At MSACL 2025, a Thermo Fisher Scientific–sponsored workshop led by Qin Fu addressed one of the most persistent challenges in proteomics: how to efficiently and reproducibly translate biomarker discoveries into clinically meaningful assays. Drawing on experience spanning academia and industry—including prior work in Jennifer Van Eyk’s lab—Fu shared practical insights into building a scalable, end-to-end biomarker discovery-to-validation pipeline.<img src="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/Thermo_Fisher_Scientific_Accelerating_Biomarker_Discovery_and_Validation_From_Discovery_to_Clinical_Utility_9558364cf2.jpg" alt="Thermo Fisher Scientific: Accelerating Biomarker Discovery and Validation: From Discovery to Clinical Utility" srcset="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/thumbnail_Thermo_Fisher_Scientific_Accelerating_Biomarker_Discovery_and_Validation_From_Discovery_to_Clinical_Utility_9558364cf2.jpg 245w," sizes="100vw" width="1024" height="512">The session highlighted how emerging mass spectrometry technologies, automation, and informatics are reshaping biomarker research—reducing complexity, improving reproducibility, and accelerating the path to clinical utility.<h3>The three tiers of biomarker assays</h3>The workshop opened with a review of the widely accepted three-tier framework that guides biomarker development from early discovery through clinical validation:<h4>Tier 3 – discovery</h4>Exploratory, untargeted workflows such as data-dependent acquisition (DDA) and data-independent acquisition (DIA). These approaches prioritize breadth, enabling the identification of large-magnitude biological changes across hundreds to thousands of analytes, typically with low-to-moderate precision and without internal standards.<h4>Tier 2 – verification</h4>Research-grade targeted assays, including parallel reaction monitoring (PRM) and multiple reaction monitoring (MRM). These methods focus on tens to hundreds of analytes, delivering improved precision and repeatability to confirm trends observed during discovery.<h4>Tier 1 – validation</h4>Clinically validated assays designed to meet rigorous quality and regulatory standards. These workflows incorporate internal standards and strict quality controls to ensure quantitative reproducibility suitable for clinical and translational use.Each tier represents a critical step toward ensuring that biomarker candidates can ultimately deliver reliable patient benefit.<h3>The central challenge: from sample to signal</h3>Reliable biomarker development depends on consistency across the entire analytical workflow—from biological sample preparation to mass spectrometry data acquisition and downstream analysis. Every step introduces potential sources of variability, and minimizing this analytical noise while preserving biological signal is essential.Automation emerged as a central theme of the workshop. Beyond improving throughput, automation fundamentally enhances reproducibility. Robotic sample preparation reduces variability associated with digestion, pipetting, and handling—enabling consistent performance across hundreds or thousands of samples, a scale that is difficult to achieve manually.<h3>Technological innovation powering a paradigm shift</h3>Recent advances in mass spectrometry are enabling researchers to bridge the gap between discovery and validation more efficiently than ever before. The workshop highlighted several Thermo Fisher Scientific platforms driving this shift:<ul><li>Thermo Scientific Orbitrap Astral mass spectrometer Optimized for discovery workflows, the Astral system delivers rapid acquisition and deep proteome coverage while maintaining high precision across large cohorts.</li><li>Thermo Scientific Stellar platform Designed for high-throughput targeted quantification, the Stellar platform supports scalable PRM workflows. Features such as PRM Conductor enable adaptive retention time tracking, which is essential for robust performance in large studies.</li><li>Thermo Scientific OptaSpray Ion Source (under evaluation) A hands-free ionization source designed to deliver consistent spray performance with simplified maintenance, supporting reproducibility across thousands of injections.</li></ul>Together, these technologies create a smoother continuum across assay tiers, shortening timelines and reducing barriers to clinical translation.<h3>Case study: Inflammatory bowel disease (IBD) cohort</h3>A key highlight of the presentation was a large-scale biomarker study in inflammatory bowel disease (IBD). The team conducted a 500-sample discovery analysis, followed by validation in a 1,000-sample cohort. Discovery was performed using the Orbitrap Astral system, while targeted validation employed the Stellar platform.This integrated approach successfully confirmed established biomarkers such as C-reactive protein (CRP) while also identifying novel protein candidates with strong translational potential. Importantly, these markers demonstrated consistency across discovery and validation data sets—underscoring the power of advanced instrumentation combined with robust workflows and informatics.