arXiv:2511.11347cs.CRcs.AI2025-11综述被引 4

梳理医疗RAG系统隐私风险,提出可落地的保护框架。

Privacy Challenges and Solutions in Retrieval-Augmented Generation-Enhanced LLMs for Healthcare Chatbots: A Review of Applications, Risks, and Future Directions

  • 构建数据存储到生成全流程隐私分析框架
  • 发现临床验证不足与评估工具缺失等关键短板
  • 适合医疗AI研发者与隐私安全研究人员参考

检索增强生成(RAG)正迅速成为整合大语言模型至临床与生物医学工作流的变革性方法。然而,如受保护健康信息(PHI)泄露等隐私风险仍未能一致缓解。本文综述了当前RAG在医疗领域的应用现状,涵盖(i)不同临床场景中的敏感数据类型,(ii)相关隐私风险,(iii)现有及新兴的数据隐私保护机制,以及(iv)患者数据隐私保护的未来方向。我们综合分析23篇关于RAG在医疗中应用的文章,通过结构化流程框架系统评估数据存储、传输、检索和生成各阶段的隐私挑战,明确潜在失效模式、威胁模型与系统机制中的根本原因及其实际影响。在此基础上,我们深入评述17篇隐私保护策略研究。评估揭示出关键缺口:临床验证不足、缺乏标准化评估框架、自动化评估工具缺失。基于此,我们提出具体改进方向,并呼吁采取行动。本综述为研究者与从业者提供理解医疗RAG隐私漏洞的结构化框架,并指明兼具临床有效性和强隐私保护的系统发展方向。

原文摘要 · Abstract (English)

Retrieval-augmented generation (RAG) has rapidly emerged as a transformative approach for integrating large language models into clinical and biomedical workflows. However, privacy risks, such as protected health information (PHI) exposure, remain inconsistently mitigated. This review provides a thorough analysis of the current landscape of RAG applications in healthcare, including (i) sensitive data type across clinical scenarios, (ii) the associated privacy risks, (iii) current and emerging data-privacy protection mechanisms and (iv) future direction for patient data privacy protection. We synthesize 23 articles on RAG applications in healthcare and systematically analyze privacy challenges through a pipeline-structured framework encompassing data storage, transmission, retrieval and generation stages, delineating potential failure modes, their underlying causes in threat models and system mechanisms, and their practical implications. Building on this analysis, we critically review 17 articles on privacy-preserving strategies for RAG systems. Our evaluation reveals critical gaps, including insufficient clinical validation, absence of standardized evaluation frameworks, and lack of automated assessment tools. We propose actionable directions based on these limitations and conclude with a call to action. This review provides researchers and practitioners with a structured framework for understanding privacy vulnerabilities in healthcare RAG and offers a roadmap toward developing systems that achieve both clinical effectiveness and robust privacy preservation.

医疗AIRAG隐私保护安全评估

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