlsanity.com/paper/1909.11942/) (2019)
- [Deep Learning with Differential Privacy](https://mlsanity.com/paper/1607.00133/) (2016)
- [Membership Inference Attacks against Machine Learning Models](https://mlsanity.com/paper/1610.05820/) (2016)
- [Extracting Training Data from Large Language Models](https://mlsanity.com/paper/2012.07805/) (2020)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Membership Inference Attacks From First Principles](https://mlsanity.com/paper/2112.03570/) (2021)
- [Differentially Private Fine-tuning of Language Models](https://mlsanity.com/paper/2110.06500/) (2021)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [Large Language Models in Finance: A Survey](https://mlsanity.com/paper/2311.10723/) (2023)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)
- [Do Membership Inference Attacks Work on Large Language Models?](https://mlsanity.com/paper/2402.07841/) (2024)
- [Large Language Models for Education: A Survey and Outlook](https://mlsanity.com/paper/2403.18105/) (2024)
- [A Survey of Large Language Models for Healthcare: from Data, Technology, and Applications to Accountability and Ethics](https://mlsanity.com/paper/2310.05694/) (2023)
- [Fine-tune BERT for Extractive Summarization](https://mlsanity.com/paper/1903.10318/) (2019)
- [Generalization in NLI: Ways (Not) To Go Beyond Simple Heuristics](https://mlsanity.com/paper/2110.01518/) (2021)
- [DP-OPT: Make Large Language Model Your Privacy-Preserving Prompt Engineer](https://mlsanity.com/paper/2312.03724/) (2023)
- [Differentially Private Low-Rank Adaptation of Large Language Model Using Federated Learning](https://mlsanity.com/paper/2312.17493/) (2023)
- [Differential Privacy: An Economic Method for Choosing Epsilon](https://mlsanity.com/paper/1402.3329/) (2014)
- [Classification of Multiple Diseases on Body CT Scans using Weakly Supervised Deep Learning](https://mlsanity.com/paper/2008.01158/) (2020)

## Abstract (arXiv)

Large Language Models (LLMs) are increasingly adopted across domains such as education, healthcare, and finance. In healthcare, LLMs support tasks including disease diagnosis, abnormality classification, and clinical decision-making. Among these, multi-abnormality classification of radiology reports is critical for clinical workflow automation and biomedical research. Leveraging strong natural language processing capabilities, LLMs enable efficient processing of unstructured medical text and reduce the administrative burden of manual report analysis. To improve performance, LLMs are often fine-tuned on private, institution-specific datasets such as radiology reports. However, this raises significant privacy concerns: LLMs may memorize training data and become vulnerable to data extraction attacks, while sharing fine-tuned models risks exposing sensitive patient information. Despite growing interest in LLMs for medical text classification, privacy-preserving fine-tuning for multi-abnormality classification remains underexplored. To address this gap, we propose a differentially private (DP) fine-tuning framework for multi-abnormality classification from free-text radiology reports. Our approach integrates differential privacy with Low-Rank Adaptation (LoRA) to efficiently fine-tune LLMs on sensitive clinical data while mitigating leakage risks. We further employ labels generated by a larger LLM to train smaller models, enabling efficient inference under strong privacy guarantees. Experiments on MIMIC-CXR and CT-RATE demonstrate the effectiveness of our DP-LoRA framework across varying privacy regimes. On MIMIC-CXR, our method achieves weighted F1-scores up to 0.89 under moderate privacy budgets, approaching non-private LoRA (0.90) and full fine-tuning (0.96), confirming that strong privacy can be achieved with only modest performance trade-offs.