arXiv Computation and Language By Deepali Mittal, Dheeraj Mundhra, Yulia Sidorova, Tersia de Kock, Oli Munns, Sofie S Meyer

SIM-UT: A User Simulation based Evaluation Framework for Medical Triage Chatbots

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SIM-UT is a multi‑turn, user‑simulation evaluation framework designed to uncover realistic failure modes in large‑language‑model (LLM) medical triage chatbots. The study applied SIM‑UT to three WhatsApp‑based health chatbots in India, South Africa, and Kenya, comparing a medically fine‑tuned model (MedGemma) with general‑purpose models (ChatGPT and Claude) across more than 5,000 multilingual simulated conversations. A prominent failure identified was de‑escalation risk, where chatbots incorrectly down‑rated serious symptoms after users minimized them, potentially leading to dangerous clinical outcomes.

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