About the map

The PROPHET project, funded by the European Union's Horizon Europe research and innovation program, aims to assess the effectiveness, clinical utility, key success factors, and gaps in personalised preventive approaches for healthcare settings. One of the main task focuses on biomarkers for personalised prevention in the general adult population and their integration with digital technologies. The objective of the task is to highlight gaps in biomarkers research for primary and secondary prevention for cancer, cardiovascular, and neurodegenerative diseases.

Three rapid scoping reviews were conducted in parallel by three research teams, one for each group of diseases: cancer, cardiovascular and neurodegenerative diseases. The reviews used a common protocol and framework for searching, data extraction and the representation of results, with disease specific corresponding information and specifications. The following evidence and gap map is a product of these scoping reviews.

Secondary prevention involves the detection of undiagnosed disease, or detection of early disease at the earliest possible point at which an intervention might be made to avoid disease progression. We have, therefore, explored whether the evidence has captured risk estimators for different subgroups of interest that are based on clinical conditions and/or risk factors. These studies are likely to be particularly valuable as they could help refine or personalised prevention strategies. This map illustrates current available biomarkers in cardiovascular diseases that can help to personalise secondary prevention strategies by taking into account different high-risk subpopulations.

Eligibility criteria of included articles

	Inclusion	Exclusion
Population	Adult general population (≥ 18 years). Specific high-risk adult population subgroups: For all: Smoking, alcohol consumption, diabetes, obesity, family history For CVD: arterial hypertension, hypercholesterolemia or dyslipidemia, chronic kidney disease. Any country of origin.	Pregnancy.
Concept	Studies with a focus on molecular, cellular, physiological, anthropometric, and imaging biomarkers used for individualised primary or secondary prevention of the following diseases: CVD: ischemic heart disease, stroke, cardiomyopathy and myocarditis, atrial fibrillation and atrial flutter, aortic aneurysm, nonrheumatic valvular heart disease (calcific aortic valve disease, degenerative mitral valve disease), peripheral artery disease. In primary prevention: Biomarkers should stratify individuals into groups. In secondary prevention Biomarkers should improve the screening or early detection: stratifying different risk groups. improving the sensitivity, specificity, and time of diagnosis for new subgroups of individuals.	Studies with a focus on diagnostic biomarkers not used for secondary prevention. Studies with a focus on biomarkers used for prognosis. Any infectious aetiology for the cardiovascular diseases included in this scoping review. Studies focusing only on well-established biomarkers used for the diagnosis of any of the diseases, infections, and conditions in the specific high-risk population groups.
Context	Clinical or Public Health settings. English language only. Any geographical setting.	Studies published before 2020.
Type of evidence	Reviews: Umbrella review, systematic review, meta-analysis, scoping review. Experimental and quasi-experimental study designs: Randomised controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies. Analytical observational study designs: Prospective and retrospective cohort studies, case-control studies, and analytical cross-sectional studies. Descriptive observational study designs: Descriptive cross-sectional studies.	Editorials and opinion pieces. Narrative reviews. Protocols. Qualitative study designs. Delphi studies. Conference abstracts, conference reports. Clinical practice guidelines. Basic research (i.e., laboratory research in animals, human tissues, and cell lines). Case reports and case series.
Sources	MEDLINE via Ovid. Embase via Ovid. Embase preprints via Ovid.

Viewing the map

This map is a matrix with biomarkers/subcategories serving as rows and cancer/populations serving as columns. Each cell contains one or more squares that represent the number of articles for a particular study design. More squares represent more articles.

To view the articles in a particular cell, move the mouse pointer over it. This will display the total number of articles that correspond to this specific cell, broken down by study design (refer to the legend at the bottom of the page). When you click it, a menu will appear on the right-hand side of the screen containing all the article titles and meta-data, as well as a summary of the article based on the published abstract.

This evidence and gap map is useful because it allows us to visualise the evidence – areas with abundant evidence and areas with limited evidence. It is essential to note, however, that the presence of a large quantity of evidence in one area does not necessarily equate to evidence of high quality or strength. Filters are also available to restrict evidence shown to studies that use artificial intelligence, mendelian randomisation, or a particular study design.

Associated report

D.2.1. Three rapid scoping reviews mapping available biomarkers, including genetics, for risk prediction and stratification in cancer, cardiovascular and neurodegenerative diseases, and their potential integration with digital technologies.

Funding

Co-funded by the European Union

UK participant in Horizon Europe Project PROPHET is supported by UKRI grant number 10040946 (Foundation for Genomics & Population Health).

How to cite

Plans-Beriso E, Cierco Jimenez RC, Erady C, Hernández O, Barahona-López C, Babb-de-Villiers C, Diez-Echave P, Turner H, Fernández de Larrea N, Petrova D, Fernández-Martínez NF, García-Ovejero E, Craciun O, Wilson H, Arruabarrena-Blanco E, Granero B, Fernández-Navarro P, García García-Esquinas E, Kuhn I, Jiménez-Planet V, Moreno V, Rodríguez Artalejo F, Sánchez MJ, Pollán M, Blackburn L, Kroese M, Perez-Gomez B. Interactive Gap Maps on Available Biomarkers for Risk Prediction and Stratification in Cancer, Cardiovascular, and Neurodegenerative Diseases [Internet]. OSF; 2023 Jul 17 [cited 2023 Jul 17]. Available from: osf.io/48g5p.

This interactive EGM was created using EPPI-Mapper web app.