Children's views on artificial intelligence and digital twins for the daily management of their asthma: a mixed-method study

Abstract

New technologies enable the creation of digital twin systems (DTS) combining continuous data collection from children's home and artificial intelligence (AI)-based recommendations to adapt their care in real time. The objective was to assess whether children and adolescents with asthma would be ready to use such DTS. A mixed-method study was conducted with 104 asthma patients aged 8 to 17 years. The potential advantages and disadvantages associated with AI and the use of DTS were collected in semi-structured interviews. Children were then asked whether they would agree to use a DTS for the daily management of their asthma. The strength of their decision was assessed as well as the factors determining their choice. The main advantages of DTS identified by children were the possibility to be (i) supported in managing their asthma (ii) from home and (iii) in real time. Technical issues and the risk of loss of humanity were the main drawbacks reported. Half of the children (56%) were willing to use a DTS for the daily management of their asthma if it was as effective as current care, and up to 93% if it was more effective. Those with the best computer skills were more likely to choose the DTS, while those who placed a high value on the physician-patient relationship were less likely to do so. Conclusions: The majority of children were ready to use a DTS for the management of their asthma, particularly if it was more effective than current care. The results of this study support the development of DTS for childhood asthma and the evaluation of their effectiveness in clinical trials. What is Known: • New technologies enable the creation of digital twin systems (DTS) for children with asthma. • Acceptance of these DTSs by children with asthma is unknown. What is New: • Half of the children (56%) were willing to use a DTS for the daily management of their asthma if it was as effective as current care, and up to 93% if it was more effective. •Children identified the ability to be supported from home and in real time as the main benefits of DTS.

Keywords: Automated decision system; Digital twins; Internet of things; Paediatrics; Telemonitoring.

Fig. 1

Animation created for the study to show children what the interface of the digital twin system might look like (https://scratch.mit.edu/projects/721368471)

Fig. 2

Directed acyclic graph used to identify the total effect of each variable on the agreement to use the digital twin system

Fig. 3

Children’s views on the place of the doctor and artificial intelligence in medical decisions about themselves. AI artificial intelligence

Fig. 4

Respondent’s strength of preference for a digital twin system-based management of childhood asthma compared to physician-based management, using varying levels of effectiveness in achieving asthma control. DTS digital twin system