Publication Name	World Journal of Hepatology
Manuscript ID	125486
DOI	10.4254/wjh.125486
Country	United States

Category	Gastroenterology & Hepatology
Manuscript Type	Minireviews
Article Title	Digital twins in pediatric metabolic dysfunction-associated steatotic liver disease: Developmentally referenced multimodal risk stratification
Manuscript Source	Invited Manuscript
All Author List	Toshifumi Yodoshi
Funding Agency and Grant Number
Corresponding Author	Toshifumi Yodoshi, Assistant Professor, MD, PhD, Division of Gastroenterology, Hepatology, Pancreatology and Nutrition, University of Iowa Stead Family Children’s Hospital, No. 200 Hawkins Drive, Iowa, IA 52242, United States. toshifumi-yodoshi@uiowa.edu
Key Words	Metabolic dysfunction-associated steatotic liver disease; Digital twin; Pediatrics; Risk stratification; Body composition; Precision medicine; Machine learning; Longitudinal modeling
Core Tip	Pediatric metabolic dysfunction-associated steatotic liver disease is dynamic, but routine monitoring relies heavily on isolated measurements. No validated pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) digital twin currently exists. This review separates direct pediatric MASLD evidence from adult, other-pediatric, and generic digital-twin evidence and proposes an author-derived, investigational architecture. A minimum viable core should begin with routinely available developmental, anthropometric, laboratory, treatment, and clinically obtained imaging data, with advanced imaging, body composition, genetics, multi-omics, microbiome, and digital phenotyping added only as separately validated modules. Near-term research should emphasize association-based prognostic monitoring, explicit uncertainty, missing-not-at-random data, false alerts and false reassurance, and silent prospective validation. Treatment-effect simulation requires separate causal validation and should not be inferred from ordinary risk prediction.
Citation	Yodoshi T. Digital twins in pediatric metabolic dysfunction-associated steatotic liver disease: Developmentally referenced multimodal risk stratification. World J Hepatol 2026; In press DOI: https://doi.org/10.4254/wjh.125486
PDF	125486-in-press.pdf

Received	2026-07-08 08:44
Peer-Review Started	2026-07-08 08:45
First Decision by Editorial Office Director
Return for Revision	2026-08-10 12:55
Revised	2026-08-10 21:57
Publication Fee Transferred
Second Decision by Editor	2026-09-08 02:42
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-09-08 10:00
Articles in Press	2026-09-08 10:00
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
Open Access	Open-Access: This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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