What if you could be 'diagnosed' with an illness years before it happens - and early enough to prevent it? Or participate in a clinical drug trial without physically taking part?

It sounds like science fiction, but some believe that computer-generated "digital twins" will be the future of personalised medicine, enabling clinicians to forecast our future health like the weather and test drugs on virtual versions of human patients first.

The possibilities will be set out later today at the Edinburgh Science Festival as Roger Highfield and Peter Coveney - the authors of 'Virtual You' - discuss how the technology is already shaping research.

Dr Highfield, director of the Science Museum Group, said: "A lot of biologists and medics think it is far too complicated to simulate what is happening in the body.

"But we already have very sophisticated digital simulations of the human heart now that are beginning to be used to screen drugs to see if they cause arrhythmias.

"There was a team in Oxford that's shown that human heart simulations give you more accurate results than animal tests in looking at heart drugs.

"The data is accepted by [US regulators] the FDA.

"In France, there's a trial - it's being used in hospitals now - which uses a sort of simplified 'digital twin' of the patient's brain in severe epilepsy cases so that the surgeons can make sure that, by removing the part of the brain where epileptic seizures start, they're not going to cause wider damage.

"The key thing is that medicine tends to be 'one-size-fits-all' at the moment, but once you start building a mathematical model - for example of a patient's heart - you can use it to predict how their heart will behave, and not just your average heart."

The Herald: Professor Peter Coveney and Dr Roger HighfieldProfessor Peter Coveney and Dr Roger Highfield (Image: X)

Work to create a digital heart dates back to the 1960s, but has become increasingly sophisticated as computer technology has advanced.

Today billions of equations and data from scans can be fed in to create a customised digital replica of any individual's heart, mimicking the electrical activity, muscle contractions, and blood flow.

A beating digital twin heart - of Dr Jazmín Aguado Sierra, an engineer based at Barcelona's Supercomputing Centre - went on display at London's Science Museum last year, in a world first.


Dr Highfield concedes that a full digital twin of a person "is probably decades away", but this is the long-term objective: to build a digital human avatar from the molecular to the organ level, complete with in-built genetics and artificial intelligence programmes able to feed back real-time risk data (what they are eating and drinking, activity levels, UV exposure) from the patient to their virtual self.

The end goal would be for everyone to have one, as routinely the NHS stores our personal medical records now.

"This is what I see happening in the fullness of time," said Professor Coveney, an expert in physical chemistry at University College London.

"We need people to own their own data, to manage it in the same way that you manage your financial affairs, and then you have the liberty to share that data with the healthcare providers, the doctors, the hospitals, and in-silico [virtual] clinical trials.

"Then you could volunteer your avatar, as it were, to be part of an in-silico trial with lots of other people with no risk to yourself obviously, but testing on a high-fidelity computer representation of yourself.

"That seems to me to be the way it will ultimately go."

The Herald: Computer simulations of human hearts are already being used in drug testingComputer simulations of human hearts are already being used in drug testing (Image: Getty)

As well making drug trials cheaper, easier, lower risk, and more representative of the population as a whole, the technology could enable doctors to skip trial-and-error and prescribe the most effective treatments to patients from the start.

Dr Highfield said: "It's quite common for doctors to say 'look, try this drug and if it doesn't work I'll put you on another drug'.

"Well, rather than using you as their guinea pig the dream would be to use your digital twin instead.

"Drug companies are already doing virtual drug trials at the molecular level where you take someone's genome, then you work out the shape of the target protein in their body and you test it in a computer simulation to see which drug would work best for them.

"The hope is that in the next few years we'll be able to do things like modelling multi-morbidity in older patients who are on five different drugs with different side effects.

"It could be that simply using computer models could help you to understand what's happening in a specific patient."

The Herald: Digital twins could enable clinical trials on drugs and vaccines to be carried out in future without any human participantsDigital twins could enable clinical trials on drugs and vaccines to be carried out in future without any human participants (Image: Getty)

Given that the mathematics underpinning digital twins is much the same as that used in weather forecasting and climate modelling, it also raises the prospect of pre-emptive healthcare.

Prof Coveney said: "It means I can treat someone because I've been able to predict what's going to happen to them.

"As with a weather forecast, I reach for my umbrella before it's going to rain.

"Currently, people in medicine don't really work like that. They want the evidence of what's happened to the person and then they try to respond to it, but you can see why that's ridiculous.

"If you want evidence that the person has died before they die, you can't have it; you just have a dead person on your hands when you could have done something to prevent it."

Dr Highfield added: "It raises interesting questions about what it means to be 'healthy' and what it means to be 'unhealthy'.

"Someone could say to you 'you're looking well', but your digital twin might say 'actually, that bottle of claret you're putting away every night is going to knock five years off your life'."

'Virtual Twins' is at the National Museum of Scotland on April 1