Beyond the Gender Data Gap: Co-Creating Equitable Digital Patient Twins

Nora Weinberger¹Daniela Hery²Dana Mahr¹Stephan O. Adler²Jean Stadlbauer²Theresa Dorothee Ahrens^2*

• ¹Institute of Technology Assessment and Systems Analysis, Karlsruhe; Institute of Technology, Karlsruhe, Germany, Karlsruhe, Baden-Württemberg, Germany
• ²Fraunhofer Institute for Experimental Software Engineering (IESE), Kaiserslautern, Germany

Digital patient twins constitute a transformative innovation in personalized medicine, integrating patient-specific data into predictive models that leverage artificial intelligence (AI) to optimize diagnostics and treatments. However, existing digital patient twins often fail to incorporate gender-sensitive and socio-economic factors, reinforcing biases and diminishing their clinical effectiveness. This (gender) data gap, long recognized as a fundamental problem in digital health, translates into significant disparities in healthcare outcomes. This mini-review explores the interdisciplinary connections of technical foundations, medical relevance, as well as social and ethical challenges of digital patient twins, emphasizing the necessity of gender-sensitive design and co-creation approaches. We argue that without intersectional and inclusive frameworks, digital patient twins risk perpetuating existing inequalities rather than mitigating them. By addressing the interplay between gender, AI-driven decision-making and health equity, this mini-review highlights strategies for designing more inclusive and ethically responsible digital patient twins to further interdisciplinary approaches.