1
|
Zhang K, Zhou HY, Baptista-Hon DT, Gao Y, Liu X, Oermann E, Xu S, Jin S, Zhang J, Sun Z, Yin Y, Razmi RM, Loupy A, Beck S, Qu J, Wu J. Concepts and applications of digital twins in healthcare and medicine. PATTERNS (NEW YORK, N.Y.) 2024; 5:101028. [PMID: 39233690 PMCID: PMC11368703 DOI: 10.1016/j.patter.2024.101028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
The digital twin (DT) is a concept widely used in industry to create digital replicas of physical objects or systems. The dynamic, bi-directional link between the physical entity and its digital counterpart enables a real-time update of the digital entity. It can predict perturbations related to the physical object's function. The obvious applications of DTs in healthcare and medicine are extremely attractive prospects that have the potential to revolutionize patient diagnosis and treatment. However, challenges including technical obstacles, biological heterogeneity, and ethical considerations make it difficult to achieve the desired goal. Advances in multi-modal deep learning methods, embodied AI agents, and the metaverse may mitigate some difficulties. Here, we discuss the basic concepts underlying DTs, the requirements for implementing DTs in medicine, and their current and potential healthcare uses. We also provide our perspective on five hallmarks for a healthcare DT system to advance research in this field.
Collapse
Affiliation(s)
- Kang Zhang
- National Clinical Eye Research Center, Eye Hospital, Wenzhou Medical University, Wenzhou 325000, China
- Institute for Clinical Data Science, Wenzhou Medical University, Wenzhou 325000, China
- Institute for AI in Medicine and Faculty of Medicine, Macau University of Science and Technology, Macau 999078, China
- Institute for Advanced Study on Eye Health and Diseases, Wenzhou Medical University, Wenzhou 325000, China
| | - Hong-Yu Zhou
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02138, USA
| | - Daniel T. Baptista-Hon
- Institute for AI in Medicine and Faculty of Medicine, Macau University of Science and Technology, Macau 999078, China
- School of Medicine, University of Dundee, DD1 9SY Dundee, UK
| | - Yuanxu Gao
- Department of Big Data and Biomedical AI, College of Future Technology, Peking University, Beijing 100000, China
| | - Xiaohong Liu
- Cancer Institute, University College London, WC1E 6BT London, UK
| | - Eric Oermann
- NYU Langone Medical Center, New York University, New York, NY 10016, USA
| | - Sheng Xu
- Department of Chemical Engineering and Nanoengineering, University of California San Diego, San Diego, CA 92093, USA
| | - Shengwei Jin
- Institute for Clinical Data Science, Wenzhou Medical University, Wenzhou 325000, China
- Department of Anesthesia and Critical Care, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325000, China
| | - Jian Zhang
- National Clinical Eye Research Center, Eye Hospital, Wenzhou Medical University, Wenzhou 325000, China
- Department of Anesthesia and Critical Care, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325000, China
| | - Zhuo Sun
- Institute for Advanced Study on Eye Health and Diseases, Wenzhou Medical University, Wenzhou 325000, China
| | - Yun Yin
- Faculty of Business and Health Science Institute, City University of Macau, Macau 999078, China
| | | | - Alexandre Loupy
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, 75015 Paris, France
| | - Stephan Beck
- Cancer Institute, University College London, WC1E 6BT London, UK
| | - Jia Qu
- National Clinical Eye Research Center, Eye Hospital, Wenzhou Medical University, Wenzhou 325000, China
- Institute for Clinical Data Science, Wenzhou Medical University, Wenzhou 325000, China
| | - Joseph Wu
- Cardiovascular Research Institute, Stanford University, Standford, CA 94305, USA
| | - International Consortium of Digital Twins in Medicine
- National Clinical Eye Research Center, Eye Hospital, Wenzhou Medical University, Wenzhou 325000, China
- Institute for Clinical Data Science, Wenzhou Medical University, Wenzhou 325000, China
- Institute for AI in Medicine and Faculty of Medicine, Macau University of Science and Technology, Macau 999078, China
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02138, USA
- Department of Big Data and Biomedical AI, College of Future Technology, Peking University, Beijing 100000, China
- Cancer Institute, University College London, WC1E 6BT London, UK
- NYU Langone Medical Center, New York University, New York, NY 10016, USA
- Department of Chemical Engineering and Nanoengineering, University of California San Diego, San Diego, CA 92093, USA
- Department of Anesthesia and Critical Care, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325000, China
- Institute for Advanced Study on Eye Health and Diseases, Wenzhou Medical University, Wenzhou 325000, China
- Faculty of Business and Health Science Institute, City University of Macau, Macau 999078, China
- Zoi Capital, New York, NY 10013, USA
- Université Paris Cité, INSERM U970 PARCC, Paris Institute for Transplantation and Organ Regeneration, 75015 Paris, France
- Cardiovascular Research Institute, Stanford University, Standford, CA 94305, USA
- School of Medicine, University of Dundee, DD1 9SY Dundee, UK
| |
Collapse
|
3
|
