Sensitivity, Specificity, and Consistency: A Tripartite Evaluation of Privacy Filters for Synthetic Data Generation

The generation of privacy-preserving synthetic datasets is a promising avenue for overcoming data scarcity in medical AI research. Post-hoc privacy filtering techniques, designed to remove samples containing personally identifiable information, have recently been proposed as a solution. However, their effectiveness remains largely unverified. This work presents a rigorous evaluation of a filtering pipeline applied to chest X-ray synthesis. Contrary to claims from the original publications, our results demonstrate that current filters exhibit limited specificity and consistency, achieving high sensitivity only for real images while failing to reliably detect near-duplicates generated from training data. These results demonstrate a critical limitation of post-hoc filtering: rather than effectively safeguarding patient privacy, these methods may provide a false sense of security while leaving unacceptable levels of patient information exposed. We conclude that substantial advances in filter design are needed before these methods can be confidently deployed in sensitive applications.