Our article, just published in PNAS Nexus, presents the outcomes of the inaugural roundtable on in silico trials and digital twins in medicine. Held during the 2024 Virtual Imaging Trials in Medicine (VITM) conference at Duke University, the roundtable brought together leading experts to discuss the future of these emerging technologies. We asked Dr. Ehsan Samei, Director of the Center for Virtual Imaging Trials, to highlight key insights and recommendations from the event.
How do digital twins and in silico trials work?
“Digital twins are dynamic, virtual representations of individual patients,” Dr. Samei explained. “They integrate multidimensional, patient-specific data to mirror both the structure and function of real human beings.” In silico trials use these digital twins to simulate and predict responses to medical interventions. Rather than relying solely on traditional clinical trials, researchers and clinicians can now explore treatments in a virtual environment, enabling faster, safer, and more cost-effective medical innovation.
What is the ‘moonshot’ vision?
The roundtable defined a moonshot vision, namely a common goal for the role of in silico and digital twins technology in medicine to identify gaps and prioritize area for development. Dr. Samei envisioned an ambitious future: “The moonshot is to create and maintain a digital twin for every individual. These twins would be part of personal medical records, continuously updated, and used to optimize care for the individual and to evaluate new medical technologies.” This novel approach would not only benefit individual patients but could also enhance public health, improve access to innovation, and help regulators and industry accelerate the path from development to deployment.
Which challenges stand in the way?
While the vision is compelling, realizing it requires overcoming scientific, ethical, economic, and regulatory barriers. “We need better models that represent diverse anatomies and disease patterns,” Dr. Samei said. “We must also protect patient data, ensure people retain ownership of their digital twins, and develop sustainable funding models.” Additionally, the regulatory landscape must adapt to evaluate and validate these new technologies. “A unified approach involving scientists, policymakers, industry, and patients is essential,” he emphasized.
What is next and how can others get involved?
“We’re advocating for increased funding, building interdisciplinary teams, setting standards for interoperability, and launching educational programs,” said Dr. Samei. “And just as importantly, we’re involving patients and the public to ensure these technologies are trusted and truly beneficial.” Digital twins and in silico trials are no longer futuristic concepts, they are becoming part of modern medicine. With the right support and collaboration, they can transform healthcare for generations to come.
A follow-up roundtable will take place at VITM 2025 in Manchester, where we will continue these discussions and explore new developments in the field. For more information about the Virtual Imaging Trials in Medicine, visit the VITM25 website.
