Journal
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
Volume 45, Issue -, Pages 134-141Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neubiorev.2014.05.010
Keywords
Psychosis; Schizophrenia; Biomarker; Marker; Treatment response; Antipsychotic; Pharmacogenetics; Diagnosis; Prognosis; Prediction
Categories
Funding
- National Institute for Health Research (NIHR) [NIHR-PDF-2010-03-047]
- Medical Research Council (MRC) [99859]
- NIHR Mental Health Biomedical Research Centre at South London
- Maudsley NHS Foundation Trust and King's College London
- MRC [G0701748, G1100574] Funding Source: UKRI
- Medical Research Council [G1100574, G0701748] Funding Source: researchfish
- National Institute for Health Research [PDF-2010-03-047] Funding Source: researchfish
- National Institutes of Health Research (NIHR) [PDF-2010-03-047] Funding Source: National Institutes of Health Research (NIHR)
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Despite five decades of search for clinically meaningful 'biomarkers' in schizophrenia there are still no common tests to inform diagnosis or treatment. Our aim was to understand why it has been so difficult to convert biological findings into clinical tests. We categorized all PubMed-indexed articles investigating psychosis-related biomarkers to date (over 3200). Studies showed an evident publication bias, a confusing array of terminology, and few systematic efforts at longitudinal evaluation or external validation. Fewer than 200 studies investigated biomarkers, longitudinally, for prediction of illness course and treatment response. These biomarkers were then evaluated in terms of their statistical reliability and clinical effect size. Only one passed our a priori threshold for clinical applicability. This is a modest record. In order to promote real progress, the field needs: (a) consistent use of terminology so that studies can be compared; (b) a system of standardized universal reporting to overcome the existing publication bias; and (c) practical criteria [a prototype is suggested here] for assessing the clinical applicability of the findings. (C) 2014 Elsevier Ltd. All rights reserved.
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