An Infectious Disease Spread Simulation Based on Large Language Model Decision Making

Modelling individual decision-making during infectious disease outbreaks is crucial for understanding behavioural dynamics and informing effective public health interventions. Prior work has shown that large language models can simulate realistic human behaviour by generating agent decisions based on demographic prompts and situational context. We build on this foundation with a spatially grounded, agent-based simulation framework that integrates LLM-generated decisions about self-reported influenza-like illness into a census-based synthetic population of agents. Location is treated as a central feature: agents are assigned to spatial units within cities, capturing the spatial distributions of different demographic groups using real-world census data and enabling geographically diverse behavioural modelling. We implement and compare three decision scenarios, independent reasoning, household influence, and message framing, and simulate self-reporting outcomes in San Francisco and Atlanta. Results reveal that income and education are the dominant drivers of reporting rate variation, with smaller but consistent effects from geography, LLM model choice, and message framing. Our framework generates synthetic data that captures both social and geographic heterogeneity, supporting spatial epidemiological modelling and bias-aware behavioural analysis.

Evaluating the Bias in LLMs for Surveying Opinion and Decision Making in Healthcare

Generative agents have been increasingly used to simulate human behaviour in silico, driven by large language models (LLMs). These simulacra serve as sandboxes for studying human behaviour without compromising privacy or safety. However, it remains unclear whether such agents can truly represent real individuals. This work compares survey data from the Understanding America Study (UAS) on healthcare decision-making with simulated responses from generative agents. Using demographic-based prompt engineering, we create digital twins of survey respondents and analyse how well different LLMs reproduce real-world behaviours. Our findings show that some LLMs fail to reflect realistic decision-making, such as predicting universal vaccine acceptance. However, Llama 3 captures variations across race and Income more accurately but also introduces biases not present in the UAS data. This study highlights the potential of generative agents for behavioural research while underscoring the risks of bias from both LLMs and prompting strategies.