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From Discharge Notes to Patient Understanding: Persona-Grounded, Open-Ended Simulation of LLMs as Discharge Educators

arXiv自然语言 2026-07-22 21:24 6 阅读 查看原文

Hospital discharge education is an interactive teaching task: a clinician adapts a discharge plan to a patient's literacy, recall, and personality.

Existing LLM evaluations target static or artifact-generation tasks and do not measure patient understanding under open-ended dialogue.

We introduce DischargeBench

We introduce DischargeBench, a persona-grounded simulation in which a candidate LLM educator conducts a multi-turn session with a Virtual Patient, while an Education Monitor Agent regulates patient realism without modifying the educator, protecting the evaluation signal.

MIMIC-IV-Ext-DischargeBench

We curate MIMIC-IV-Ext-DischargeBench, 477 cases over 24 ICD chapters with persona axes (personality, education level, health literacy, past-medical-history recall) for stratified analysis.

Simulation Scoring

Each simulation is scored on four axes -- Conversation Quality, Topic Checklist, Comprehension, and Factual Consistency -- by an LLM-as-a-Judge aligned against physician annotations.

Aggregate Scores

Across closed- and open-source LLMs, aggregate scores conceal clinically relevant variation across ICD chapters and patient personas; difficult personas expose coverage failures, comprehension gaps, and reduced source-answer agreement.

LLM Evaluation Focus

LLM evaluation for discharge education should center patient understanding, not text quality or answer accuracy alone.