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Journal of Medical Internet Research

Anonymization of Portuguese Clinical Notes Using Large Language Models and Quantum-Enhanced Hybrid Architectures: Comparative Evaluation Study

This study built a gold-standard corpus of 1000 Portuguese outpatient clinical notes manually annotated by 5 trained researchers for 5 protected-entity categories (patient names, dates, identifiers, organizations, and geographic locations) and, on a held-out test set of 500 notes, compared two stand-alone LLMs (Llama-3.1-8B-instruct and Llama-3.3-70B-instruct) with two quantum-enhanced hybrid models (Dynex-QML with 8B and 70B base models, using QUBO formulations to transform the final attention layer into a global constraint satisfaction problem solved by neuromorphic quantum annealing); the quantum-enhanced Dynex-QML-70B achieved the highest macro-F1 of 0.855 (95% CI 0.823-0.880), above stand-alone Llama-3.3-70B (0.726), Dynex-QML-8B (0.733), and Llama-3.1-8B (0.