arXiv:2505.17818cs.AIcs.CL2025-05NeurIPS被引 29

构建可定制的虚拟病人系统,模拟真实医疗对话中的多样化患者特征。

PatientSim: A Persona-Driven Simulator for Realistic Doctor-Patient Interactions

  • 基于真实医疗数据生成37种患者人格组合,涵盖性格、语言能力等四维特征。
  • 验证8个大模型在事实准确性和人格一致性上表现,顶级开源模型达临床可用水平。
  • 支持隐私保护与个性化配置,适合医学对话系统训练与医学生教学使用。

医生与患者之间的诊疗交流需要多轮、上下文敏感的沟通,并针对不同患者个性进行调整。训练或评估医生类大模型在此类场景下的表现,需依赖真实的患者交互系统。然而,现有模拟器往往无法覆盖临床实践中多样化的患者特征。为此,我们提出PatientSim,一个基于医学知识生成真实且多样患者人格的模拟系统。该系统利用来自MIMIC-ED和MIMIC-IV数据集的真实临床资料构建患者病历,并通过四个维度(性格、语言能力、病史回忆水平、认知混乱程度)定义人格,形成37种独特组合。我们评估了8个大模型在事实准确性和人格一致性上的表现,其中性能最佳的开源模型Llama 3.3 70B经四位临床医生验证,确认框架可靠性。作为开源可定制平台,PatientSim提供可复现、可扩展的解决方案,支持特定训练需求。其隐私合规设计使其成为评估医疗对话系统在多元患者表现下的可靠测试平台,也具备医疗教育应用潜力。代码已公开于https://github.com/dek924/PatientSim。

原文摘要 · Abstract (English)

Doctor-patient consultations require multi-turn, context-aware communication tailored to diverse patient personas. Training or evaluating doctor LLMs in such settings requires realistic patient interaction systems. However, existing simulators often fail to reflect the full range of personas seen in clinical practice. To address this, we introduce PatientSim, a patient simulator that generates realistic and diverse patient personas for clinical scenarios, grounded in medical expertise. PatientSim operates using: 1) clinical profiles, including symptoms and medical history, derived from real-world data in the MIMIC-ED and MIMIC-IV datasets, and 2) personas defined by four axes: personality, language proficiency, medical history recall level, and cognitive confusion level, resulting in 37 unique combinations. We evaluate eight LLMs for factual accuracy and persona consistency. The top-performing open-source model, Llama 3.3 70B, is validated by four clinicians to confirm the robustness of our framework. As an open-source, customizable platform, PatientSim provides a reproducible and scalable solution that can be customized for specific training needs. Offering a privacy-compliant environment, it serves as a robust testbed for evaluating medical dialogue systems across diverse patient presentations and shows promise as an educational tool for healthcare. The code is available at https://github.com/dek924/PatientSim.

医疗对话人格模拟大模型评估医学教育

Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。