{"id":"https://openalex.org/W7225334941","doi":"https://doi.org/10.2196/preprints.116250","title":"Developing a Contextual Framework for Cognitive Digital Twins in Surgery: An Exploratory Interdisciplinary Survey to Inform a Delphi Consensus Study (Preprint)","display_name":"Developing a Contextual Framework for Cognitive Digital Twins in Surgery: An Exploratory Interdisciplinary Survey to Inform a Delphi Consensus Study (Preprint)","publication_year":2026,"publication_date":"2026-11-05","ids":{"openalex":"https://openalex.org/W7225334941","doi":"https://doi.org/10.2196/preprints.116250"},"language":"en","primary_location":{"id":"doi:10.2196/preprints.116250","doi":"https://doi.org/10.2196/preprints.116250","is_oa":false,"landing_page_url":"https://doi.org/10.2196/preprints.116250","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5039130398","display_name":"Rafid Rahman","orcid":"https://orcid.org/0000-0001-7490-7818","observed_orcids":["https://orcid.org/0000-0001-7490-7818"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Rafid Rahman","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0001-7490-7818","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160779718","display_name":"Tvishi Agrawal","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Tvishi Agrawal","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5055785355","display_name":"Ara Wardkes Darzi","orcid":"https://orcid.org/0000-0001-7815-7989","observed_orcids":["https://orcid.org/0000-0001-7815-7989","https://orcid.org/0000-0001-8717-0130","https://orcid.org/0000-0001-5653-8633"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ara Darzi","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0001-7815-7989","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031176491","display_name":"Daniel Richard Leff","orcid":"https://orcid.org/0000-0002-5310-1046","observed_orcids":["https://orcid.org/0000-0002-5310-1046"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Daniel Leff","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0002-5310-1046","affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5032805520","display_name":"George P. Mylonas","orcid":"https://orcid.org/0000-0003-3725-5843","observed_orcids":["https://orcid.org/0000-0003-3725-5843"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"George Mylonas","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0003-3725-5843","affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10916","display_name":"Surgical Simulation and Training","score":0.5342000126838684,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10916","display_name":"Surgical Simulation and Training","score":0.5342000126838684,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.1387999951839447,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14512","display_name":"Technology and Human Factors in Education and Health","score":0.08749999850988388,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cognitive-digital-twin","display_name":"cognitive digital twin","score":1.0},{"id":"https://openalex.org/keywords/multidisciplinary-collaboration","display_name":"multidisciplinary collaboration","score":0.7670000195503235},{"id":"https://openalex.org/keywords/neurophysiological-data","display_name":"neurophysiological data","score":0.6650000214576721},{"id":"https://openalex.org/keywords/surgical-robotics","display_name":"surgical robotics","score":0.4230000078678131}],"concepts":[{"id":"https://openalex.org/C60641444","wikidata":"https://www.wikidata.org/wiki/Q841602","display_name":"Delphi method","level":2,"score":0.6855000257492065},{"id":"https://openalex.org/C2778476105","wikidata":"https://www.wikidata.org/wiki/Q628539","display_name":"Workload","level":2,"score":0.5931000113487244},{"id":"https://openalex.org/C169900460","wikidata":"https://www.wikidata.org/wiki/Q2200417","display_name":"Cognition","level":2,"score":0.5794000029563904},{"id":"https://openalex.org/C22467394","wikidata":"https://www.wikidata.org/wiki/Q849359","display_name":"Multidisciplinary