What Is Really Real? A Commentary on Digital Patient and Digital Twin Technologies

Digital patient technologies promise personalized healthcare but remain limited by inconsistent terminology and uncertain clinical readiness. Drawing on three companion preprints using the same 61-review evidence map, we argue that operational characteristics determine the computational evidence and clinical accountability required for a stated use. Patient specificity appeared in 55/61 reviews, bidirectionality in 26/61 and patient specificity, dynamic orientation and bidirectionality together in 25/61. These are review-level reporting patterns, not verified capabilities or patient benefit. Clear capabilities, system-level validation, semantic interoperability, governance and prospective clinical evidence remain priorities.