arXiv:2608.29528cs.LGcs.DC2026-08

构建可随时间演化的患者记忆,提升长期临床推理效率与准确率

MedCache: Efficient and Temporally Valid Memory for Longitudinal Clinical Agents

论文配图:MedCache: Efficient and Temporally Valid Memory for Longitudinal Clinical Agents
图 1 · 摘自论文原文
  • 设计分时序有效记忆,按专科重叠组织医疗证据
  • 在多轮诊疗数据上实现更高推理准确率与内存效率
  • 适合需要跨时间、跨专科协作的临床智能系统

纵向临床智能体需整合来自不同就诊记录、时间点和专科的患者信息。然而,如何设计此类场景下的记忆机制仍不明确。本文提出一个包含多就诊、多专科的患者记录基准,用于评估长上下文证据检索、跨时间证据聚合及跨专科临床推理能力。基于该基准,系统研究了四种记忆设计选择:筛选、组织、检索与记忆增强推理。发现时间有效性比单纯保留历史更重要;专科分解式记忆虽减少上下文但可能隐藏共性证据;多智能体协作在需联合推理时才真正有益,而非仅因证据来源多样。据此提出MedCache,一种混合框架:构建时序有效的患者记忆,将证据组织为重叠的专科视图,根据查询路由至相关记忆,并自适应调用单个或多个专科专家。实验表明,MedCache在多项指标上优于强基线,且对不同模型架构和外部数据集具有泛化能力。

原文摘要 · Abstract (English)

Longitudinal clinical agents must maintain an evolving patient state from evidence distributed across visits, time points, and specialties. However, how agent memory should be designed for this setting remains unclear. We introduce a benchmark of multi-visit, multi-specialty patient records that evaluates long-context evidence retrieval, cross-time evidence aggregation, and cross-specialty clinical reasoning. Using this benchmark, we systematically study four memory design choices: curation, organization, retrieval, and memory-augmented reasoning. We find that temporal validity is more important than simply retaining more history; specialty-factorized memory reduces context but can hide shared evidence; and multiple agents help when specialists must reason together, not merely when evidence comes from multiple memories. Guided by these findings, we propose \textit{MedCache}, a hybrid framework that constructs temporally valid patient memory, organizes evidence into overlapping specialty views, routes each query to relevant memories, and adaptively invokes one or multiple specialists. Experiments show that MedCache improves reasoning accuracy and memory efficiency over strong single-agent and multi-agent baselines, while generalizing across model backbones and external datasets.

临床智能记忆机制多专科时序建模

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