An undeclared civil war is breaking out in biomedicine. On one side is precision medicine, with its emphasis on tailoring treatments to ever-narrower groups of patients. On the other side is population health, which emphasizes predominantly preventive interventions that have broad applications across populations.
Which vision will provide the most durable and efficient path to improved health for all?
Disregarding the “breakthrough” announcements that appear on a regular basis, the question of whether precision medicine will lead to better health for all remains an open one.
We believe that genomics and precision medicine have ridden a wave of hype without substance for far too long. Unless they are able to go well beyond their thin record of empirical success and demonstrate their effectiveness in meeting the actual health needs of populations, they will be marginal players with regard to any lasting impact on the health of the public.
Fortunately, it appears that the tide is beginning to turn toward population health, especially as a more balanced perspective of the value of polygenic risk scores — one of the most widely advocated innovations of the precision medicine movement — is beginning to emerge.