# Personalized State-Transition-Aware Memory for Clinical Agents

arXiv: https://arxiv.org/abs/2609.38490 · HTML: https://mlsanity.com/paper/2609.38490/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 27 of its 30 references that are in the map.
- First posted on arXiv 29 Sep 2026.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 27 of 27)

- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [Efficient Memory Management for Large Language Model Serving with PagedAttention](https://mlsanity.com/paper/2309.06180/) (2023)
- [Self-RAG: Learning to Retrieve, Generate, and Critique through Self-Reflection](https://mlsanity.com/paper/2310.11511/) (2023)
- [A-MEM: Agentic Memory for LLM Agents](https://mlsanity.com/paper/2502.12110/) (2025)
- [Mem0: Building Production-Ready AI Agents with Scalable Long-Term Memory](https://mlsanity.com/paper/2504.19413/) (2025)
- [C-Pack: Packed Resources For General Chinese Embeddings](https://mlsanity.com/paper/2309.07597/) (2023)
- [Adaptive-RAG: Learning to Adapt Retrieval-Augmented Large Language Models through Question Complexity](https://mlsanity.com/paper/2403.14403/) (2024)
- [Zep: A Temporal Knowledge Graph Architecture for Agent Memory](https://mlsanity.com/paper/2501.13956/) (2025)
- [Memory-R1: Enhancing Large Language Model Agents to Manage and Utilize Memories via Reinforcement Learning](https://mlsanity.com/paper/2508.19828/) (2025)
- [LightMem: Lightweight and Efficient Memory-Augmented Generation](https://mlsanity.com/paper/2510.18866/) (2025)
- [MemOS: A Memory OS for AI System](https://mlsanity.com/paper/2507.03724/) (2025)
- [MemRL: Self-Evolving Agents via Runtime Reinforcement Learning on Episodic Memory](https://mlsanity.com/paper/2601.03192/) (2026)
- [STALE: Can LLM Agents Know When Their Memories Are No Longer Valid?](https://mlsanity.com/paper/2605.06527/) (2026)
- [From Recall to Forgetting: Benchmarking Long-Term Memory for Personalized Agents](https://mlsanity.com/paper/2604.20006/) (2026)
- [TIMER: Temporal Instruction Modeling and Evaluation for Longitudinal Clinical Records](https://mlsanity.com/paper/2503.04176/) (2025)
- [APEX-MEM: Agentic Semi-Structured Memory with Temporal Reasoning for Long-Term Conversational AI](https://mlsanity.com/paper/2604.14362/) (2026)
- [Beyond Dialogue Time: Temporal Semantic Memory for Personalized LLM Agents](https://mlsanity.com/paper/2601.07468/) (2026)
- [Temporal Validity in Retrieval Memory: Eliminating Stale-Fact Errors for AI Agents over Evolving Knowledge](https://mlsanity.com/paper/2606.26511/) (2026)
- [TOKI: A Bitemporal Operator Algebra for Contradiction Resolution in LLM-Agent Persistent Memory](https://mlsanity.com/paper/2606.06240/) (2026)
- [Can Agent Memory Systems Track Evolving State?](https://mlsanity.com/paper/2608.19652/) (2026)
- [LongMedBench: Benchmarking Medical Agents for Long-Horizon Clinical Decision-Making](https://mlsanity.com/paper/2607.09322/) (2026)
- [A-TMA: Decoupling State-Aware Memory Failures in Long-Term Agent Memory](https://mlsanity.com/paper/2607.01935/) (2026)
- [MedLoCoMo: A Long-Context Multi-Session Medical Dialogue Benchmark for Large Language Models](https://mlsanity.com/paper/2607.22566/) (2026)
- [ClinicalBench: Stress-Testing Assertion-Aware Retrieval for Cross-Admission Clinical QA on MIMIC-IV](https://mlsanity.com/paper/2605.11143/) (2026)
- [MedMemoryBench: Benchmarking Agent Memory in Personalized Healthcare](https://mlsanity.com/paper/2605.11814/) (2026)
- [MedCache: Efficient and Temporally Valid Memory for Longitudinal Clinical Agents](https://mlsanity.com/paper/2608.29528/) (2026)
- [ClinTraceBench: Source-Verifiable Longitudinal Clinical Reasoning over EHR-Derived Dialogues](https://mlsanity.com/paper/2609.01111/) (2026)

## Abstract (arXiv)

Large language model (LLM) agents that reason over clinical records must track changes in a patient's state while preserving the history needed to understand them. Simply accumulating memories leaves it unclear which information still applies, whereas overwriting earlier memories can erase evidence needed to reconstruct treatment history and clinical trajectories. We introduce STAM, a state-transition-aware memory framework that records state changes as new clinical entries arrive. STAM combines semantic retrieval with typed clinical relations to identify affected memories, maintaining current information in Active and superseded or resolved information in History. At read time, a query-dependent gate selectively serves historical memory. Across four longitudinal clinical benchmarks, we evaluate STAM with downstream question answering, direct state-maintenance diagnostics, and comparisons at approximately matched context lengths.