The emergence and future of precision public health: a scoping review

Objectives

Rapid uptake of big data and technologies in healthcare are transforming methodological capabilities in medicine and public health, giving rise to new fields such as precision public health. We conceptualised precision public health as an emerging technology to understand the emergence of this term and its associated characteristics.

Methods

We undertook a scoping review to collate and analyse existing literature on precision public health. Documents in English that mentioned the exact phrase “precision public health” were searched for in CINAHL, Medline, PubMed, Scopus, Web of Science and Google Scholar. A descriptive statistical analysis was performed on resulting documents to generate an account of precision public health terminology and definitions as well as author and funder characteristics of articles. Data were analysed through a sociotechnical lens, which is an approach for understanding how technologies emerge and disrupt existing systems.

Results

Precision public health was ill-defined at first but is now stabilising. Using an emerging technology conceptual framework, we identified characteristics of precision public health including rapid growth, incoherence, uncertainty about future impacts and outcomes, and ambiguity about use of terminology. Novelty was contested.

Conclusions

Definitions of precision public health are continuously changing, and terms have different meanings and uses. Lack of consensus on definitions and terms for precision public health may impact progress of resarch. A single definitions of precision public health is not achievable; however, definitions should be negotiable among stakeholders, acknowledge similarities and differences between stakeholder values and expectations, and reflect research and policy objectives.

Public interest summary

Precision public health is an emerging field which often relies on data-centric approaches, including artificial intelligence and machine learning, to improve population health outcomes, which potentially disrupt traditional evidence-based research methods and practice. We conducted a scoping review of current literature, and conceptualised precision public health as an emerging technology to understand how it impacts evidence-based practice and how terms and definitions of precision public health have changed over time.

There is currently no consensus around terms and definitions most appropriate for the field and the absence of empirical evidence makes it difficult to evaluate potential future impacts. If precision public health is going to deliver on its promises, researchers and practitioners must be transparent about reporting potential uncertainties, benefits and harms. Definitions should also be open and negotiable among stakeholders in precision public health, and reflect research and policy objectives.