Clinically meaningful biomarkers for psychosis: A systematic and quantitative review

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-inde...

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Published in:	Neuroscience and biobehavioral reviews Vol. 45; pp. 134 - 141
Main Authors:	Prata, Diana, Mechelli, Andrea, Kapur, Shitij
Format:	Journal Article
Language:	English
Published:	Kidlington Elsevier 01.09.2014
Subjects:	Adult and adolescent clinical studies Behavioral psychophysiology Biological and medical sciences Biomarkers - metabolism Fundamental and applied biological sciences. Psychology Humans Medical sciences Neuropharmacology Pharmacology. Drug treatments Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychology. Psychophysiology Psychopathology. Psychiatry Psychopharmacology Psychoses Psychotic Disorders - diagnosis Psychotic Disorders - genetics Psychotic Disorders - metabolism Publishing Schizophrenia Terminology as Topic Pharmacogenetics Biomarker Prognosis Neuroleptic Psychotropic Prediction Biological marker Pharmacotherapy Schizophrenia Treatment response Review Marker Psychosis Treatment Antipsychotic Diagnosis
ISSN:	0149-7634, 1873-7528, 1873-7528
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Abstract	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.
AbstractList	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.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. 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.
Author	Mechelli, Andrea Prata, Diana Kapur, Shitij
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Keywords	Pharmacogenetics Biomarker Prognosis Neuroleptic Psychotropic Prediction Biological marker Pharmacotherapy Schizophrenia Treatment response Review Marker Psychosis Treatment Antipsychotic Diagnosis
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Snippet	Despite five decades of search for clinically meaningful 'biomarkers' in schizophrenia there are still no common tests to inform diagnosis or treatment. Our...
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SubjectTerms	Adult and adolescent clinical studies Behavioral psychophysiology Biological and medical sciences Biomarkers - metabolism Fundamental and applied biological sciences. Psychology Humans Medical sciences Neuropharmacology Pharmacology. Drug treatments Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychology. Psychophysiology Psychopathology. Psychiatry Psychopharmacology Psychoses Psychotic Disorders - diagnosis Psychotic Disorders - genetics Psychotic Disorders - metabolism Publishing Schizophrenia Terminology as Topic
Title	Clinically meaningful biomarkers for psychosis: A systematic and quantitative review
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