# Towards Fair and Efficient De-identification: Quantifying the Efficiency and Generalizability of De-identification Approaches

arXiv: https://arxiv.org/abs/2602.15869 · HTML: https://mlsanity.com/paper/2602.15869/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 8 of its 36 references that are in the map.
- First posted on arXiv 27 Jan 2026.

## Builds on (most cited first, 8 of 8)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [ClinicalBERT: Modeling Clinical Notes and Predicting Hospital Readmission](https://mlsanity.com/paper/1904.05342/) (2019)
- [Benchmarking large language models for biomedical natural language processing applications and recommendations](https://mlsanity.com/paper/2305.16326/) (2023)
- [Few-shot clinical entity recognition in English, French and Spanish: masked language models outperform generative model prompting](https://mlsanity.com/paper/2402.12801/) (2024)
- [Unlocking the Potential of Large Language Models for Clinical Text Anonymization: A Comparative Study](https://mlsanity.com/paper/2406.00062/) (2024)
- [Not What the Doctor Ordered: Surveying LLM-based De-identification and Quantifying Clinical Information Loss](https://mlsanity.com/paper/2509.14464/) (2025)

## Built on by (most cited first, 1 of 1)

- [Institution-Specific LLM Prompting Recovers PHI That De-identification Systems and Their Gold Standards Both Miss](https://mlsanity.com/paper/2608.17051/) (2026)

## Abstract (arXiv)

Large language models (LLMs) have shown strong performance on clinical de-identification, the task of identifying sensitive identifiers to protect privacy. However, previous work has not examined their generalizability between formats, cultures, and genders. In this work, we systematically evaluate fine-tuned transformer models (BERT, ClinicalBERT, ModernBERT), small LLMs (Llama 1-8B, Qwen 1.5-7B), and large LLMs (Llama-70B, Qwen-72B) at de-identification. We show that smaller models achieve comparable performance while substantially reducing inference cost, making them more practical for deployment. Moreover, we demonstrate that smaller models can be fine-tuned with limited data to outperform larger models in de-identifying identifiers drawn from Mandarin, Hindi, Spanish, French, Bengali, and regional variations of English, in addition to gendered names. To improve robustness in multi-cultural contexts, we introduce and publicly release BERT-MultiCulture-DEID, a set of de-identification models based on BERT, ClinicalBERT, and ModernBERT, fine-tuned on MIMIC with identifiers from multiple language variants. Our findings provide the first comprehensive quantification of the efficiency-generalizability trade-off in de-identification and establish practical pathways for fair and efficient clinical de-identification. Details on accessing the models are available at: https://doi.org/10.5281/zenodo.18342291