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Oct 16

Vision Token Masking Alone Cannot Prevent PHI Leakage in Medical Document OCR: A Systematic Evaluation

Large vision-language models (VLMs) are increasingly deployed for optical character recognition (OCR) in healthcare settings, raising critical concerns about protected health information (PHI) exposure during document processing. This work presents the first systematic evaluation of inference-time vision token masking as a privacy-preserving mechanism for medical document OCR using DeepSeek-OCR. We introduce seven masking strategies (V3-V9) targeting different architectural layers (SAM encoder blocks, compression layers, dual vision encoders, projector fusion) and evaluate PHI reduction across HIPAA-defined categories using 100 synthetic medical billing statements (drawn from a corpus of 38,517 annotated documents) with perfect ground-truth annotations. All masking strategies converge to 42.9% PHI reduction, successfully suppressing long-form spatially-distributed identifiers (patient names, dates of birth, physical addresses at 100% effectiveness) while failing to prevent short structured identifiers (medical record numbers, social security numbers, email addresses, account numbers at 0% effectiveness). Ablation studies varying mask expansion radius (r=1,2,3) demonstrate that increased spatial coverage does not improve reduction beyond this ceiling, indicating that language model contextual inference - not insufficient visual masking - drives structured identifier leakage. A simulated hybrid architecture combining vision masking with NLP post-processing achieves 88.6% total PHI reduction (assuming 80% NLP accuracy on remaining identifiers). This negative result establishes boundaries for vision-only privacy interventions in VLMs, provides guidance distinguishing PHI types amenable to vision-level versus language-level redaction, and redirects future research toward decoder-level fine-tuning and hybrid defense-in-depth architectures for HIPAA-compliant medical document processing.

  • 1 authors
·
Nov 22, 2025

Inadvertent Context Leakage in Language Models

For AI agents to be useful beyond simple chat, they must hold sensitive user context such as calendars, credentials, health records, and financial data. We study whether the mere presence of such secrets in a model's context window introduces hidden correlations into the model's benign outputs, allowing reconstruction even when the model correctly refuses direct extraction. We further study whether an adversary can actively engineer prompts that amplify this effect, using the model as a covert carrier to transmit secrets through seemingly innocuous text. In both cases, this limited leakage is exploited using a novel adaptive attack that assumes black-box access to the underlying model. In controlled experiments across eight proprietary models, we find that 2-digit in-context secrets are reconstructed with near-perfect accuracy and 4-digit secrets at 82\% exact match, all from outputs the model produces in response to ordinary, non-adversarial requests. We observe that more capable models leak more: stronger instruction-following amplifies sensitivity to in-context secrets, suggesting leakage is a byproduct of capability as opposed to a patchable bug. We show this leakage enables two practical attacks: (1) a trained classifier that infers semantic predicates about user memories (e.g., health conditions, financial events) from routine natural-language outputs, and (2) an RL-trained adversary that extracts full Social Security Numbers from a production-style agent.

  • 5 authors
·
Aug 19

How life-table right-censoring affected the Brazilian Social Security Factor: an application of the gamma-Gompertz-Makeham model

Automatic Adjustment Mechanisms (AAM) are legal instruments that help social security systems respond to demographic and economic changes. In Brazil, the Social Security Factor (SSF) was introduced in the late 1990s as an AAM to link retirement benefits to life expectancy at the retirement age, with the hope of promoting contributory justice and discouraging early retirement. Recent research has highlighted the limitations of right-censored life tables, such as those used in Brazil. It has recommended using the gamma-Gompertz-Makeham (GGM) model to estimate adult and old-age mortality. This study investigated the impact of right-censoring on the SSF by comparing the official SSF and other social security metrics with a counterfactual scenario computed based on fitted GGM models. The results indicate that from 2004 to 2012, official life tables may have negatively impacted retirees' income, particularly for those who delayed their retirement. Furthermore, the GGM-fitted models' life expectancies had more stable paths over time, which could have helped with long-term planning. This study's findings are significant for policymakers as they highlight the importance of using appropriate mortality metrics in AAMs to ensure accurate retirement benefit payments. They also underscore the need to consider the potential impacts of seemingly innocuous hypotheses on public action outcomes. Overall, this study provides valuable insights for public planners and policymakers looking to enhance the effectiveness and fairness of social security systems.

  • 3 authors
·
Sep 11, 2023