# PatientHub: A Unified Framework for Patient Simulation

arXiv: https://arxiv.org/abs/2602.11684 · HTML: https://mlsanity.com/paper/2602.11684/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 28 of its 58 references that are in the map.
- First posted on arXiv 12 Feb 2026.

## Builds on (most cited first, 28 of 28)

- [Towards Emotional Support Dialog Systems](https://mlsanity.com/paper/2106.01144/) (2021)
- [SoulChat: Improving LLMs' Empathy, Listening, and Comfort Abilities through Fine-tuning with Multi-turn Empathy Conversations](https://mlsanity.com/paper/2311.00273/) (2023)
- [AugESC: Dialogue Augmentation with Large Language Models for Emotional Support Conversation](https://mlsanity.com/paper/2202.13047/) (2022)
- [Roleplay-doh: Enabling Domain-Experts to Create LLM-simulated Patients via Eliciting and Adhering to Principles](https://mlsanity.com/paper/2407.00870/) (2024)
- [A Computational Framework for Behavioral Assessment of LLM Therapists](https://mlsanity.com/paper/2401.00820/) (2024)
- [Cactus: Towards Psychological Counseling Conversations using Cognitive Behavioral Theory](https://mlsanity.com/paper/2407.03103/) (2024)
- [Automatic Interactive Evaluation for Large Language Models with State Aware Patient Simulator](https://mlsanity.com/paper/2403.08495/) (2024)
- [Towards a Client-Centered Assessment of LLM Therapists by Client Simulation](https://mlsanity.com/paper/2406.12266/) (2024)
- [LLMs Can Simulate Standardized Patients via Agent Coevolution](https://mlsanity.com/paper/2412.11716/) (2024)
- [AnnaAgent: Dynamic Evolution Agent System with Multi-Session Memory for Realistic Seeker Simulation](https://mlsanity.com/paper/2506.00551/) (2025)
- [Human Decision-making is Susceptible to AI-driven Manipulation](https://mlsanity.com/paper/2502.07663/) (2025)
- [Chatbots for Mental Health Support: Exploring the Impact of Emohaa on Reducing Mental Distress in China](https://mlsanity.com/paper/2209.10183/) (2022)
- [Consistent Client Simulation for Motivational Interviewing-based Counseling](https://mlsanity.com/paper/2502.02802/) (2025)
- [Scaffolding Empathy: Training Counselors with Simulated Patients and Utterance-level Performance Visualizations](https://mlsanity.com/paper/2502.18673/) (2025)
- [MAGI: Multi-Agent Guided Interview for Psychiatric Assessment](https://mlsanity.com/paper/2504.18260/) (2025)
- [Can LLM-Simulated Practice and Feedback Upskill Human Counselors? A Randomized Study with 90+ Novice Counselors](https://mlsanity.com/paper/2505.02428/) (2025)
- [CAMI: A Counselor Agent Supporting Motivational Interviewing through State Inference and Topic Exploration](https://mlsanity.com/paper/2502.02807/) (2025)
- [Crisp: Cognitive Restructuring of Negative Thoughts through Multi-turn Supportive Dialogues](https://mlsanity.com/paper/2504.17238/) (2025)
- [PSYCHE: A Multi-faceted Patient Simulation Framework for Evaluation of Psychiatric Assessment Conversational Agents](https://mlsanity.com/paper/2501.01594/) (2025)
- [Psi-Arena: Interactive Assessment and Optimization of LLM-based Psychological Counselors with Tripartite Feedback](https://mlsanity.com/paper/2505.03293/) (2025)
- [Simulating Psychological Risks in Human-AI Interactions: Real-Case Informed Modeling of AI-Induced Addiction, Anorexia, Depression, Homicide, Psychosis, and Suicide](https://mlsanity.com/paper/2511.08880/) (2025)
- [Adaptive-VP: A Framework for LLM-Based Virtual Patients that Adapts to Trainees' Dialogue to Facilitate Nurse Communication Training](https://mlsanity.com/paper/2506.00386/) (2025)
- [Can You Share Your Story? Modeling Clients' Metacognition and Openness for LLM Therapist Evaluation](https://mlsanity.com/paper/2507.19643/) (2025)
- [TalkDep: Clinically Grounded LLM Personas for Conversation-Centric Depression Screening](https://mlsanity.com/paper/2508.04248/) (2025)
- [MAGneT: Coordinated Multi-Agent Generation of Synthetic Multi-Turn Mental Health Counseling Sessions](https://mlsanity.com/paper/2509.04183/) (2025)
- [Trust Modeling in Counseling Conversations: A Benchmark Study](https://mlsanity.com/paper/2501.03064/) (2025)
- [Patient-Zero: Scaling Synthetic Patient Agents to Real-World Distributions without Real Patient Data](https://mlsanity.com/paper/2509.11078/) (2025)
- [Human or LLM as Standardized Patients? A Comparative Study for Medical Education](https://mlsanity.com/paper/2511.14783/) (2025)

## Built on by (most cited first, 4 of 4)

- [Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming](https://mlsanity.com/paper/2602.19948/) (2026)
- [PSI-Bench: Interpretable and Clinically Meaningful Evaluation of Depression Patient Simulators](https://mlsanity.com/paper/2604.25840/) (2026)
- [PatientAct: Theory-Grounded Mental Health Client Simulation](https://mlsanity.com/paper/2608.12750/) (2026)
- [Creating Multilingual Mental Health Dialogue Datasets: Limits of Persona-Based Localization via Nationality and Language](https://mlsanity.com/paper/2606.19640/) (2026)

## Abstract (arXiv)

As Large Language Models increasingly power role-playing applications, simulating patients has become a valuable tool for training counselors and scaling therapeutic assessment. However, prior work remains fragmented: existing approaches rely on incompatible, non-standardized profiles, prompts, and evaluation metrics, hindering reproducibility, fair comparison, and reuse. We introduce PatientHub, a unified and modular framework that standardizes the creation, simulation, and evaluation of LLM-based patients. Our framework provides 16 patient simulators, a graph-based orchestrator for multi-turn, multi-session interactions, and a configurable LLM-as-a-judge evaluator that supports multiple rubric types. Via our command-line interface, users can generate patient profiles, run simulations, and apply rubric-driven evaluation at the turn and session level. To demonstrate PatientHub's utility, we compare several supported simulators under a shared interaction protocol and showcase its extensibility by prototyping a new simulator variant with minimal additional code. By consolidating existing work into a single reproducible pipeline, our framework eliminates much of the infrastructure overhead that currently fragments this research and accelerates the development of new methods. Our code and data are publicly available via https://github.com/Sahandfer/PatientHub.