A word of caution on using tumor biomarker reference change values to guide medical decisions and the need for alternatives

What is it about?

In a recent study from the EFLM working group on biological variation, the biological variation of tumor markers has been investigated and estimates of the within and between subject biological variations were obtained. Based on their results the authors make recommendations on the use of reference change values for follow-up and clinical decision-making in tumor patients. This letter summarizes some significant objections to this recommendation that is presented as a major outcome of the EFLM working group study.

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