<h3>From high quantity to high quality</h3>Historically, biomarker discovery has involved a tradeoff between throughput and data quality. The workshop demonstrated that this compromise is no longer necessary. By integrating automated sample preparation, optimized informatics, and next-generation mass spectrometry, researchers can now generate high-quality, high-throughput data that is both scalable and reproducible.This shift enables faster discovery while increasing confidence that candidate biomarkers are ready for downstream validation and clinical follow-up.<h3>The future of biomarker translation</h3>The workshop concluded on an optimistic note. Innovations in proteomics are fundamentally transforming biomarker development—shortening timelines, reducing costs, and accelerating the transition from discovery to clinical application.By integrating platforms such as Orbitrap Astral, Stellar, and OptaSpray, Thermo Fisher Scientific is helping advance a new era of translational biomarker science—where precision, scalability, and reliability work together to deliver meaningful clinical impact.Watch the full workshop recording to <a target="_blank" rel="noopener noreferrer" href="https://www.youtube.com/watch?v=ziyffQzZTwk">explore the data, workflows, and results behind this end-to-end approach to biomarker discovery and validation.</a><h3>Intended use disclaimer</h3>General Laboratory Equipment – Not For Diagnostic Procedures. Thermo Scientific general laboratory equipment, consumables, and software are intended for research, academic, and industrial use only. These products are not designed, validated, or approved for in vitro diagnostic or clinical use. Use of these products for diagnostic purposes may result in inaccurate results and potential health and safety risks.<h3>Resources</h3>Workshop &amp; educational content<ul><li>MSACL 2025 workshop recording: <a target="_blank" rel="noopener noreferrer" href="https://www.youtube.com/watch?v=ziyffQzZTwk">Accelerating Biomarker Discovery and Validation</a></li><li>Other MSACL workshop recordings coming soon</li></ul>Thermo Fisher Scientific Product Pages<ul><li><a target="_blank" rel="noopener noreferrer" href="https://lcms.labrulez.com/products/2207">Thermo Scientific TSQ Certis Mass Spectrometer</a></li><li><a target="_blank" rel="noopener noreferrer" href="https://lcms.labrulez.com/products/836">Thermo Scientific Orbitrap Astral Mass Spectrometer</a></li><li><a target="_blank" rel="noopener noreferrer" href="https://lcms.labrulez.com/products/1149">Thermo Scientific Stellar Mass Spectrometer</a></li><li><a target="_blank" rel="noopener noreferrer" href="https://www.thermofisher.com/order/catalog/product/B51004132">Thermo Scientific OptaSpray Ion Source</a></li><li><a target="_blank" rel="noopener noreferrer" href="https://www.thermofisher.com/content/lifetech/global/en/home/industrial/mass-spectrometry/mass-spectrometer-price-affordability-programs.html">Mass spectrometer affordability programs</a> (Refurbished MS, trade-in, financing/ leasing)</li></ul>Peer-Reviewed Literature<ul><li>Baker ES et al. <a target="_blank" rel="noopener noreferrer" href="https://europepmc.org/article/MED/22943415">Mass spectrometry for translational proteomics: progress and clinical implications.</a> Genome Medicine (2012).</li><li>Fu Q et al. <a target="_blank" rel="noopener noreferrer" href="https://academic.oup.com/clinchem/article/62/1/198/5611803">An Empirical Approach to Signature Peptide Choice for Selected Reaction Monitoring.</a> Clinical Chemistry (2016).</li><li>Fu Q et al. <a target="_blank" rel="noopener noreferrer" href="https://doi.org/10.1002/mas.21750">Automated proteomic sample preparation: The key component for high throughput and quantitative mass spectrometry analysis.</a> Mass Spectrometry Reviews (2023).</li><li>Fu Q et al. <a target="_blank" rel="noopener noreferrer" href="https://doi.org/10.1021/acs.jproteome.7b00623">Highly Reproducible Automated Proteomics Sample Preparation Workflow for Quantitative Mass Spectrometry.</a> Journal of Proteome Research (2018).</li><li>Fu Q et al. <a target="_blank" rel="noopener noreferrer" href="https://doi.org/10.1002/anie.202409446">A Proteomics Pipeline for Generating Clinical Grade Biomarker Candidates from DIA-MS Discovery.</a> Angewandte Chemie International Edition (2024).</li><li>Fu Q et al. <a target="_blank" rel="noopener noreferrer" href="https://doi.org/10.1002/anie.202507610">Development and Clinical Evaluation of a Multiplexed Health Surveillance Panel Using Ultra High-Throughput PRM-MS in an Inflammatory Bowel Disease Cohort.</a> Angewandte Chemie International Edition (2025).</li></ul><blockquote>Visit us on&nbsp;<a target="_blank" rel="noopener noreferrer" href="https://www.linkedin.com/showcase/72003132/admin/dashboard/">LinkedIn:</a>&nbsp;#Omics #BiomarkerDiscovery #MassSpectrometry #ClinicalResearch</blockquote>

