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Biomarcadores predictivos para adultos asintomáticos: oportunidades, riesgos y orientación para la práctica general
Christian J Wiedermann1, Giuliano Piccoliori1, Adolf Engl1
1Institute of General Practice and Public Health, Claudiana-College of Health Professions, 39100 Bolzano, Italy.
Diagnostics (Basel, Switzerland)
|January 28, 2026
Resumen
El uso de biomarcadores en la prevención está creciendo, pero muchos carecen de utilidad clínica. Los médicos de atención primaria (médicos de atención primaria) deben interpretar los resultados cuidadosamente para garantizar una atención equitativa y centrada en el paciente y evitar daños potenciales.
Área de la Ciencia:
- Diagnóstico biomédico y medicina preventiva.
- Investigación en atención primaria y servicios de salud.
Sus antecedentes:
- La prevención basada en biomarcadores se está expandiendo debido a los diagnósticos moleculares y las pruebas directas al consumidor (DTC).
- Los médicos de atención primaria (médicos de atención primaria) enfrentan desafíos para interpretar los resultados de los biomarcadores fuera de las pautas establecidas.
- Esto afecta la comunicación, el uso de recursos y la atención equitativa en los entornos de atención primaria.
Objetivo del estudio:
- Revisar el valor predictivo, las limitaciones y las implicaciones de los biomarcadores en adultos asintomáticos.
- Evaluar biomarcadores para afecciones neurodegenerativas, cardiovasculares y de envejecimiento.
- Informar la integración responsable de biomarcadores en la medicina preventiva.
Principales métodos:
- Revisión narrativa que sintetiza la evidencia de estudios poblacionales, pautas e investigación de comunicación.
- Se centró en puntuaciones de riesgo poligénico, pruebas genéticas DTC y marcadores cardiovasculares/neurodegenerativos específicos.
- Se evaluó la validez analítica, la validez clínica y la utilidad clínica para uso preventivo.
Principales resultados:
- Algunos biomarcadores (p. ej., hs-cTn, NT-proBNP, Lp(a), CAC, p-tau) muestran una sólida validez predictiva.
- Muchos biomarcadores comercializados carecen de utilidad clínica, beneficios accionables o tienen un rendimiento deficiente en la atención primaria.
- Las consecuencias imprevistas incluyen el sobre diagnóstico, la angustia y la ampliación de las desigualdades en salud.
Conclusiones:
- Una minoría de biomarcadores cumple los criterios para uso preventivo en la práctica general.
- Los médicos de atención primaria son cruciales para contextualizar los resultados, la toma de decisiones compartida y la mitigación de daños.
- La integración responsable requiere una comunicación clara, salvaguardias éticas, evidencia sólida y apoyo del sistema.
Palabras clave:
biomarcadorespruebas directas al consumidorconsideraciones éticasmédicos de atención primariasobre diagnósticopuntuaciones de riesgo poligénicomedicina preventivaatención primariacomunicación de riesgosMás Videos Relacionados
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