DualAlign: Generating Clinically Grounded Synthetic Data

Abstract: Synthetic clinical data are increasingly important for advancing AI in healthcare, given strict privacy constraints on real-world EHRs, limited availability of annotated rare-condition data, and systemic biases in observational datasets. While LLMs can generate fluent clinical text, producing synthetic data that is both realistic and clinically meaningful remains challenging. We introduce DualAlign, a framework that enhances statistical fidelity and clinical plausibility through dual alignment: (1) statistical alignment, which conditions generation on patient demographics and risk factors; and (2) semantic alignment, which incorporates real-world symptom trajectories to guide content generation. Using Alzheimer's disease (AD) as a case study, DualAlign produces context-grounded symptom-level sentences that better reflect real-world clinical documentation. Fine-tuning an LLaMA 3.1-8B model with a combination of DualAlign-generated and human-annotated data yields substantial performance gains over models trained on gold data alone or unguided synthetic baselines. While DualAlign does not fully capture longitudinal complexity, it offers a practical approach for generating clinically grounded, privacy-preserving synthetic data to support low-resource clinical text analysis.