Accelerating Biomarker Discovery and Validation: From Discovery to Clinical Utility

Choosing the correct membrane for a syringe filter is an important step in achieving dependable and reproducible analytical results. Whether you work with nylon, PTFE, hydrophilic PTFE, or cellulose acetate filters, the membrane material directly influences filtration efficiency, sample integrity, and overall method performance. In this article, we explore why membrane selection matters, review the characteristics of common membrane materials, and provide practical guidance for choosing the best option for your application.<h4>Why Are Syringe Filters Important?</h4>Syringe filters are routinely used to remove particulate matter from samples prior to analysis. Unfiltered samples can introduce contaminants into chromatographic systems, leading to clogged columns, increased system backpressure, reduced instrument lifetime, and compromised analytical performance.Selecting an appropriate membrane is therefore essential for developing a robust and reliable HPLC workflow. An ideal membrane effectively removes particles while preserving the original composition of the sample. Since the membrane comes into direct contact with both the analyte and the sample solvent, compatibility must always be carefully considered.<img src="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/KNAUER_syringe_filters_f3eaa1381e.webp" alt="KNAUER: Syringe filters" srcset="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/thumbnail_KNAUER_syringe_filters_f3eaa1381e.webp 156w," sizes="100vw" width="720" height="720">Let’s examine the key factors involved in choosing the most suitable membrane.<h4>Step 1: Consider the Nature of Your Sample</h4>The first and most important factor is the chemical composition of the sample and the solvents involved. Different membrane materials offer different chemical resistance and sample interaction characteristics.<h5>Nylon Membranes</h5>Nylon is one of the most commonly used membrane materials in HPLC laboratories because of its broad compatibility with aqueous solutions and many organic solvents.Recommended applications:<ul><li>Routine filtration of HPLC samples containing aqueous solvents, organic solvents, or mixed mobile phases.</li><li>Removal of suspended particles prior to chromatographic injection.</li><li>General-purpose laboratory filtration where versatility is required.</li></ul>Avoid using Nylon when:<ul><li>Working with strongly acidic solutions or samples with pH values below 3.</li><li>Filtering protein-containing samples, since proteins can adsorb to the membrane surface and reduce recovery.</li></ul><h5>Cellulose Acetate (CA) Membranes</h5>Cellulose acetate membranes exhibit very low protein binding and are widely used for biological and biochemical applications.Recommended applications:<ul><li>Filtration of biological fluids such as serum, plasma, and cell culture media.</li><li>Applications where protein recovery must be maximized.</li><li>Aqueous laboratory procedures involving enzymes or other sensitive biomolecules.</li></ul>Avoid using CA when:<ul><li>Filtering samples containing organic solvents that may damage the membrane.</li><li>Working under highly acidic or highly alkaline conditions that could degrade the material.</li></ul><h5>Hydrophilic PTFE (hPTFE) Membranes</h5>Hydrophilic PTFE combines the exceptional chemical resistance of PTFE with the ability to process aqueous samples without pre-wetting.Recommended applications:<ul><li>Filtration of both aqueous and organic solutions.</li><li>HPLC sample preparation involving mixed solvent systems.</li><li>Applications requiring compatibility across a broad pH range.</li></ul>Avoid using hPTFE when:<ul><li>Processing highly viscous samples that may rapidly clog the membrane.</li><li>Performing PFAS analysis, where fluorinated materials may introduce unwanted contamination.</li></ul><h5>PTFE Membranes</h5>PTFE membranes provide excellent resistance to aggressive chemicals and are especially suitable for demanding solvent environments.Recommended applications:<ul><li>Samples containing strong acids, strong bases, or aggressive organic solvents.</li><li>Environmental, industrial, and chemical analyses involving non-polar solvents such as hexane, toluene, or acetone.</li><li>Filtration of predominantly organic solvent-based samples.</li></ul>Avoid using PTFE when:<ul><li>Filtering aqueous solutions without first wetting the membrane or using a hydrophilic PTFE alternative.</li><li>Working with protein-rich or highly hydrophilic samples where adsorption or poor wetting may occur.