Health & Medicinearticle2026-09-02

Structural requirements for intelligent clinical digital twins in feedback-driven care

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Abstract

Clinical digital twins are increasingly promoted for decision support, yet most are designed and validated for prediction under observed care rather than decision-support validity. We identify four structural requirements for intelligent clinical digital twins used in bidirectional clinical care. Using Alzheimer’s disease and related dementias as an example, we show how routine deployment can induce care-path-dependent epistemic drift despite stable predictive performance.

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View paper (DOI)Open access versionOpenAlexnpj Health SystemsPublished 2026-09-02

Authors: Yanfei Wang, Glenn E. Smith, Gloria P. Lipori, Ramon C. Sun, Elizabeth Shenkman, Mei Liu, Yonghui Wu, Yi Guo

Institutions: University of Florida, University of Florida Health