VeriSim: A Configurable Framework for Stress-Testing Medical AI Under Patient Communication Noise — Paper

Abstract

Medical large language models are typically evaluated on idealized patient cases that do not reflect how real patients communicate. We introduce VeriSim, a patient simulation framework that injects controllable noise along six clinically grounded communication dimensions while substantially preserving each patient's medical record. Truth adherence is supported by a verifier that extracts atomic claims from each candidate utterance and judges them against a UMLS-grounded vector index built with BioLORD embeddings, using the retrieved atoms' structured clinical metadata (e.g., drug class, anatomical site, treats-condition relations) rather than surface-text similarity alone. Across seven open-weight LLMs, realistic noise reduces diagnostic accuracy by 15-25 percentage points and increases conversation length by 34-55%; the 7-8B models degrade 1.4x more than 70B+ models. A board-certified physician and a licensed nurse rate VeriSim's conversations highly on truth, realism, clinical utility, and noise fidelity (inter-annotator agreement >= 0.80 across all dimensions), and an LLM-as-judge closely tracks their ratings, enabling scalable evaluation. We release VeriSim as an open-source framework for rigorous stress-testing of clinical AI: https://github.com/mohitmarvania/VeriSim

Authors 8

Han Ngoc Tran, Kazhal Shafiei, Mehrdad Fazli, Mohit Marvania, Sina Mansouri, Vibhavari Ashok Shihorkar, Yikuan Li, Ziwei Zhu

Specification

Official page: arxiv.org/abs/2604.10441
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Arxiv announce type: replace
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
arXiv id: 2604.10441
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Categories: cs.AI
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
PDF: arxiv.org/pdf/2604.10441
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Primary category: cs.AI
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Published: 12 Sept 2026
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh

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9

Source tiers

T19

Freshest observation

2 h ago

Conflicts

None

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Authors: Sina Mansouri, Mohit Marvania, Vibhavari Ashok Shihorkar

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Claim history

9 claims · 9 properties

Official pageofficial_url1

Claim history for Official page
Value	Valid from → to	Status	Source	Confidence	Extractor
https://arxiv.org/abs/2604.10441	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Abstractabstract1

Claim history for Abstract
Value	Valid from → to	Status	Source	Confidence	Extractor
Medical large language models are typically evaluated on idealized patient cases that do not reflect how real patients communicate. We introduce VeriSim, a patient simulation framework that injects controllable noise along six clinically grounded communication dimensions while substantially preserving each patient's medical record. Truth adherence is supported by a verifier that extracts atomic claims from each candidate utterance and judges them against a UMLS-grounded vector index built with BioLORD embeddings, using the retrieved atoms' structured clinical metadata (e.g., drug class, anatomical site, treats-condition relations) rather than surface-text similarity alone. Across seven open-weight LLMs, realistic noise reduces diagnostic accuracy by 15-25 percentage points and increases conversation length by 34-55%; the 7-8B models degrade 1.4x more than 70B+ models. A board-certified physician and a licensed nurse rate VeriSim's conversations highly on truth, realism, clinical utility, and noise fidelity (inter-annotator agreement >= 0.80 across all dimensions), and an LLM-as-judge closely tracks their ratings, enabling scalable evaluation. We release VeriSim as an open-source framework for rigorous stress-testing of clinical AI: https://github.com/mohitmarvania/VeriSim	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Arxiv announce typearxiv_announce_type1

Claim history for Arxiv announce type
Value	Valid from → to	Status	Source	Confidence	Extractor
replace	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

arXiv idarxiv_id1

Claim history for arXiv id
Value	Valid from → to	Status	Source	Confidence	Extractor
2604.10441	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Authorsauthors1

Claim history for Authors
Value	Valid from → to	Status	Source	Confidence	Extractor
Han Ngoc Tran, Kazhal Shafiei, Mehrdad Fazli, Mohit Marvania, Sina Mansouri, Vibhavari Ashok Shihorkar, Yikuan Li, Ziwei Zhu	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Categoriescategories1

Claim history for Categories
Value	Valid from → to	Status	Source	Confidence	Extractor
cs.AI	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

PDFpdf_url1

Claim history for PDF
Value	Valid from → to	Status	Source	Confidence	Extractor
https://arxiv.org/pdf/2604.10441	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Primary categoryprimary_category1

Claim history for Primary category
Value	Valid from → to	Status	Source	Confidence	Extractor
cs.AI	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Publishedpublished_at1

Claim history for Published
Value	Valid from → to	Status	Source	Confidence	Extractor
12 Sept 2026	12 Sept 2026 04:12 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Claims are temporal and append-only: a new observation closes the previous claim (valid_to) instead of overwriting it. Conflicting claims from different sources are kept side by side and flagged — never averaged. Methodology →

12 Sept 2026
New paperPaperVeriSim: A Configurable Framework for Stress-Testing Medical AI Under Patient Communication Noise
New paper: VeriSim: A Configurable Framework for Stress-Testing Medical AI Under Patient Communication Noise
arxiv
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Source documents
Source	Document	Type	Tier	Last observed	Snapshots
arXiv (Atom API + RSS)	rss.arxiv.org/rss/cs.AI	feed	T1· Official	2 h ago	2

Tier 1 = official/primary, 2 = quality secondary, 3 = community, 4 = unverified. Every snapshot is archived; see all sources and the methodology.