ArticleJournal of the American Medical Informatics Association : JAMIA2020
Resilience of clinical text de-identified with "hiding in plain sight" to hostile reidentification attacks by human readers.
Article in Journal of the American Medical Informatics Association : JAMIA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Large Language Models Using Clinical Text in Pediatrics: A Scoping Review.JAMA network open · 2026Article
- A Markov Chain Replacement Strategy for Surrogate Identifiers: Minimizing Re-Identification Risk While Preserving Text Reuse.Electronics · 2025Article
- Informatics impact requires effective, scalable tools and standards-based infrastructure.Journal of the American Medical Informatics Association : JAMIA · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectiveEffective, scalable de-identification of personally identifying information (PII) for information-rich clinical text is critical to support secondary use, but no method is 100% effective. The hiding-in-plain-sight (HIPS) approach attempts to solve this "residual PII problem." HIPS replaces PII tagged by a de-identification system with realistic but fictitious (resynthesized) content, making it harder to detect remaining unredacted PII. MATERIALS AND
methodsUsing 2000 representative clinical documents from 2 healthcare settings (4000 total), we used a novel method to generate 2 de-identified 100-document corpora (200 documents total) in which PII tagged by a typical automated machine-learned tagger was replaced by HIPS-resynthesized content. Four readers conducted aggressive reidentification attacks to isolate leaked PII: 2 readers from within the originating institution and 2 external readers.
resultsOverall, mean recall of leaked PII was 26.8% and mean precision was 37.2%. Mean recall was 9% (mean precision = 37%) for patient ages, 32% (mean precision = 26%) for dates, 25% (mean precision = 37%) for doctor names, 45% (mean precision = 55%) for organization names, and 23% (mean precision = 57%) for patient names. Recall was 32% (precision = 40%) for internal and 22% (precision =33%) for external readers. DISCUSSION AND
conclusionsApproximately 70% of leaked PII "hiding" in a corpus de-identified with HIPS resynthesis is resilient to detection by human readers in a realistic, aggressive reidentification attack scenario-more than double the rate reported in previous studies but less than the rate reported for an attack assisted by machine learning methods.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.