Evidence map›Paper›PMID 41813230›Full record

ArticleJournal of medical Internet research2026

Digital Twins for Just-in-Time Adaptive Interventions (JITAIs): Framework for Optimizing and Continually Improving JITAIs.

Asim H Gazi, Daiqi Gao, Susobhan Ghosh, Ziping Xu, Anna L Trella, Predrag Klasnja, Susan A Murphy

Abstract read
In one paragraph

Article in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Asim H GaziSchool of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 02138, United States.ORCID http://orcid.org/0000-0003-4698-2823
Daiqi GaoSchool of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 02138, United States.ORCID http://orcid.org/0009-0009-9036-7466
Susobhan GhoshSchool of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 02138, United States.ORCID http://orcid.org/0000-0003-3654-4141
Ziping XuSchool of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 02138, United States.ORCID http://orcid.org/0000-0002-2591-0356
Anna L TrellaSchool of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 02138, United States.ORCID http://orcid.org/0000-0003-4779-9115
Predrag KlasnjaSchool of Information, University of Michigan-Ann Arbor, Ann Arbor, MI, United States.ORCID http://orcid.org/0000-0002-4570-703X
Susan A MurphySchool of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA, 02138, United States.ORCID http://orcid.org/0000-0002-2032-4286

Funding

Validating novel sleep sensors and devices in older adults with Alzheimer's diseaseP30AG073107 · NIA · UNIVERSITY OF MASSACHUSETTS AMHERST · PI Sudeshna Das, Deepak Ganesan · 2021 to 2026
$32.0M
Pilot and Mentoring CoreP50DA054039 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LINDA M COLLINS, SUSAN A MURPHY · 2021 to 2026
$18.2M
TR&D3 - Rapid Translation of AI-powered Temporally Precise mHealth Interventions via Efficient and Embeddable Trustworthy Biomarker ImplementationsP41EB028242 · NIBIB · UNIVERSITY OF MEMPHIS · PI Santosh Kumar · 2020 to 2026
$9.5M
Personalized Digital Behavior Change Interventions to Promote Oral HealthUH3DE028723 · NIDCR · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI VIVEK SHETTY · 2022 to 2026
$3.8M
Heart Steps: Adaptive mHealth intervention for physical-activity maintenanceR01HL125440 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Predrag Klasnja · 2015 to 2026
$3.8M
Uncertainty-Informed Decision Making for Just-in-Time Adaptive Interventions (JITAIs)K99EB037411 · NIBIB · HARVARD UNIVERSITY · PI Asim Hossain Gazi · 2025 to 2026
$229k
NHLBI NIH HHS R01 HL125440NIA NIH HHS P30 AG073107NIBIB NIH HHS K99 EB037411NIBIB NIH HHS P41 EB028242NIDA NIH HHS P50 DA054039NIDCR NIH HHS UH3 DE028723
6 · The paper itself

Abstract

Unlabelled: In the context of digital health, just-in-time adaptive interventions (JITAIs) are nascent precision medicine systems that can extend personalized health care support to everyday life. A challenge in designing JITAIs is that personalized support often involves sophisticated decision-making algorithms. These decision-making algorithms can require numerous nontrivial design decisions that must be made between successive JITAI deployments (eg, hyperparameter selection for an artificial intelligence algorithm). Making design decisions between deployments-rather than during deployment-ensures intervention fidelity and enhances the ability to replicate results. Yet, each deployment can be costly, precluding the use of A/B testing for every design decision. How should design decisions be made strategically between JITAI deployments? This paper introduces "digital twins for just-in-time adaptive interventions (JITAI-Twins)" to address this question. JITAI-Twins are "digital twins of a subpopulation" (term used in the 2023 National Academies workshop proceedings on digital twins). JITAI-Twins are used to virtually simulate the potential outcomes of a JITAI's design decisions for an upcoming deployment. Based on simulation results, design decisions are made for the deployed JITAI. To continually improve the JITAI, data collected during deployment are used to update the JITAI-Twin-and this bidirectional feedback between deployments and simulation environments continues. JITAI-Twins are thus "fit-for-purpose" (term used in the National Academies 2024 consensus report on digital twins) instantiations of the digital twin concept. In this paper, we elucidate the specifics and design process of JITAI-Twins, with examples of prior use in clinical settings. JITAI-Twins highlight continuity over the course of a JITAI's optimization and continual improvement, emphasizing the need for bidirectional feedback between versions of a simulation environment and a JITAI's deployments.

Indexed as

Precision MedicineAdaptive AlgorithmsAlgorithmsArtificial IntelligenceDigital HealthHumansAIartificial intelligencedeploymentdigital healthdigital twinJITAIjust-in-time adaptive interventionmachine learningmHealthmobile healthprecision medicinereinforcement learningRLsimulation

Identifiers

PMID41813230
PMCPMC12978917

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.