Imagine going to the doctor with a virtual version of yourself. The doctor listens to you, enters the data into his computer and already knows exactly your prognosis: this “digital twin” the screen tells you How will your problem evolve?. He will also dictate a treatment specially designed for you.
“Today, [esto] “It’s more science than fiction,” he explains to EL ESPAÑOL. Miguel Quintelaresearcher at the National Cancer Research Center (CNIO).
Doctors are looking to create an avatar for you, not to save a city threatened by deforestation like in the famous James Cameron movie. What they are looking for is “experiment” to find out what works best for you if you have a health problem. It is not the present, but it is not the very distant future either.
Quintela is one of the promoters of a CNIO project on “digital twins” patients with breast, lung and colon cancer in metastatic stages. About a hundred have been recruited and the idea is to recover all possible data to reconstruct an avatar (i.e. a virtual image) of each of them.
“We follow them all the way, we do a very deep longitudinal sampling and, in addition, they have a mobile application where they can enter their events, their emotions, etc. as well as a clock portable devices to monitor their physical parameters.”
He estimates that within two or three years they will be able to do This avatar “speaks” and tells you what your risk is of getting worse, of suffering from a secondary diseasewhy a medicine works better or worse for you than someone else in the same situation or how your cancer will progress in the months to come.
The next step will be experimentation. Millions of simulations will test different strategies: vary the level of gene expression, modify the intestinal microbiota, follow one diet or another, vary physical exercise routines… to choose what best suits the patient.
The oncologist believes that in two or three years The first will be possible to achieve. The second will take a little longer, “but not as long as when a possible therapeutic target is announced that has worked in mice and could take decades to reach clinical practice.”
From engineering to biomedicine
In fact, it may be closer than we think. The term “digital (or virtual) twin” has been around for decades, and applies to relatively simpler systems: an engine, a reservoir dam, etc.
Recreating the real object allowed the engineers carry out simulations on what would happen if certain elements were modified or if the conditions of their use varied.
Of course, a human being is much more complex than a machine and, moreover, not all the parameters that influence health are known (or measurable).
This is why it is only recently that this concept has begun to be applied in biomedicineThe ability to collect and process data has grown rapidly in recent years.
There was only one tool left that could interpret them. “A human mind cannot handle the expression of 20,000 genes or the 3,000 strains of bacteria in our gut,” Quintela illustrates.
But artificial intelligence. The rise of tools machine learning It now allows predictions to be made from a massive amount of data.
And, as with AI, the definitive leap could happen overnight.”Nobody knew something like ChatGPT existed until two weeks before it was released.So it is possible that times are speeding up.”
If we talk about managing large amounts of data, there is a place in Spain where they specialize in this area. At the Barcelona Supercomputing Center they also carry out human digital twin projects, complementing the CNIO vision.
“It’s not a complete human, with its genome, its organs, etc.,” he explains. Alfonso Valenciadirector of the institution’s life sciences department and coordinator of one of these projects.
“We’re talking about multi-level approaches, such as creating a virtual twin of a person’s metabolism.”
One of the pioneering approaches is that of recreate the patient’s heart to prepare for an arrhythmia operation, or a tumor to predict the consequences of their specific mutations and possible treatments.
The twin in your consultation
At the BSC, they developed lung models to study inhalers that reach the last alveolior of a spine to design intervertebral discs which is most suitable for the patient.
“We start with something very general, to develop the technology,” Valencia explains, “and then we start to personalize it. For example, creating a library of heart models and seeing where each person is.”
Valencia and Quintela believe that in the future it will be possible to create digital files with our twins ready to be consulted and experienced, a true digital twin with all the available (and relevant) information about your health in real time.
However, there are issues that will need to be addressed in the future. “There are issues of fairness and security, because the data has to be hosted somewhere and is always subject to breaches,” Valencia says.
Quintela offers another point of view. “The level of data completion will not be the same in all patients: The one who goes to the doctor more will offer more information“.
Of course: the more information, the more expensive our digital twin will be. That’s why the oncologist believes there will be a rationalization process to determine which data is really important and which is not.
“A reasonable aspiration is to think that understanding 85% of patient variability may be enough. There may be models that achieve 90%, but they will be more expensive. If we can understand, for example, 80% of the factors explaining variability, we will be able to treat more patients appropriately.“.
In other words, a “simpler” model, which, instead of thousands of parameters, manages hundreds, could be closer to daily clinical practice, more practical.” Perhaps it is not necessary to have an avatar like the one in James Cameron’s film; a better one like the one we use to play Animal Crossing.
