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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vitj</journal-id><journal-title-group><journal-title xml:lang="ru">Врач и информационные технологии</journal-title><trans-title-group xml:lang="en"><trans-title>Medical Doctor and Information Technologies</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1811-0193</issn><issn pub-type="epub">2413-5208</issn><publisher><publisher-name>Pirogov National Medical and Surgical Center</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25881/18110193_2025_4_16</article-id><article-id custom-type="elpub" pub-id-type="custom">vitj-271</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Цифровые двойники в медицине: критический анализ применимости промышленной парадигмы</article-title><trans-title-group xml:lang="en"><trans-title>Digital twins in medicine: a critical analysis of the applicability of the industrial paradigm</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гулиев</surname><given-names>Я. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Guliev</surname><given-names>Y. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.т.н.</p><p>г. Переславль-Залесский</p></bio><bio xml:lang="en"><p>PhD</p><p>Pereslavl-Zalessky</p></bio><email xlink:type="simple">yadulla@interin.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гулиева</surname><given-names>И. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Gulieva</surname><given-names>I. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>г. Переславль-Залесский</p></bio><bio xml:lang="en"><p>Pereslavl-Zalessky</p></bio><email xlink:type="simple">irina@interin.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Институт программных систем им. А.К. Айламазяна РАН Российской академии наук<country>Россия</country></aff><aff xml:lang="en">A.K. Ailamazyan Program Systems Institute of the Russian Academy of Sciences<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>23</day><month>12</month><year>2025</year></pub-date><volume>0</volume><issue>4</issue><fpage>16</fpage><lpage>27</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Гулиев Я.И., Гулиева И.Ф., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Гулиев Я.И., Гулиева И.Ф.</copyright-holder><copyright-holder xml:lang="en">Guliev Y.I., Gulieva I.F.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.vit-j.ru/jour/article/view/271">https://www.vit-j.ru/jour/article/view/271</self-uri><abstract><p>Статья рассматривает применимость промышленной парадигмы цифровых двойников (ЦД) в медицине. Анализ ключевых определений (ГОСТ, ISO/IEC 30173, DTC) показывает: зрелый цифровой двойник предполагает двустороннее взаимодействие с физическим объектом, тогда как реальные медицинские приложения являются либо цифровыми моделями, либо ограничиваются односторонним мониторингом — так называемой «цифровой тенью».</p><p>Прямой перенос промышленных подходов оказывается проблематичным в силу фундаментальных различий между техническими системами и живыми организмами. Речь идет о принципиальной невозможности создания полной модели человека из-за сложности и биологической вариабельности, этической неприемлемости автоматического управления физиологией, а также вычислительной сложности и строгих регуляторных требований.</p><p>В статье проанализированы международные и российские проекты, выявлены специфические риски и предложены принципы внедрения. Среди них достаточная точность для конкретной задачи вместо стремления к абсолютной полноте модели, обязательное участие врача в принятии решений, валидация на реальных клинических данных. Сформулирован тезис о том, что медицинские цифровые двойники требуют собственной методологии, и их успех должен измеряться клинической пользой, а не следованием промышленным стандартам.</p></abstract><trans-abstract xml:lang="en"><p>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.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>цифровой двойник</kwd><kwd>цифровая тень</kwd><kwd>персонализированная медицина</kwd><kwd>медицинские данные</kwd><kwd>стандарты DTC</kwd><kwd>стандарты ISO</kwd><kwd>стандарты ГОСТ</kwd><kwd>валидация</kwd><kwd>этика</kwd><kwd>биоконтроль</kwd><kwd>конфиденциальность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>digital twin</kwd><kwd>digital shadow</kwd><kwd>personalized medicine</kwd><kwd>medical data</kwd><kwd>DTC standards</kwd><kwd>ISO standards</kwd><kwd>GOST standards</kwd><kwd>validation</kwd><kwd>ethics</kwd><kwd>biocontrol</kwd><kwd>confidentiality</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Grand View Research. 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