Digital twins in medicine: a critical analysis of the applicability of the industrial paradigm

Abstract

The article examines the applicability of the industrial digital twin (DT) paradigm in medicine. An analysis of key definitions (GOST, ISO/IEC 30173, DTC) reveals that a mature digital twin implies bidirectional interaction with a physical object, whereas real-world medical applications are either digital models or are limited to one-way monitoring—the socalled "digital shadow."Direct transfer of industrial approaches proves problematic due to fundamental differences between technical systems and living organisms. This concerns the inherent impossibility of creating a complete model of a human being due to complexity and biological variability, the ethical unacceptability of automatic physiological control, as well as computational complexity and strict regulatory requirements.The article analyzes international and Russian projects, identifies specific risks, and proposes implementation principles. These include sufficient accuracy for a specific task rather than striving for absolute model completeness, mandatory physician participation in decision-making, and validation on real clinical data. It also argues that medical digital twins require their own methodology, and their success should be measured by clinical benefit rather than adherence to industrial standards.

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