Precision public health is an emerging practice to more granularly predict and understand public health risks and customize treatments for more specific and homogeneous subpopulations, often using new data, technologies, and methods. Big data is one element that has consistently helped to achieve these goals, through its ability to deliver to practitioners a volume and variety of structured or unstructured data not previously possible. Big data has enabled more widespread and specific research and trials of stratifying and segmenting populations at risk for a variety of health problems. Examples of success using big data are surveyed in surveillance and signal detection, predicting future risk, targeted interventions, and understanding disease. Using novel big data or big data approaches has risks that remain to be resolved. The continued growth in volume and variety of available data, decreased costs of data capture, and emerging computational methods mean big data success will likely be a required pillar of precision public health into the future. This review article aims to identify the precision public health use cases where big data has added value, identify classes of value that big data may bring, and outline the risks inherent in using big data in precision public health efforts.

It is critical to ensure that COVID-19 studies provide clear and timely answers to the scientific questions that will guide us to scalable solutions for all global regions. Significant challenges in operationalizing trials include public policies for managing the pandemic, public health and clinical capacity, travel and migration, and availability of tests and infrastructure. These factors lead to spikes and troughs in patient count by location, disrupting the ability to predict when or if a trial will reach recruitment goals. The focus must also be on understanding how to provide equitable access to these interventions ensuring that interventions reach those who need them the most, be it patients in low resource settings or vulnerable groups.  We introduce a website to be used by The Bill & Melinda Gates Foundation, Wellcome Trust, and other funders of the COVID Therapeutics Accelerator that accept proposals for future clinical research. The portal enables evaluations of clinical study applications that focus on study qualities most likely to lead to informative outcomes and completed studies.

El perfil de políticas destinatarias (TpoP, por sus siglas en inglés) es una herramienta para facilitar el diálogo en torno a la evidencia necesaria para efectuar un cambio en la política. Se pretende articular claramente el cambio de política propuesto, las pruebas existentes para apoyar el cambio, las brechas en las pruebas y la naturaleza de las pruebas necesarias para llenar esas brechas. Es una herramienta para ayudar a decidir sobre la puesta en marcha de una investigación, así como para revisar los estudios recientemente propuestos en el contexto de los objetivos generales del programa. El TPoP también se utilizará para describir el proceso y el cronograma para la participación de las políticas a lo largo del ciclo de vida de desarrollo del cambio de política propuesto. Como resultado, el TPoP servirá como punto focal para el diálogo y la alineación entre las partes interesadas clave en el proceso de generación de políticas, facilitando el diálogo temprano y sustantivo.

The Target Policy Profile (TPoP) is a tool to aid discussion on the evidence needed to change or establish a new policy. This policy could be at the country, regional, or global level. The TPoP should state the proposed policy, the supporting evidence, gaps in the evidence, and the nature of evidence required to fill these gaps. The TPoP should serve as a framework for dialogue and alignment between key stakeholders in the policy development process. By laying out a roadmap to intended policy impact, this tool can also support funding decisions for a particular research agenda.

In many cases, the end goal of clinical research is a change in policy, but there is often a gap between the research and policy sides, which can lead to wasted money and time. To address this, the Target Policy Profile (TPoP) has been developed for use both prior to research to identify key research questions to support policy decisions and at the point of evidence generation and dissemination. It is envisaged that the TPoP could help researchers analyze the evidence underlying a given policy, the gaps in that evidence, and the nature of additional evidence needed to improve the policy. Furthermore, it aims to facilitate early and ongoing communication between researchers and policymakers. Armed with this knowledge and these relationships, clinical researchers can maximize the likelihood that studies meet the requirements to generate optimal policies in an efficient way.