Li J, Xiang Y, Han J, Gao Y, Wang R, Dong Z, Chen H, Gao R, Liu C, Teng GJ, Qi X. Retinopathy as a predictive indicator for significant hepatic fibrosis according to T2DM status: A cross-sectional study based on the national health and nutrition examination survey data. Ann Hepatol 2024; 29:101478. [PMID: 38354949 DOI: 10.1016/j.aohep.2024.101478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 01/26/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION AND OBJECTIVES Type 2 Diabetes Mellitus (T2DM), a prevalent metabolic disorder, often coexists with a range of complications, with retinopathy being particularly common. Recent studies have shed light on a potential connection between diabetic retinopathy (DR) and hepatic fibrosis, indicating a possible shared pathophysiological foundation in T2DM. This study investigates the correlation between retinopathy and hepatic fibrosis among individuals with T2DM, as well as evaluates the diagnostic value of DR for significant hepatic fibrosis. MATERIALS AND METHODS Our cross-sectional analysis incorporated 5413 participants from the National Health and Nutrition Examination Survey (NHANES) 2005-2008. The Fibrosis-4 score (FIB-4) classified hepatic fibrosis into different grades (F0-F4), with significant hepatic fibrosis marked as F2 or higher. Retinopathy severity was determined using retinal imaging and categorized into four levels. The analysis of variance or Chi-square tests facilitated group comparisons. Additionally, the receiver operating characteristic (ROC) analysis appraised the predictive accuracy of retinopathy for significant hepatic fibrosis in the T2DM population. RESULTS Among 5413 participants, the mean age was 59.56 ± 12.41, with 50.2% male. And 20.6% were diagnosed with T2DM. Hepatic fibrosis grading was positively associated with retinopathy severity (OR [odds ratio]: 1.521, 95%CI [confidence interval]: 1.152-2.008, P = 0.003) across the entire population. The association was amplified in the T2DM population according to Pearson's analysis results. The ROC curve demonstrated retinopathy's diagnostic capacity for significant hepatic fibrosis in the T2DM population (AUC [area under curve] = 0.72, 95%CI: 0.651-0.793, P < 0.001). CONCLUSIONS Retinopathy could serve as an independent predictor of significant hepatic fibrosis in T2DM population. Ophthalmologists are advised to closely monitor T2DM patients with retinopathy.
Collapse
Affiliation(s)
- Jinze Li
- Institute for AI in Medicine, School of Artificial Intelligence, Nanjing University of Information Science and Technology, Nanjing 210044, Jiangsu Province, China
| | - Yi Xiang
- Department of Oncology, The First Affiliated Hospital, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China; Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China
| | - Jiahao Han
- Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China
| | - Youfang Gao
- Department of Infectious Disease, The People's Hospital of Bozhou, Bozhou 236800, Anhui Province, China
| | - Ruiying Wang
- Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Zihe Dong
- Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China; The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Huihui Chen
- Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China; Department of Ultrasound, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Ruixia Gao
- Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China; Medical School, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Chuan Liu
- Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China
| | - Gao-Jun Teng
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Xiaolong Qi
- Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing 210044, Jiangsu Province, China; Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China; State Key Laboratory of Digital Medical Engineering, Nanjing 210044, Jiangsu Province, China.
| |
Collapse
|
4
|
Orfanidou M, Ntenti C, Evripidou K, Mataftsi A, Goulas A, Polyzos SA. Retinal Vascular Lesions in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. J Pers Med 2023; 13:1148. [PMID: 37511760 PMCID: PMC10381395 DOI: 10.3390/jpm13071148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/30/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Background: This systematic review and meta-analysis aimed to summarize and compare data on retinal vascular lesions between patients with nonalcoholic fatty liver disease (NAFLD) and individuals without the disease. Methods: Search was performed in PubMed, Scopus and Cochrane Library, complemented by handsearching (PROSPERO ID: CRD42022345558). Thirty-six studies comprising 24,985 individuals (12,387 NAFLD patients and 12,598 controls) were selected for the meta-analysis. Results: Apart from retinopathy, no study with a different type of retinal vascular lesion was retrieved. Overall, there was no significant difference in the presence of retinopathy in NAFLD patients compared to controls (Odds Ratio (OR) = 1.20; 95% Confidence Interval (CI): 0.91-1.59). Heterogeneity among studies was high (I2 = 93%; p < 0.00001), while Egger's test revealed no publication bias (p = 0.60). However, subgroup analysis showed positive association between retinopathy and NAFLD in type 1 diabetes mellitus (T1DM) (OR = 2.35; 95% CI: 1.53-3.60), but not in type 2 diabetes mellitus patients. Meta-regression analysis exploring potential confounders revealed no significant association. Conclusions: The presence of retinopathy was not overall different between individuals with and without NAFLD; however, T1DM patients with NAFLD had higher rates of retinopathy compared to T1DM patients without NAFLD, a finding warranting further research to show whether NAFLD may predict retinopathy in T1DM patients.
Collapse
Affiliation(s)
- Myrsini Orfanidou
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Charikleia Ntenti
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Kleo Evripidou
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Asimina Mataftsi
- Second Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Antonis Goulas
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| |
Collapse
|