L'obsessió per obtenir marcadors que siguin capaços de predir malalties topa amb els mètodes utilitzats per avaluar la seva utilitat. Des del darrer Annals posen ordre a les idees i als fets, semblantment com ho van fer els de Medical decision making fa uns mesos. Objectiu final: que els biomarcadors siguin objecte d'assaigs clínics. De no fer-ho ens hi juguem molts doblers i fins i tot la QALE.
Destaco això de l'abstract:
De la mateixa manera que la borsa descompta a 3-6 mesos el que passa a l'economia real, els biomarcadors descompten el que passarà a la pràctica de la medicina en el futur..Treatment selection markers, sometimes called predictive markers, are factors that help clinicians select therapies that maximize good outcomes and minimize adverse outcomes for patients. Existing statistical methods for evaluating a treatment selection marker include assessing its prognostic value, evaluating treatment effects in patients with a restricted range of marker values, and testing for a statistical interaction between marker value and treatment. These methods are inadequate, because they give misleading measures of performance that do not answer key clinical questions about how the marker might help patients choose treatment, how treatment decisions should be made on the basis of a continuous marker measurement, what effect using the marker to select treatment would have on the population, or what proportion of patients would have treatment changes on the basis of marker measurement
PD. Deures: llegir el comentari del gran Quim Monzó a LV.
