Is personal the same as precise? How Cambridge is revolutionising healthcare on two fronts

14 July 2025 to 25 July 2025 is PHG Foundation’s personalised health fortnight. Follow and share the campaign on LinkedIn

Thank you to Tom Bashford and Brandon Smith (The Precision Health Initiative, Cambridge Public Health, and the International Health Systems Group) for contributing today’s #personalisedhealth article.

The 2024 review of the NHS by Lord Darzi, and the subsequent NHS 10-year plan released earlier this month, mark a clear direction of travel for those seeking to improve health and care in the United Kingdom. The explicit focus on prevention, the digital transformation, and community engagement provides a roadmap for both care delivery and research efforts. It also brings together areas of historic strength for the University of Cambridge; the biosciences, public health, and information technology.

The deep research expertise of teaching Departments such as Medicine, Engineering, Clinical Neurosciences, and Public Health & Primary Care are cross-linked by a range of research collaboratives including the Precision Health Initiative and Cambridge Public Health. These also help coordinate efforts of independent institutes such as the MRC’s Epidemiology Unit and Laboratory of Molecular Biology, the Sanger and Babraham Institutes, along with industrial and policy partners. However, these interdisciplinary research bodies highlight a tension at the heart of the 10-year plan which is easily lost in the rhetoric – one of integration. How can digital tools help manage the health of communities to prevent disease? 

We would argue that the scientific landscape is at a critical juncture in terms of our ability to deliver on the 10-year plan, which might have been unworkable even a decade ago. The explosion of understanding which began with the Human Genome Project in 2003 is beginning to realise its potential in examples such as Activated PI3-kinase Delta Syndrome (APDS) which this year moved from discovery to revolutionary treatment by Cambridge researchers and clinicians led by Dr Anita Chandra. This, along with huge studies such as the MRC Epidemiology Unit’s Fenlands study led by Prof Nick Wareham and the NIHR BioResource led by Prof John Bradley are providing datasets which can only be fully explored using emerging approaches based on machine learning, championed in Cambridge through the Centre for Human Inspired Artificial Intelligence led by Prof Anna Korhonen and the Centre for AI in Medicine led by Prof Mihaela van der Schaar.

For the first time, painstakingly derived biological detail at the population level can be digitally managed through learning algorithms to direct individual care. 

Physical technology is also poised to help facilitate this transition. Wearable monitors, now embedded into many commercial products but with increasingly high-quality sensors and diagnostics, can provide exceptional data to epidemiological studies as demonstrated by Dr Kirsten Rennie but have also been used by Prof Jonathan Mant and Dr Peter Charlton from the Department of Public Health and Primary Care to screen for conditions such as atrial fibrillation at the population level.

At the same time, technological interfaces are being used by Dr Coco Newton to revolutionise the diagnostic pathway for those living with with dementia. Combining innovation in biosciences and technology, Prof Ulrich Keyser and Cambridge Nucleomics may soon provide the opportunity to diagnose infections at the bedside, not only characterising the bacteria or virus involved, but also its resistance to a range of antibiotics – allowing doctors to treat the actual disease, not simply the most likely.

At the other end of technology spectrum, globally-facing early career researchers such as Dr Brandon Smith are seeking to use simple technology to support patient follow-up from brain injury and provide paperless, transferrable, medical record systems. 

These efforts show just how the 10-year plan might be delivered: wearable technology which helps diagnose disease early and implement lifestyle changes to prevent progression, combined with point-of-care diagnostics to initiate targeted medical management at the community pharmacy level. Phone-based diagnostic games, coupled with personalised follow-up driven by learning algorithms with a physician in the loop. Personalised proteomic profiling combined with all of the above to calculate personal risk for known disease states, identify new diseases, and develop therapeutics in record time.

While this might seem like breathless hyperbole, it remains solidly in the realm of science fact. In Cambridge this is exemplified in the management of traumatic brain injury, led by Prof Peter Hutchinson and Prof David Menon, in which novel technologies, molecular diagnostics, complex imaging, networked datasets and experimental medicine are being coordinated through the major global platform TBI-REPORTER to bring about a new age of both personalised and precise neurosurgical and neurointensive care.

There is a conceptual point in all this worthy of exploration: are we clear that there is a difference between personalised medicine and precision health? We would argue that these are related but divergent efforts – one being to use the vast array of personal data now available about an individual to help diagnose and treat them early, or even to prevent disease entirely, and the other to provide highly-specific treatments tailored to that given individual. These have a natural Venn-diagram overlap (Venn himself being a Cambridge academic) but are not necessarily always the same thing. We might diagnose atrial fibrillation early but still rely on our population-based risk factors to guide management options. However, we might similarly develop genetic therapies which manage the conditions of only a handful of sufferers or even the metabolome of a single individual. The first is personal, the latter is precise.

The 10-year plan calls for digitally enabled prevention of illness at the community level. For the first time in history, insights such as those being developed at Cambridge make this a possibility. The peerless work of the Cambridge Centre for Science and Policy, along with the PHG Foundation’s focus on genomics policy, keeps Cambridge academics connected to leading policy makers at the centre of our national response to this call. What is clear is that Cambridge has as vital a role to play in the next 10 years as it has in the past 800 – the only question is where that future might take us.

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