Handling missing values at test time is challenging for machine learning models, especially when aiming for both high accuracy and interpretability. Established approaches often add bias through imputation or excessive model complexity via missingness indicators. Moreover, either method can obscure interpretability, making it harder to understand how the model utilizes the observed variables in predictions. We propose *missingness-avoiding* (MA) machine learning, a general framework for training models to rarely require the values of missing (or imputed) features at test time. We create tailored MA learning algorithms for decision trees, tree ensembles, and sparse linear models by incorporating classifier-specific regularization terms in their learning objectives. The tree-based models leverage contextual missingness by reducing reliance on missing values based on the observed context. Experiments on real-world datasets demonstrate that **MA-DT, MA-LASSO, MA-RF**, and **MA-GBT** effectively reduce the reliance on features with missing values while maintaining predictive performance competitive with their unregularized counterparts. This shows that our framework gives practitioners a powerful tool to maintain interpretability in predictions with test-time missing values.

Foundation models trained on large-scale de-identified electronic health records (EHRs) hold promise for clinical applications. However, their capacity to memorize patient information raises important privacy concerns. In this work, we introduce a suite of black-box evaluation tests to assess privacy-related memorization risks in foundation models trained on structured EHR data. Our framework includes methods for probing memorization at both the embedding and generative levels, and aims to distinguish between model generalization and harmful memorization in clinically relevant settings. We contextualize memorization in terms of its potential to compromise patient privacy, particularly for vulnerable subgroups. We validate our approach on a publicly available EHR foundation model and release an open-source toolkit to facilitate reproducible and collaborative privacy assessments in healthcare AI.

Rule models are often preferred in prediction tasks with tabular inputs as they can be easily interpreted using natural language and provide predictive performance on par with more complex models. However, most rule models’ predictions are undefined or ambiguous when some inputs are missing, forcing users to rely on statistical imputation models or heuristics like zero imputation, undermining the interpretability of the models. In this work, we propose fitting concise yet precise rule models that learn to avoid relying on features with missing values and, therefore, limit their reliance on imputation at test time. We develop MINTY, a method that learns rules in the form of disjunctions between variables that act as replacements for each other when one or more is missing. This results in a sparse linear rule model, regularized to have small dependence on features with missing values, that allows a trade-off between goodness of fit, interpretability, and robustness to missing values at test time. We demonstrate the value of MINTY in experiments using synthetic and real-world data sets and find its predictive performance comparable or favorable to baselines, with smaller reliance on features with missing values.

Missing values are unavoidable in many applications of machine learning and present challenges both during training and at test time. When variables are missing in recurring patterns, fitting separate pattern submodels have been proposed as a solution. However, fitting models independently does not make efficient use of all available data. Conversely, fitting a single shared model to the full data set relies on imputation which often leads to biased results when missingness depends on unobserved factors. We propose an alternative approach, called sharing pattern submodels (SPSM), which i) makes predictions that are robust to missing values at test time, ii) maintains or improves the predictive power of pattern submodels, and iii) has a short description, enabling improved interpretability. Parameter sharing is enforced through sparsity-inducing regularization which we prove leads to consistent estimation. Finally, we give conditions for when a sharing model is optimal, even when both missingness and the target outcome depend on unobserved variables. Classification and regression experiments on synthetic and real-world data sets demonstrate that our models achieve a favorable tradeoff between pattern specialization and information sharing.