The precise roles of most biomarkers in the management of septic patients have not been well defined, and of the many biomarkers that have been studied, only a few have been evaluated in large or repeated studies.

As such, it is not possible to draw any reliable conclusions about which compounds could be considered as the most “promising” candidates. Even the biomarkers that had an AUC > 0.8 for diagnosis or prognosis, making them potentially more interesting for further study, were evaluated in studies with a high risk of bias.

Moreover, while there are multiple putative biomarkers, rarely have they been compared against each other to determine how they differ in what they are measuring, and which does it better.

Almost all studies report a single marker in isolation, but given the complexity of sepsis, surely these markers are not biologically independent, so how can we know which is best to use?

It is therefore important to develop a more rigorous, standardized methodology to assess sepsis biomarkers and identify those that can provide valuable, clinically relevant information.

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