The Role of Algorithms in Molecular Tumour Boards-Managing the Gap Between Research and Clinic in Precision Medicine

The article explores the role of algorithmic procedures in the implementation of the programme of precision medicine (PM), currently pursued in molecular tumour boards (MTBs) that emerged from the confluence of previous tumour boards and the increasing molecularisation of medicine. Our observation of the deliberations in MTBs, confirmed by interviews with participants, shows that the crucial contribution of algorithms in all stages of the processing of molecular data is neither acknowledged nor mentioned. One reason, we argue, is that these highly innovative technologies are very distant from the traditional skills and training of clinicians. The mediation through MTBs provides algorithmic procedures with the viability required to be implemented in medical decisions-and is more effective the more it goes unnoticed. Contrary to the widespread assumption of a blurring boundary between research and care, we claim that the intensification of contacts and exchanges among research endeavours and clinical operations makes the separation between the two fields increasingly sharp. As a consequence, there is a need for new forms of translation, which are accomplished by MTBs.