Clinical decision support systems (CDSSs) enable users to make decisions based on clinical data from electronic medical records, facilitating personalized precision medicine treatments. A digital twin (DT) approach enables the interoperability between physical and virtual environments through data analysis using machine learning (ML). By combining DT with the prostate cancer (PCa) process, it is possible to predict cancer prognosis. In this study, we propose a DT-based prediction model for clinical decision-making in the PCa process. Pathology and biochemical recurrence (BCR) were predicted with ML using data from a clinical data warehouse and the PCa process. The DT model was developed using data from 404 patients. The BCR prediction accuracy increased according to the amount of data used, and reached as high as 96.25% when all data were used. The proposed DT-based predictive model can help provide a clinical decision support system for PCa. Further, it can be used to improve medical processes, promote health, and reduce medical costs and problems.
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