The development and evaluation of novel biomarkers and testing strategies requires a close examination of existing clinical pathways, including mapping of current pathways and identifying areas of unmet need. This approach enables early recognition of analytical and clinical performance criteria to guide evaluation studies, in a cyclical and iterative manner, all the time keeping the clinical pathway and patient health outcomes as the key drivers in the process. The Test Evaluation Working Group of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM TE-WG) https://www.eflm.eu/site/page/a/1158 has published a conceptual framework of the test evaluation cycle which is driven by the clinical pathway, inherent to which is the test purpose and role within the pathway that are defined by clinical need. To supplement this framework, the EFLM TE-WG has also published an interactive checklist for identifying unmet clinical needs for new biomarkers; a practical tool that laboratories, clinicians, researchers and industry can equally use in a consistent manner when new tests are developed and before they are released to the market. It is hoped that these practical tools will provide consistent and appropriate terminology in this diverse field and offer a platform that facilitates greater consultation and collaboration between all stakeholders. The checklist should assist the work of all colleagues involved in the discovery of novel biomarkers and implementation of new medical tests. The tool is aligned with the IOM recommendations and the FDA and CE regulating body's requirements.

Abbott Diagnostics Wiesbaden Germany

ARC Consulting Perth Australia

Clinical Chemistry Department Altnagelvin Hospital Western Health and Social Care Trust Londonderry N Ireland United Kingdom

Department of Clinical Biochemistry and Hematology Medical Faculty in Pilsen Charles University Czech Republic

Department of Clinical Chemistry and Laboratory Medicine Leiden University Medical Centre The Netherlands For the Test Evaluation Working Group of the European Federation of Clinical Chemistry and Laboratory Medicine

Department of Clinical Epidemiology Biostatistics and Bioinformatics Academic Medical Center University of Amsterdam The Netherlands

Laboratory of Clinical Biochemistry Haukeland University Hospital Helse Bergen HF Bergen Norway Norwegian Quality Improvement of Laboratory examinations Haraldsplass Deaconess Hospital Bergen Norway and Department of Global Health and Primary Health Care University of Bergen Norway

Medical and Scientific Affairs CPS Roche Diagnostics GmbH Mannheim Germany

New South Wales Health Pathology Department of Clinical Chemistry and Endocrinology Prince of Wales Hospital and School of Medical Sciences University of New South Wales Australia School of Public Health University of Sydney Australia For the Test Evaluation Working Group of the European Federation of Clinical Chemistry and Laboratory Medicine

School of Medicine University of Notre Dame Sydney Australia National Health and Medical Research Council Clinical Trials Centre University of Sydney Australia

The Christie Pathology Partnership The Christie NHS Foundation Trust Manchester United Kingdom

Thermo Fisher Scientific Clinical Mass Spectrometry Clinical Diagnostics Systems United Kingdom