approach","level":2,"score":0.5127999782562256},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.5109999775886536},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.4731999933719635},{"id":"https://openalex.org/C75630572","wikidata":"https://www.wikidata.org/wiki/Q538904","display_name":"Applied psychology","level":1,"score":0.46720001101493835},{"id":"https://openalex.org/C85973986","wikidata":"https://www.wikidata.org/wiki/Q1091731","display_name":"Exploratory research","level":2,"score":0.4081000089645386},{"id":"https://openalex.org/C2779495148","wikidata":"https://www.wikidata.org/wiki/Q487378","display_name":"Delphi","level":2,"score":0.4059999883174896},{"id":"https://openalex.org/C133462117","wikidata":"https://www.wikidata.org/wiki/Q4929239","display_name":"Data collection","level":2,"score":0.40049999952316284},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.3702000081539154},{"id":"https://openalex.org/C87156501","wikidata":"https://www.wikidata.org/wiki/Q7268708","display_name":"Qualitative property","level":2,"score":0.35670000314712524},{"id":"https://openalex.org/C198477413","wikidata":"https://www.wikidata.org/wiki/Q7647069","display_name":"Survey data collection","level":2,"score":0.34150001406669617},{"id":"https://openalex.org/C162446236","wikidata":"https://www.wikidata.org/wiki/Q653137","display_name":"Content analysis","level":2,"score":0.3409999907016754},{"id":"https://openalex.org/C26760741","wikidata":"https://www.wikidata.org/wiki/Q160402","display_name":"Perception","level":2,"score":0.3343000113964081},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.3336000144481659},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.3334999978542328},{"id":"https://openalex.org/C26517878","wikidata":"https://www.wikidata.org/wiki/Q228039","display_name":"Key (lock)","level":2,"score":0.33329999446868896},{"id":"https://openalex.org/C75795011","wikidata":"https://www.wikidata.org/wiki/Q917904","display_name":"Typology","level":2,"score":0.3215000033378601},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.3050999939441681},{"id":"https://openalex.org/C36503486","wikidata":"https://www.wikidata.org/wiki/Q11235244","display_name":"Domain (mathematical analysis)","level":2,"score":0.2946999967098236},{"id":"https://openalex.org/C105002631","wikidata":"https://www.wikidata.org/wiki/Q4833645","display_name":"Subject-matter expert","level":3,"score":0.2919999957084656},{"id":"https://openalex.org/C2776035688","wikidata":"https://www.wikidata.org/wiki/Q1606558","display_name":"Affect (linguistics)","level":2,"score":0.29170000553131104},{"id":"https://openalex.org/C161407221","wikidata":"https://www.wikidata.org/wiki/Q4382939","display_name":"Cognitive model","level":3,"score":0.2897999882698059},{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.26820001006126404},{"id":"https://openalex.org/C73945780","wikidata":"https://www.wikidata.org/wiki/Q814232","display_name":"Survey methodology","level":2,"score":0.26100000739097595},{"id":"https://openalex.org/C58916136","wikidata":"https://www.wikidata.org/wiki/Q1663508","display_name":"Content validity","level":3,"score":0.2603999972343445},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.2599000036716461},{"id":"https://openalex.org/C104582849","wikidata":"https://www.wikidata.org/wiki/Q787282","display_name":"Automatic identification and data