Conceptualizations of Big Data and their epistemological claims in healthcare: A discourse analysis

In recent years, the healthcare field welcomed an emerging field of practices captured under the umbrella term ‘Big Data’. This term is surrounded with positive rhetoric and promises about the ability to analyse real-world data quickly and comprehensively. Such rhetoric is highly consequential in shaping debates on Big Data. While the fields of Science and Technology Studies and Critical Data Studies have been instrumental in elaborating the neglected and problematic dimensions of Big Data, it remains an open question how and to what extent such insights become embedded in other fields. In this paper, we analyse the epistemological claims that accompany Big Data in the healthcare domain. We systematically searched scientific literature and selected 206 editorials as these reflect on developments in the domain. Through an interpretive analysis, we construct five ideal-typical discourses that all frame Big Data in specific ways. Three of the discourses (the modernist, instrumentalist and pragmatist) frame Big Data in positive terms and disseminate a compelling rhetoric. Metaphors of ‘capturing’, ‘illuminating’ and ‘harnessing’ data presume that Big Data are benign and leading to valid knowledge. The scientist and critical-interpretive discourses question the objectivity and effectivity claims of Big Data. Metaphors of ‘selecting’ and ‘constructing’ data illustrate another political message, framing Big Data as limited. We conclude that work in the critical-interpretive discourse has not broadly infiltrated the medical domain. Ways to better integrate aspects of the discourse in the healthcare domain are urgently needed.

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