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 evidence gap map is useful to visualise the areas with abundant or limited biomarker research activity in different CVDs. It is essential to note that this map reports activity and cannot be used to judge the quality or strength of the research findings.

This evidence gap map is a matrix with population serving as rows and cardiovascular disease (CVD) serving as columns. The size of the bubbles in each cell of the matrix reflects the number of studies of a particular population and CVD in that cell. Each cell is also segmented by biomarker type. The legend at the bottom of the map highlights the colours used to represent the different biomarker types.

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 each biomarker type in the specific cell. 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 the published abstract.

Filters are also available to restrict display to studies that use, for example, artificial intelligence, mendelian randomisation, meta-analysis 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.

How to cite

Plans-Beriso E, Cierco Jimenez RC, Erady C, Hernández O, Barahona-López C, Babb-de-Villiers C, Diez P, Turner H, Fernández de Larrea N, Petrova D, Fernández-Martínez NF, García-Ovejero E, Craciun O, Arruabarrena 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 evidence gap map (EGM) was created using EPPI-Mapper web app.