capture","level":2,"score":0.25690001249313354}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.2196/preprints.116250","doi":"https://doi.org/10.2196/preprints.116250","is_oa":false,"landing_page_url":"https://doi.org/10.2196/preprints.116250","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"posted-content"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.8048999905586243,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7128209359","https://openalex.org/W7163555772","https://openalex.org/W7135054246","https://openalex.org/W4416931992","https://openalex.org/W7134827231","https://openalex.org/W7212270436","https://openalex.org/W4400367117","https://openalex.org/W7164883290","https://openalex.org/W4414480002","https://openalex.org/W7102665450"],"abstract_inverted_index":{"BACKGROUND":[0],"Cognitive":[1],"digital":[2,9,14],"twins":[3],"(CDTs)":[4],"represent":[5],"a":[6,67,106,111,115,147,203,243,256,303],"subset":[7],"of":[8,16,57,84,94,102,123,146,206,214,308],"twins,":[10],"which":[11],"are":[12,294],"dynamic":[13],"representations":[15],"real-world":[17],"objects":[18],"or":[19,30,60,77],"processes,":[20],"generated":[21],"using":[22,28,197],"data":[23,32,34,164,176],"collected":[24,166],"from":[25,223,249,267],"sensors.":[26],"CDTs":[27,124],"cognitive":[29,37,79],"neurophysiological":[31],"i.e.":[33],"reflecting":[35],"human":[36],"processes":[38],"have":[39],"huge":[40],"potential":[41],"within":[42,87,287],"the":[43,54,58,82,100,121,198,233,250,261,288,309],"surgical":[44],"field,":[45],"they":[46],"could":[47,65,298],"model":[48],"how":[49],"different":[50],"intraoperative":[51],"scenarios":[52],"affect":[53],"mental":[55],"workload":[56,86],"surgeon":[59],"wider":[61],"operating":[62],"team.":[63],"This":[64,141],"provide":[66],"platform":[68],"for":[69,156],"identifying":[70,280],"and":[71,152,161,167,216,226,264,283,291],"modifying":[72],"factors":[73],"contributing":[74],"to":[75,98,105,109,113,139,144,228,254,269,276,285,301],"excessive":[76],"insufficient":[78],"demand,":[80],"with":[81,135,210],"aim":[83,93],"maintaining":[85],"an":[88,136,211],"optimal":[89],"range.":[90],"OBJECTIVE":[91],"The":[92,247,296],"this":[95],"study":[96,119],"was":[97,130,142,165,195,202,240,252],"use":[99],"results":[101,190],"survey":[103,129,235,251],"disseminated":[104,143],"multidisciplinary":[107,292],"audience":[108],"devise":[110],"framework":[112,194,258,297],"guide":[114,306],"future":[116],"Delphi":[117,310],"consensus":[118],"on":[120,279],"topic":[122],"in":[125,172,230],"surgery.":[126],"METHODS":[127],"A":[128,193],"conceived":[131],"highlighting":[132],"key":[133,265,281],"areas":[134],"information-gap":[137],"pertaining":[138],"CDTs.":[140],"participants":[145],"multi-disciplinary":[148],"workshop":[149],"titled":[150],"\u2018Physics-":[151],"AI-Driven":[153],"Digital":[154],"Twins":[155],"Patient-Specific":[157],"Robotic":[158],"Diagnosis,":[159],"Interventions":[160],"Therapies\u2019.":[162],"Demographic":[163],"open-ended":[168],"questions":[169,313],"were":[170,177,221],"used":[171,253,300],"four":[173,234],"domains.":[174],"Qualitative":[175],"analysed":[178],"by":[179,182],"content":[180,224],"analysis":[181,225,248],"two":[183],"independent":[184],"reviewers,":[185],"who":[186],"then":[187],"collated":[188],"their":[189],"after":[191],"review.":[192],"created":[196],"results.":[199],"RESULTS":[200],"There":[201],"response":[204],"rate":[205],"13/27":[207],"(48%)":[208],"participants,":[209],"equal":[212],"distribution":[213],"clinicians":[215],"researchers/academics.":[217],"12":[218],"coded":[219],"domains":[220],"derived":[222],"found":[227],"vary":[229],"frequency":[231],"throughout":[232],"sections.":[236],"No":[237],"single":[238],"domain":[239],"represented":[241],"as":[242],"majority":[244],"amongst":[245],"respondents.":[246],"create":[255],"robust":[257],"centred":[259],"around":[260],"translational":[262,289],"pathway":[263],"challenges":[266],"conception":[268],"clinical":[270],"application.":[271],"CONCLUSIONS":[272],"More":[273],"work":[274],"needs":[275],"be":[277,299],"achieved":[278],"issues":[282],"solutions":[284],"hurdles":[286],"pipeline":[290],"collaboration":[293],"vital.":[295],"help":[302],"steering":[304],"group":[305],"formation":[307],"first":[311],"round/qualitative":[312]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-06T00:00:00"}