Algorithm 1: Selection Process for Narrative Review on Digital Twins in Oncology

Define search query:  (“(digital twins[Title/Abstract]) AND ((oncology[Title/Abstract]) OR (cancer[Title/Abstract]) OR (tumor[Title/Abstract])) “) 2.Conduct searches in PubMed and Scopus using the defined query.  3.Select relevant studies from peer-reviewed journals.  The reviews selected for this work center on the intersection of oncology and digital twin technology. Priority was given to the following: Recent review articles that synthesize findings from earlier studies, including previous reviews, offering an updated and integrated perspective on the evolving field. Comprehensive analyses that combine prior research insights with a specific emphasis on the application of DTs in oncology. To ensure alignment with the journal’s focus, articles primarily technical or centered on computer science—without clear clinical or translational implications—were excluded. 4. Evaluate each study based on the following parameters: N1: Clear rationale in the introduction  The study should clearly explain the background, objectives, and the significance of the research question. The introduction must establish why the study is important and how it contributes to advancing knowledge in the field. N2: Adequate research design  The design should be well suited to address the research question. This includes clear definitions of the study’s variables, appropriate control groups (if applicable), and a design that enables the study to produce valid, reliable results. N3: Clearly described methodology  The methods used in the study must be explicitly outlined, with sufficient detail on how data were collected, analyzed, and interpreted. This allows other researchers to replicate or build upon the work. N4: Well-presented results  The results should be clearly presented, with sufficient data to support conclusions. This includes appropriate use of tables, figures, and statistical analysis to highlight key findings. N5: Conclusions justified by the results  The study’s conclusions should be logically derived from the results. Authors should refrain from making unsubstantiated claims, and their interpretation of the findings should be reasonable and supported by evidence. N6: Disclosure of conflicts of interest  The study should explicitly disclose any potential conflicts of interest, including financial or personal interests that could have influenced the study’s design, conduct, or interpretation of results. 5.Assign scores to parameters N1-N5 on a scale from 1 to 5.  Each parameter is rated on a 5-point scale, where ○1 = Poor ○2 = Fair ○3 = Good ○4 = Very Good ○5 = Excellent This scale helps assess the overall quality of each study based on these key criteria. 6.Assess N6 using a binary Yes/No measure.  For conflicts of interest (N6), the evaluation is binary: ○Yes = The study discloses any potential conflicts of interest. ○No = The study does not disclose conflicts of interest. 7.Preselect studies that meet the following criteria:  To ensure that only studies with a high level of methodological rigor and transparency are included, preselect studies based on the following criteria: ○N6 = Yes (conflicts of interest disclosed). ○N1–N5 scores > 3 (ensuring sufficient methodological quality). 8.Include preselected studies in the final synthesis.  Only studies that meet the above criteria (N6 = “Yes” and N1–N5 scores > 3) will be included in the final synthesis for review. This ensures the inclusion of studies with strong scientific integrity and relevance.