Advancing Health Care With Digital Twins: Meta-Review of Applications and Implementation Challenges
Bibliographic record
Abstract
BACKGROUND: Digital twins (DTs) are digital representations of real-world systems, enabling advanced simulations, predictive modeling, and real-time optimization in various fields, including health care. Despite growing interest, the integration of DTs in health care faces challenges such as fragmented applications, ethical concerns, and barriers to adoption. OBJECTIVE: This study systematically reviews the existing literature on DT applications in health care with three objectives: (1) to map primary applications, (2) to identify key challenges and limitations, and (3) to highlight gaps that can guide future research. METHODS: A meta-review was conducted in a systematic fashion, adhering to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, and included 25 literature reviews published between 2021 and 2024. The search encompassed 5 databases: PubMed, CINAHL, Web of Science, Embase, and PsycINFO. Thematic synthesis was used to categorize DT applications, stakeholders, and barriers to adoption. RESULTS: A total of 3 primary DT applications in health care were identified: personalized medicine, operational efficiency, and medical research. While current applications, such as predictive diagnostics, patient-specific treatment simulations, and hospital resource optimization, remain in their early stages of development, they highlight the significant potential of DTs. Challenges include data quality, ethical issues, and socioeconomic barriers. This review also identified gaps in scalability, interoperability, and clinical validation. CONCLUSIONS: DTs hold transformative potential in health care, providing individualized care, operational optimization, and accelerated research. However, their adoption is hindered by technical, ethical, and financial barriers. Addressing these issues requires interdisciplinary collaboration, standardized protocols, and inclusive implementation strategies to ensure equitable access and meaningful impact.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.081 | 0.272 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.009 | 0.021 |
| Bibliometrics | 0.019 | 0.020 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.009 | 0.007 |
| Open science | 0.004 | 0.006 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".