SIMAX: A Scalable and Interpretable Framework for Multi-Fidelity and Annotated Clinician-Patient Dialogue Simulation

Background. The widespread deployment of ambient digital scribes is driving large-scale capture of clinician-patient dialogues. Human coding of clinical communication data remains costly, inconsistent, and difficult to scale, motivating AI-driven communication coding systems. However, evaluating these systems requires real-world dialogues and human-coded labels, both hard to obtain at scale. Methods. We developed SIMAX (Scalable and Interpretable Framework for Multi-Fidelity and Annotated Clinician-Patient Dialogue Simulation), a framework for generating controlled clinical dialogue data wit