Biomarkers for advancing diagnosis and prognosis in stroke

Summary The complexity and incomplete understanding of the pathophysiology of stroke poses substantial challenges to personalised medicine and the development of novel therapies, as reflected in the neutral results of many randomised trials. Current clinical algorithms lack the precision to diagnose stroke before hospital admission, predict disease progression and recovery, or assess recurrence risk. Biomarkers are urgently needed, yet the absence of a robust evidence base hinders their clinical translation. To lay the groundwork for addressing this knowledge gap, an international multidisciplinary panel of stroke experts conducted a literature review that informed a Delphi consensus process. The stroke experts panel proposes 17 research priorities and five minimum reporting datasets for stroke biomarker studies, each corresponding to a key domain of stroke care: prehospital diagnosis, ischaemic stroke progression, atrial cardiopathy, plaque vulnerability, and intracerebral haemorrhage. This framework will promote consistency and collaboration towards the discovery, validation, and clinical translation of biomarkers to improve stroke care.