</li></ul><img src="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/KNAUER_Fig_1_4_Nylon_top_left_CA_top_right_h_PTFE_bottom_left_and_PTFE_bottom_right_86a6481d0b.jpg" alt="KNAUER: Fig. 1–4 Nylon (top left), CA (top, right), hPTFE (bottom, left), and PTFE (bottom, right)" srcset="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/thumbnail_KNAUER_Fig_1_4_Nylon_top_left_CA_top_right_h_PTFE_bottom_left_and_PTFE_bottom_right_86a6481d0b.jpg 157w," sizes="100vw" width="1111" height="1107"><h4>Step 2: Select an Appropriate Pore Size</h4>The membrane pore size determines the level of particulate removal and should be selected according to the requirements of the analytical method.Common pore sizes include:<ul><li>0.2 µm – Suitable for removing very fine particles and for sterile filtration. Frequently used in UHPLC and LC-MS workflows.</li><li>0.45 µm – The standard choice for most routine HPLC applications.</li><li>1.0 µm and larger – Often used for coarse filtration or as a pre-filtration step for heavily contaminated samples.</li></ul>Choosing the correct pore size helps protect instrumentation while minimizing unnecessary sample loss.<img src="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/KNAUER_Fig_1_2_0_22_m_left_and_0_45_m_right_Nylon_Syringe_Filter_48ffc3d777.jpg" alt="KNAUER: Fig. 1–2 0.22 µm (left), and 0.45 µm (right) Nylon Syringe Filter" srcset="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/thumbnail_KNAUER_Fig_1_2_0_22_m_left_and_0_45_m_right_Nylon_Syringe_Filter_48ffc3d777.jpg 245w," sizes="100vw" width="1177" height="573"><h4>Step 3: Verify Chemical Compatibility</h4>Before selecting a membrane, confirm that it is compatible with both the sample matrix and the solvents present. Incompatible materials may swell, degrade, release extractables, or alter the composition of the sample.Consulting a solvent compatibility chart is highly recommended whenever unfamiliar solvents or mixtures are involved.<h4>Step 4: Match the Membrane to the Application</h4>Different analytical applications often benefit from specific membrane types.<h5>HPLC Analysis</h5><ul><li>Nylon and PTFE membranes are among the most frequently used options due to their broad chemical compatibility and excellent filtration performance.</li></ul><h5>Protein and Biomolecule Analysis</h5><ul><li>CA, PVDF, and PES membranes are generally preferred because they exhibit low protein binding and help preserve sample recovery.</li></ul><h5>Microbiological Testing</h5><ul><li>Mixed cellulose ester (MCE) membranes are commonly employed for microbial monitoring and microbiological quality control procedures.</li></ul>Selecting a membrane tailored to the analytical objective can significantly improve data quality and method reliability.<h4>Step 5: Evaluate Product Quality and Certification</h4>Not all syringe filters are manufactured to the same standards. For critical applications, select products that comply with recognized quality systems and certifications such as ISO standards or CE requirements.This becomes particularly important in regulated industries, where traceability, consistency, and documented performance are essential.<h4>Practical Recommendations for Using Syringe Filters</h4>Following good filtration practices can further improve analytical performance.<ul><li>Pre-Wet Hydrophobic Membranes: Hydrophobic materials such as PTFE often require pre-wetting with a compatible organic solvent before filtering aqueous samples.</li><li>Avoid Excessive Pressure: Applying excessive force may rupture the membrane or cause leakage. Luer-lock syringes are recommended to provide secure connections and controlled pressure.</li><li>Use Filters Only Once: Syringe filters are intended for single-use operation. Reusing filters increases the risk of carryover and cross-contamination.</li><li>Dispose of Filters Properly: Used syringe filters should be discarded according to laboratory safety procedures and local waste disposal regulations.</li></ul><h4>Final Thoughts</h4>Selecting the right syringe filter membrane is a key factor in obtaining accurate, reproducible, and reliable analytical results. By considering sample composition, solvent compatibility, pore size, and application requirements, laboratories can choose filtration solutions that protect instruments, preserve sample integrity, and improve overall analytical performance.A carefully selected membrane may seem like a small detail, but it can have a substantial impact on the quality and robustness of your entire analytical workflow.<blockquote>If you want to optimize your HPLC workflow, check out our brand-new <a target="_blank" rel="noopener noreferrer" href="https://lcms.labrulez.com/products/2380">SEPAPURE Syringe Filter</a>.</blockquote>

How to Choose the Right Membrane for Your Syringe Filter

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KNAUER Eurospher II 100 CN (U)HPLC Columns for NP & RP (USP L10)

CN is one of the most versatile stationary phases that can be used in reversed phase mode as well as in normal phase mode. 

