Fluid-Based Protein Biomarkers in Traumatic Brain Injury: The View from the Bedside.

Published version
Repository DOI

Change log
Authors
Helmy, Adel 
Abstract

There has been an explosion of research into biofluid (blood, cerebrospinal fluid, CSF)-based protein biomarkers in traumatic brain injury (TBI) over the past decade. The availability of very large datasets, such as CENTRE-TBI and TRACK-TBI, allows for correlation of blood- and CSF-based molecular (protein), radiological (structural) and clinical (physiological) marker data to adverse clinical outcomes. The quality of a given biomarker has often been framed in relation to the predictive power on the outcome quantified from the area under the Receiver Operating Characteristic (ROC) curve. However, this does not in itself provide clinical utility but reflects a statistical association in any given population between one or more variables and clinical outcome. It is not currently established how to incorporate and integrate biofluid-based biomarker data into patient management because there is no standardized role for such data in clinical decision making. We review the current status of biomarker research and discuss how we can integrate existing markers into current clinical practice and what additional biomarkers do we need to improve diagnoses and to guide therapy and to assess treatment efficacy. Furthermore, we argue for employing machine learning (ML) capabilities to integrate the protein biomarker data with other established, routinely used clinical diagnostic tools, to provide the clinician with actionable information to guide medical intervention.

Description

Peer reviewed: True


Publication status: Published


Funder: NIHR Brain Injury MedTech Cooperative

Keywords
biomarkers, brain, clinical, injury, mechanistic, phenotypes, utility, Humans, Brain Injuries, Traumatic, Biomarkers, Machine Learning, ROC Curve
Journal Title
Int J Mol Sci
Conference Name
Journal ISSN
1661-6596
1422-0067
Volume Title
24
Publisher
MDPI AG
Sponsorship
NIHR Cambridge Biomedical Research Campus (MR/Y008502/1, MR/X021882/1)