Evaluation of Biomarkers in Critical Care and Perioperative Medicine

A Clinician's Overview of Traditional Statistical Methods and Machine Learning Algorithms

Sabri Soussi, M.D., M.Sc.; Gary S. Collins, Ph.D.; Peter Jüni, M.D.; Alexandre Mebazaa, M.D., Ph.D.; Etienne Gayat, M.D., Ph.D.; Yannick Le Manach, M.D., Ph.D.


Anesthesiology. 2020;134(1):15-25. 

In This Article

Different Biomarker Development Phases

A biomarker may have several roles in clinical practice. It may provide a diagnosis, have a prognostic role, be used to assess treatment responsiveness, or to guide the use of pharmaceuticals in treatment. Biomarkers were also proposed to identify critically ill patients' molecular subphenotypes, regardless of outcome. Examples of biomarkers with different roles used in critical care and perioperative medicine are presented in Table 1.[6–14]

Biomarker development is a multiphased process requiring different statistical methods to accomplish the various objectives. The three phases of biomarker development, in chronological order, include (1) discovery; (2) evaluation of predictive (or diagnostic) accuracy; and (3) assessment of incremental value when added to existing clinical prediction (or diagnostic) tools.[15]