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A Clinician's Perspective on Biomarkers.

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Date
2018-04-27
Authors
Rush, A John
Ibrahim, Hicham M
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Abstract
Psychiatrists and mental health professionals regularly perform various clinical tasks (e.g., detection, differential diagnosis, prognostication, treatment selection and implementation). How well they perform each of these tasks has a direct impact on patient outcomes. Measurement-based care has brought greater precision to these tasks and has improved outcomes. This article provides an overview of the types of biomeasures and biomarkers, the clinical uses of biomarkers, and the challenges in their development and clinical use. Although still in their infancy, biomarkers hold the promise of bringing even greater precision and even better outcomes in mental health. Biomeasures that could become biomarkers include genetic, proteomic, metabolomic, and immunologic measures, as well as physiological, functional, and brain structural measures. Mechanistic markers reflect and are based on the specific pathobiological processes that are involved in the development of a clinically defined condition. Some clinically relevant biomarkers may rely on this mechanistic understanding while others may not. Clinical biomarkers serve three broadly defined goals. Diagnostic markers define what is wrong. Prognostic markers define what will happen in the natural course of the condition, although they may also predict the course of illness during treatment. Theranostic markers address issues pertinent to treatment by defining whether, when, whom, and how to treat. Other biomarkers may be used to monitor the overall effect of treatment regardless of the therapeutic effects or to monitor the specific therapeutic effects of the intervention on the disorder itself. Biomarkers can also be used to estimate susceptibility/risk of developing the condition or the biological consequences of having had the disorder.
Type
Journal article
Subject
bio-measures
biomarker
prognostication. diagnosis
psychiatry
treatment selection
Permalink
https://hdl.handle.net/10161/24817
Published Version (Please cite this version)
10.1176/appi.focus.20170044
Publication Info
Rush, A John; & Ibrahim, Hicham M (2018). A Clinician's Perspective on Biomarkers. Focus (American Psychiatric Publishing), 16(2). pp. 124-134. 10.1176/appi.focus.20170044. Retrieved from https://hdl.handle.net/10161/24817.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Augustus John Rush

Adjunct Professor in the Department of Psychiatry and Behavioral Sciences
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