EMSDialog: Synthetic Multi-person Emergency Medical Service Dialogue Generation from Electronic Patient Care Reports via Multi-LLM Agents

Conversational artificial intelligence has the potential to assist users in preliminary medical consultations, particularly in settings where access to healthcare professionals is limited. However, many existing medical dialogue systems operate in a single-turn question--answering paradigm or rely on template-based datasets, limiting conversational realism and multilingual applicability. In this work, we introduce MedAidDialog, a multilingual multi-turn medical dialogue dataset designed to simulate realistic physician--patient consultations. The dataset extends the MDDial corpus by generating synthetic consultations using large language models and further expands them into a parallel multilingual corpus covering seven languages: English, Hindi, Telugu, Tamil, Bengali, Marathi, and Arabic. Building on this dataset, we develop MedAidLM, a conversational medical model trained using parameter-efficient fine-tuning on quantized small language models, enabling deployment without high-end computational infrastructure. Our framework additionally incorporates optional patient pre-context information (e.g., age, gender, allergies) to personalize the consultation process. Experimental results demonstrate that the proposed system can effectively perform symptom elicitation through multi-turn dialogue and generate diagnostic recommendations. We further conduct medical expert evaluation to assess the plausibility and coherence of the generated consultations.

Pre-consultation medical dialogues are essential for collecting comprehensive patient information, but are costly to obtain at scale due to privacy and ethical constraints. Existing LLM-based synthesis methods often rely on prompt engineering or rigid rules, limiting their ability to balance clinical relevance with realistic patient diversity. We propose CoRPS-Dial, a controllable dual-agent framework for pre-consultation medical dialogue synthesis that integrates patient personas with guideline-aligned clinical workflow rules. CoRPS-Dial generates dialogues through interactions between a persona-driven patient agent and a process-guided doctor agent, followed by post-hoc quality control for role consistency, workflow completeness, and textual consistency. Experiments on coronary heart disease demonstrate that CoRPS-Dial improves alignment between synthetic and real dialogues in information coverage, clinical compliance, and dialogue naturalness. Downstream fine-tuning experiments further confirm the utility of the generated synthetic data for medical dialogue tasks. These results highlight the effectiveness of CoRPS-Dial for clinically grounded and controllable medical dialogue synthesis.

Real-world clinical diagnosis is a complex process in which the doctor is required to obtain information from both interaction with the patient and conducting medical exams. Additionally, the doctor needs to adapt to different patient personas, as well as noisy and incomplete information that can happen at any time during the process. However, existing benchmarks for medical LLMs and methods for automatic diagnosis largely simplify this process by reducing it to single-turn question answering, noise-free conversations, or sequential exam making, etc., ignoring the interactive and uncertain nature of clinical diagnosis. In this paper, we aim to address this gap by formalizing clinical diagnosis as a Partially Observable Markov Decision Process (POMDP) with three action types: questioning the patient, ordering medical exams as tool calls, and issuing a diagnosis. We also introduce a systematic noise model comprising seven patient noise types and three exam noise types. Using our proposed environment, we train an effective diagnosis agent, MedExAgent, through a two-stage pipeline that first performs supervised finetuning on synthetic conversations structured after the Calgary-Cambridge model for clinical interviews, and then applies DAPO to optimize a composite reward capturing diagnostic accuracy, tool call quality, and exam cost including financial cost and patient discomfort. Through extensive experiments and ablation studies, we demonstrate that MedExAgent achieves diagnostic performance comparable to larger models while maintaining cost-efficient examination strategies.