Large Language Models are typically trained on datasets collected from the web, which may inadvertently contain harmful or sensitive personal information. To address growing privacy concerns, unlearning methods have been proposed to remove the influence of specific data from trained models. Of these, exact unlearning-- which retrains the model from scratch without the target data--is widely regarded as the gold standard for mitigating privacy risks in deployment. In this paper, we revisit this assumption in a practical deployment setting where both the pre-and post-unlearning logits API are exposed, such as in open-weight scenarios. Targeting this setting, we introduce a novel data extraction attack that leverages signals from the pre-unlearning model to guide the post-unlearning model, uncovering patterns that reflect the removed data distribution. Combining model guidance with a token filtering strategy, our attack significantly improves extraction success rates-- doubling performance in some cases--across common benchmarks such as MUSE, TOFU, and WMDP. Furthermore, we demonstrate our attack's effectiveness on a simulated medical diagnosis dataset to highlight real-world privacy risks associated with exact unlearning. In light of our findings, which suggest that unlearning may, in a contradictory way, increase the risk of privacy leakage during realworld deployments, we advocate for evaluation of unlearning methods to consider broader threat models that account not only for post-unlearning models but also for adversarial access to prior checkpoints.

In recent years, there has been a proliferation of ready-to-use large language models (LLMs) designed for various applications, both general-purpose and domain-specific. Instead of advocating for the development of a new model or continuous pretraining of an existing one, this paper introduces a pragmatic teacher-teacher framework to facilitate mutual learning between two pre-existing models.By leveraging two teacher models possessing complementary knowledge, we introduce a LIghtweight kNowledge alignmEnt (LINE) module aimed at harmonizing their knowledge within a unified representation space. This framework is particularly valuable in clinical settings, where stringent regulations and privacy considerations dictate the handling of detailed clinical notes. Our trained LINE module excels in capturing critical information from clinical notes, leveraging highly de-identified data. Validation and downstream tasks further demonstrate the effectiveness of the proposed framework.

Electronic Health Records (EHRs) are integral for storing comprehensive patient medical records, combining structured data (e.g., medications) with detailed clinical notes (e.g., physician notes). These elements are essential for straightforward data retrieval and provide deep, contextual insights into patient care. However, they often suffer from discrepancies due to unintuitive EHR system designs and human errors, posing serious risks to patient safety. To address this, we developed EHRCon, a new dataset and task specifically designed to ensure data consistency between structured tables and unstructured notes in EHRs.EHRCon was crafted in collaboration with healthcare professionals using the MIMIC-III EHR dataset, and includes manual annotations of 3,943 entities across 105 clinical notes checked against database entries for consistency.EHRCon has two versions, one using the original MIMIC-III schema, and another using the OMOP CDM schema, in order to increase its applicability and generalizability. Furthermore, leveraging the capabilities of large language models, we introduce CheckEHR, a novel framework for verifying the consistency between clinical notes and database tables.

Large language models (LLMs) have recently showcased remarkable capabilities, spanning a wide range of tasks and applications, including those in the medical domain. Models like GPT-4 excel in medical question answering but may face challenges in the lack of interpretability when handling complex tasks in real clinical settings. We thus introduce the diagnostic reasoning dataset for clinical notes (DiReCT), aiming at evaluating the reasoning ability and interpretability of LLMs compared to human doctors. It contains 511 clinical notes, each meticulously annotated by physicians, detailing the diagnostic reasoning process from observations in a clinical note to the final diagnosis. Additionally, a diagnostic knowledge graph is provided to offer essential knowledge for reasoning, which may not be covered in the training data of existing LLMs. Evaluations of leading LLMs on DiReCT bring out a significant gap between their reasoning ability and that of human doctors, highlighting the critical need for models that can reason effectively in real-world clinical scenarios.

A.1 Motivation For what purpose was the dataset created?