Biomarkers in medicine

The utility of biomarkers is the reason for the funding of projects based on new biomarkers, which has increased in the last few years. Once a successful biomarker diagnostic is developed the cost for screening large populations is reduced and this results in lower health-care costs in the short term. In the long term, this will facilitate the increased use of screening tests for a greater number of diseases. The increased screening of populations facilitates early diagnosis, better control of chronic conditions, and improved health in large populations, thereby improving patient care and reducing the cost of health care. Current screening tools can be resource intensive, expensive, and requiring expert examination of the data (mammograms, ultrasound, biopsy, etc.), and this causes their use to be limited. A biomarker test is generally less expensive and invasive than other forms of testing facilitating a more efficient use of medical resources while improving health care. This becomes clear when we look at the use of diagnostic tests in the clinic. The measurement of cholesterol, for example, is so inexpensive and noninvasive that many people are tested twice a year in their entire life. This results in early detection of a problem and early treatment reducing the risk of disease resulting from high cholesterol.

The ultimate goal of biomarker discovery is the development of screening tests to detect diseases before they are symptomatic or at a stage where they are more effectively treated. This is an ambitious goal and will require many years or decades of basic and medical research. Each discovered and validated biomarker is a contribution toward this goal.

The short-term goal of many researchers in the field of medical biomarker discovery is to achieve two things. The first is the discovery and validation of bio-markers for diagnostic/prognostic purposes and to improve patient care. The second is to provide information that will assist in the understanding of the pathology of the disease. Both of these goals are worked on together using the same data and the same experiments.

The data generated from the discovery of diagnostic biomarkers are valuable information for basic science and research into disease pathology. Information about changes in the concentration of a biomolecule, modified forms of a compound, changes in protein expression, and posttranslational modifications, just to name a few, provides clues to the changes in the cellular machinery and pathways. This information can be used to determine where one should look for the changes that contribute to the disease pathology. Biomarkers will not provide all of the information, but they are a good tool for sorting out where to start looking.

The real goal here is to improve the information that a test can provide the physician in:

• Differentiating diseases that are currently difficult to separate or diagnose

• Detecting a disease condition earlier when treatments are more effective

• Understanding the pathology of a condition that is affecting a patient

• Assisting in choosing the best course of treatment

• Reducing the negative side effects of a treatment

• Monitoring the course of treatment to determine effectiveness

In summary, the proposed role of the biomarkers in medicine is to facilitate early diagnosis, the customization of treatment, and improved quality and quantity of life for the patient.

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