Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review

BackgroundThe concept of digital twins, widely adopted in industry, is entering health care. However, there is a lack of consensus on what constitutes the digital twin of a patient. ObjectiveThe objective of this scoping review was to analyze definitions and chara...

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Main Authors: David Drummond, Apolline Gonsard
Format: Article
Language:English
Published: JMIR Publications 2024-11-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2024/1/e58504
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author David Drummond
Apolline Gonsard
author_facet David Drummond
Apolline Gonsard
author_sort David Drummond
collection DOAJ
description BackgroundThe concept of digital twins, widely adopted in industry, is entering health care. However, there is a lack of consensus on what constitutes the digital twin of a patient. ObjectiveThe objective of this scoping review was to analyze definitions and characteristics of patient digital twins being developed for clinical use, as reported in the scientific literature. MethodsWe searched PubMed, Scopus, Embase, IEEE, and Google Scholar for studies claiming digital twin development or evaluation until August 2023. Data on definitions, characteristics, and development phase were extracted. Unsupervised classification of claimed digital twins was performed. ResultsWe identified 86 papers representing 80 unique claimed digital twins, with 98% (78/80) in preclinical phases. Among the 55 papers defining “digital twin,” 76% (42/55) described a digital replica, 42% (23/55) mentioned real-time updates, 24% (13/55) emphasized patient specificity, and 15% (8/55) included 2-way communication. Among claimed digital twins, 60% (48/80) represented specific organs (primarily heart: 15/48, 31%; bones or joints: 10/48, 21%; lung: 6/48, 12%; and arteries: 5/48, 10%); 14% (11/80) embodied biological systems such as the immune system; and 26% (21/80) corresponded to other products (prediction models, etc). The patient data used to develop and run the claimed digital twins encompassed medical imaging examinations (35/80, 44% of publications), clinical notes (15/80, 19% of publications), laboratory test results (13/80, 16% of publications), wearable device data (12/80, 15% of publications), and other modalities (32/80, 40% of publications). Regarding data flow between patients and their virtual counterparts, 16% (13/80) claimed that digital twins involved no flow from patient to digital twin, 73% (58/80) used 1-way flow from patient to digital twin, and 11% (9/80) enabled 2-way data flow between patient and digital twin. Based on these characteristics, unsupervised classification revealed 3 clusters: simulation patient digital twins in 54% (43/80) of publications, monitoring patient digital twins in 28% (22/80) of publications, and research-oriented models unlinked to specific patients in 19% (15/80) of publications. Simulation patient digital twins used computational modeling for personalized predictions and therapy evaluations, mostly for one-time assessments, and monitoring digital twins harnessed aggregated patient data for continuous risk or outcome forecasting and care optimization. ConclusionsWe propose defining a patient digital twin as “a viewable digital replica of a patient, organ, or biological system that contains multidimensional, patient-specific information and informs decisions” and to distinguish simulation and monitoring digital twins. These proposed definitions and subtypes offer a framework to guide research into realizing the potential of these personalized, integrative technologies to advance clinical care.
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spelling doaj-art-d590bf9d9e054ac5a31e5f477806fbcc2025-08-20T02:14:45ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-11-0126e5850410.2196/58504Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping ReviewDavid Drummondhttps://orcid.org/0000-0002-7324-4992Apolline Gonsardhttps://orcid.org/0009-0002-1943-6237 BackgroundThe concept of digital twins, widely adopted in industry, is entering health care. However, there is a lack of consensus on what constitutes the digital twin of a patient. ObjectiveThe objective of this scoping review was to analyze definitions and characteristics of patient digital twins being developed for clinical use, as reported in the scientific literature. MethodsWe searched PubMed, Scopus, Embase, IEEE, and Google Scholar for studies claiming digital twin development or evaluation until August 2023. Data on definitions, characteristics, and development phase were extracted. Unsupervised classification of claimed digital twins was performed. ResultsWe identified 86 papers representing 80 unique claimed digital twins, with 98% (78/80) in preclinical phases. Among the 55 papers defining “digital twin,” 76% (42/55) described a digital replica, 42% (23/55) mentioned real-time updates, 24% (13/55) emphasized patient specificity, and 15% (8/55) included 2-way communication. Among claimed digital twins, 60% (48/80) represented specific organs (primarily heart: 15/48, 31%; bones or joints: 10/48, 21%; lung: 6/48, 12%; and arteries: 5/48, 10%); 14% (11/80) embodied biological systems such as the immune system; and 26% (21/80) corresponded to other products (prediction models, etc). The patient data used to develop and run the claimed digital twins encompassed medical imaging examinations (35/80, 44% of publications), clinical notes (15/80, 19% of publications), laboratory test results (13/80, 16% of publications), wearable device data (12/80, 15% of publications), and other modalities (32/80, 40% of publications). Regarding data flow between patients and their virtual counterparts, 16% (13/80) claimed that digital twins involved no flow from patient to digital twin, 73% (58/80) used 1-way flow from patient to digital twin, and 11% (9/80) enabled 2-way data flow between patient and digital twin. Based on these characteristics, unsupervised classification revealed 3 clusters: simulation patient digital twins in 54% (43/80) of publications, monitoring patient digital twins in 28% (22/80) of publications, and research-oriented models unlinked to specific patients in 19% (15/80) of publications. Simulation patient digital twins used computational modeling for personalized predictions and therapy evaluations, mostly for one-time assessments, and monitoring digital twins harnessed aggregated patient data for continuous risk or outcome forecasting and care optimization. ConclusionsWe propose defining a patient digital twin as “a viewable digital replica of a patient, organ, or biological system that contains multidimensional, patient-specific information and informs decisions” and to distinguish simulation and monitoring digital twins. These proposed definitions and subtypes offer a framework to guide research into realizing the potential of these personalized, integrative technologies to advance clinical care.https://www.jmir.org/2024/1/e58504
spellingShingle David Drummond
Apolline Gonsard
Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review
Journal of Medical Internet Research
title Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review
title_full Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review
title_fullStr Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review
title_full_unstemmed Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review
title_short Definitions and Characteristics of Patient Digital Twins Being Developed for Clinical Use: Scoping Review
title_sort definitions and characteristics of patient digital twins being developed for clinical use scoping review
url https://www.jmir.org/2024/1/e58504
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