Digital twins, synthetic patient data, and in-silico trials: can they empower paediatric clinical trials?

Summary: Randomised controlled trials are the gold standard to assess the effectiveness and safety of clinical interventions; however, many paediatric trials are discontinued early due to challenges in patient enrolment. Hence, most paediatric clinical trials suffer from lack of adequate power. Addi...

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Main Authors: ProfMD Mohan Pammi, Prakesh S Shah, MD, Liu K Yang, PhD, Joseph Hagan, ScD, Nima Aghaeepour, PhD, ProfMD Josef Neu, PhD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:The Lancet: Digital Health
Online Access:http://www.sciencedirect.com/science/article/pii/S258975002500007X
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author ProfMD Mohan Pammi
Prakesh S Shah, MD
Liu K Yang, PhD
Joseph Hagan, ScD
Nima Aghaeepour, PhD
ProfMD Josef Neu, PhD
author_facet ProfMD Mohan Pammi
Prakesh S Shah, MD
Liu K Yang, PhD
Joseph Hagan, ScD
Nima Aghaeepour, PhD
ProfMD Josef Neu, PhD
author_sort ProfMD Mohan Pammi
collection DOAJ
description Summary: Randomised controlled trials are the gold standard to assess the effectiveness and safety of clinical interventions; however, many paediatric trials are discontinued early due to challenges in patient enrolment. Hence, most paediatric clinical trials suffer from lack of adequate power. Additionally, trials are expensive and might expose patients to unproven therapies. Alternatives to overcome these issues using virtual patient data—namely, digital twins, synthetic patient data, and in-silico trials—are now possible due to rapid advances in digital health-care tools and interventions. However, such digital innovations have been rarely used in paediatric trials. In this Viewpoint, we propose using virtual patient data to empower paediatric trials. The use of virtual patient data has the advantages of decreased exposure of children to potentially ineffective or risky interventions, shorter trial durations leading to more rapid ascertainment of safety and effectiveness of interventions, and faster drug approvals. Use of virtual patient data could lead to more personalised treatment options with low costs and could result in faster clinical implementation of interventions in children. However, ethical and regulatory concerns, including replacing humans with digital data, data privacy, and security should be addressed and the safety and sustainability of digital data innovation ensured before virtual patient data are adopted widely.
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series The Lancet: Digital Health
spelling doaj-art-d7a26bdc1572460dbd3903d3cc33925e2025-08-20T02:37:42ZengElsevierThe Lancet: Digital Health2589-75002025-05-017510085110.1016/j.landig.2025.01.007Digital twins, synthetic patient data, and in-silico trials: can they empower paediatric clinical trials?ProfMD Mohan Pammi0Prakesh S Shah, MD1Liu K Yang, PhD2Joseph Hagan, ScD3Nima Aghaeepour, PhD4ProfMD Josef Neu, PhD5Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA; Correspondence to: Prof Mohan Pammi, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USADepartment of Paediatrics, Mount Sinai Hospital, University of Toronto, Toronto, ON, CanadaStanford University School of Medicine, San Francisco, CA, USADepartment of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USAStanford University School of Medicine, San Francisco, CA, USAUniversity of Florida, Gainesville, FL, USASummary: Randomised controlled trials are the gold standard to assess the effectiveness and safety of clinical interventions; however, many paediatric trials are discontinued early due to challenges in patient enrolment. Hence, most paediatric clinical trials suffer from lack of adequate power. Additionally, trials are expensive and might expose patients to unproven therapies. Alternatives to overcome these issues using virtual patient data—namely, digital twins, synthetic patient data, and in-silico trials—are now possible due to rapid advances in digital health-care tools and interventions. However, such digital innovations have been rarely used in paediatric trials. In this Viewpoint, we propose using virtual patient data to empower paediatric trials. The use of virtual patient data has the advantages of decreased exposure of children to potentially ineffective or risky interventions, shorter trial durations leading to more rapid ascertainment of safety and effectiveness of interventions, and faster drug approvals. Use of virtual patient data could lead to more personalised treatment options with low costs and could result in faster clinical implementation of interventions in children. However, ethical and regulatory concerns, including replacing humans with digital data, data privacy, and security should be addressed and the safety and sustainability of digital data innovation ensured before virtual patient data are adopted widely.http://www.sciencedirect.com/science/article/pii/S258975002500007X
spellingShingle ProfMD Mohan Pammi
Prakesh S Shah, MD
Liu K Yang, PhD
Joseph Hagan, ScD
Nima Aghaeepour, PhD
ProfMD Josef Neu, PhD
Digital twins, synthetic patient data, and in-silico trials: can they empower paediatric clinical trials?
The Lancet: Digital Health
title Digital twins, synthetic patient data, and in-silico trials: can they empower paediatric clinical trials?
title_full Digital twins, synthetic patient data, and in-silico trials: can they empower paediatric clinical trials?
title_fullStr Digital twins, synthetic patient data, and in-silico trials: can they empower paediatric clinical trials?
title_full_unstemmed Digital twins, synthetic patient data, and in-silico trials: can they empower paediatric clinical trials?
title_short Digital twins, synthetic patient data, and in-silico trials: can they empower paediatric clinical trials?
title_sort digital twins synthetic patient data and in silico trials can they empower paediatric clinical trials
url http://www.sciencedirect.com/science/article/pii/S258975002500007X
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