Page 104 - Journal of Special Operations Medicine - Spring 2017

An Ongoing Series

Human Performance Optimization and Precision Performance

The Future of Special Operations Human Performance Efforts

Adam Russell, PhD; Patricia Deuster, PhD, MPH, FACSM

ABSTRACT

The Precision Medicine Initiative (PMI) was launched the Union address in which he announced the launch
by the White House to promote individualized medicine. of a Precision Medicine Initiative (PMI). The PMI’s
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Although the focus of the PMI is on curing disease, we mission is “to enable a new era of medicine through
introduce the concept of Precision Performance (P2)— research, technology, and policies that empower pa-
advances that might “enable a new era of human perfor- tients, researchers, and providers to work together to-
mance optimization through research, technology, and ward development of individualized care.” Driven
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policies that empower warfighters and those who sup- by new advances in tools and methods for collecting,
port them to work together toward development of in- sharing, and analyzing ever-larger amounts of clinical
dividually optimized performance” (The White House, and medical data on both individuals and populations,
2015). We provide a limited review of the current state of many federal agencies have moved ahead in support of
the science in human performance optimization (HPO) the PMI. Some early, promising new discoveries and
and show that averages among individuals can be both treatments for cancer, Alzheimer disease, diabetes, and
misleading and potentially counterproductive. Several other disorders have given researchers reason to be opti-
examples where individual differences have historically mistic about benefits of precision medicine.
presented challenges to HPO research and application
are provided, as are ideas on how such differences might Although the focus of the PMI is obviously on curing
be leveraged to enable new opportunities to approach disease, the technological advances enabling much of
the goal of individually optimized human performance. the PMI need not be limited to medical applications. In
We end with a few questions likely to be of increasing this article, we explore what it might mean to leverage
importance if the notion of P2 continues to evolve and these same advances to move from precision medicine
mature; we also provide limited recommendations, given to precision performance—advances that, to paraphrase
this is a nascent concept. The Special Operations Forces the PMI mission statement, might “enable a new era
human performance programs can move the science of human performance optimization through research,
forward by considering and then implementing the in- technology, and policies that empower warfighters and
frastructures, processes, and approaches to best identify those who support them to work together toward devel-
and exploit emerging tools for ever greater and faster opment of individually optimized performance.”
P2 data collection, analyses, sharing, and applications.
First we consider why precision performance (P2) might
Keywords: human performance optimization; precision per- be of interest by providing our perspective of the current
formance; human performance programs, Precision Medi- state of the science in human performance optimization
cine Initiative; individualized care (HPO), which has been described in a previous article
in this journal and elsewhere. In brief, we argue that
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the use of “averages” in human performance research,
particularly group averages, may make sense for certain
Introduction
purposes, but we are increasingly having to confront the
“Precision medicine” is a term gaining increasing at- limitations of relying on group averages when trying
tention throughout medical and research communities, to optimize an individual’s performance. We will show
promoted in part by President Obama’s 2015 State of that averages can be both misleading and potentially

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