The Changing Concept of Actionability in Precision Medicine

This article tracks the origins, developments, and current usages of the concept of actionability in precision medicine. Originally a label for highlighting 'incidental' findings from genetic research, over time this concept became ascribed to catalogued genetic 'variants' that are both potentially pathogenic and 'druggable'. Drawing on a qualitative document analysis, the article identifies several clusters of relevant actors promoting actionability, and several developments to which the concept was subject over time. The concept answers to various problems that emerged gradually, at different points in time, and partially as consequences of previous solutions: the translation between genomic testing in research and clinical settings, the problem of overdiagnosis resulting from a technologically induced information overflow, the complexity of test results combining various dimensions of meaning of non-linearly linked variables, and the problem of having to 'personalize' a therapy selection while integrating a new logic into a pre-existing health system.