Precision medicine has been studied by social scientists to understand the conceptualizations, contexts, and implications of this research field.  

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Chorev (2020) wrote about a precision oncology clinical trial, and found that multiplicity and uncertainty were key themes that emerge from the research in practice. An abundance of data is obtained from patients in the trial leading to an uncertainty in treatment choice, yet the technology (genetic/transcriptomic sequencing, algorithms) does not necessarily narrow down this multiplicity or reduce uncertainty but instead attempts to reconfigure and rationalize treatment options in molecular terms. This can be applied to the personalized recommendations offered by DTC microbiome tests - in an incredibly complex world of conflicting nutrition information, personalized recommendations on what foods to eat or avoid don't necessarily make dietary decisions simpler, but rather re-frame it in micro-scale terms of for example avoiding spinach containing oxalates and purines to improve your poor oxalate metabolism pathway score.

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In her analysis of TED talks on the microbiome, Penelope Ironstone (2019) presents how narratives are constructed of a citizen scientist who attempts to manipulate their microbiome as a "prosumer, both producer and consumer, of scientific and biomedical research”. The implication of this position, she argues: 

 

Is that results from personal microbial genomics tests may induce action by individuals who lack sufficient expertise to know how their interventions may       negatively impact their health. In other words, the human microbiome is not simply an idea worth spreading, it is one that spreads in contexts that have very real social, political,  economic, legal, and other consequences, and it has the capacity to yield unexpected and deleterious results

 

Another thoughtful analysis is presented by Pinel and Svendsen (2021) in their research on Danish biobanks used for precision therapeutics. The outline how biological data flows from personal, to collective, to personalized. Applied to this context of precision microbiome research, first stool samples are collected and sequenced from individuals, creating a set of personal data. This data then becomes added to a collective biobank from which it is compared against, finding similarities and differences in abundance patterns, diversity, and expression patterns to create a database from which personalized recommendations can be extracted. This offers a useful point of reflection on the nature of microbiomic data and the collective biobanks from which individual recommendations emerge ??

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Importantly, what might these recommendations mean for individuals? Levin (2020) wrote on precision metabolomics research and suggested that persons within its clinical application were defined relationally - not socially, but statistically within the database that their personal data is entered. She writes, "as metabolomics research looks for more personalized approaches to disease diagnosis and treatment, it makes up persons as metabolic patterns and relationships.” This is another point for reflection, in that the division or co-existence between an individual and their microbiome - does the sequenced data and its personalized recommendations make us who we are? How might people become defined by the characterization of their microbiome? 

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