Manipulating the microbiome has enormous potential to treat important human diseases. Microbiome surveys are often used to identify potential therapeutic targets by finding associations between microbial elements and disease status. We argue that many reported associations between the microbiome and disease are incompatible with translational research because they are insufficiently specific. We encourage the clear specification of manipulable microbial elements that can be tested in follow-up randomized experiments, and we provide multiple examples of specific and nonspecific microbial elements.