Cyano or CN for Normal Phase and Reversed Phase (USP L10)CN is one of the most versatile stationary phases that can be used in reversed phase mode as well as in normal phase mode. The cyano modification supports the π-π interaction as well as polar and hydrophobic interactions with low polarity solvents. These phases are preferred for compounds with double bonds and aromatic groups. Cyano bonded phases show unique selectivity for polar compounds and are more suitable than bare silica for normal phase (NP) gradient separations. The cyano functional group is a strong dipole that can interact with other dipoles or induce dipoles on solutes. These phases also exhibit moderate hydrophobicity due to the alkyl linker.Due to the quick equilibration time of the CN bonded phase, it is the best choice for gradient elution in normal phase mode. CN phases can be used as a less polar alternative to Si phases.The material is typically preferred for:<ul><li>Compounds with double bonds</li><li>Cyclic antidepressants</li></ul><img src="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/KNAUER_CN_4fff7a1e28.webp" alt="KNAUER: CN" srcset="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/thumbnail_KNAUER_CN_4fff7a1e28.webp 130w," sizes="100vw" width="358" height="428"><blockquote>Stationary phase Eurospher II 100 CN is provided in these column types: analytical, semi-preparative and preparative.</blockquote>Eurospher II 100 CN Analytical Columns are available with these parameters:<ul><li>Column length (mm): 50, 100, 150, 250</li><li>Column ID (mm): 3, 4, 4.6</li><li>Particle size (µm): 3, 5</li></ul>Eurospher II 100 CN Semi-Preparative Standard Columns are available with these parameters:<ul><li>Column length (mm): 30, 50, 125, 150, 250</li><li>Column ID (mm): 8, 16</li><li>Particle size (µm): 5, 10</li></ul><h3>KNAUER (U)HPLC Columns</h3>Widest range of HPLC and UHPLC columns for all separation modes and applications.<ul><li>Safe Investment: Robust and reliable columns for attractive price&nbsp;</li><li>Separation Mode: Reversed Phase, HILIC, Normale</li><li>Simplicity: Easy purchase via our online store with fast delivery</li><li>Application: All-rounder for research or highly specialised for high-throughput analysis? We have the best column for your requirements.</li><li>Flexibility: Wide selection of column and particle sizes, for (U)HPLC applications up to 1000 bar</li></ul>KNAUER offers the perfect column for any small molecule separation. No matter which separation mode, molecule and the mobile phase, we offer a suitable (U)HPLC stationary phase. Choose from a wide range of modifications, particle sizes and column dimensions to suit your application. To elongate the lifetime of your column, you can choose to use a suitable precolumn.<img src="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/KNAUER_KNAUER_U_HPLC_C8_and_C8_A_Columns_083c60f401.webp" alt="KNAUER: KNAUER (U)HPLC Columns" srcset="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/thumbnail_KNAUER_KNAUER_U_HPLC_C8_and_C8_A_Columns_083c60f401.webp 182w," sizes="100vw" width="787" height="674">

KNAUER Eurospher II 100 CN Prep HPLC Columns for NP & RP (USP L10)

Cyano or CN for Normal Phase and Reversed Phase (USP L10)CN is one of the most versatile stationary phases that can be used in reversed phase mode as well as in normal phase mode. The cyano modification supports the π-π interaction as well as polar and hydrophobic interactions with low polarity solvents. These phases are preferred for compounds with double bonds and aromatic groups. Cyano bonded phases show unique selectivity for polar compounds and are more suitable than bare silica for normal phase (NP) gradient separations. The cyano functional group is a strong dipole that can interact with other dipoles or induce dipoles on solutes. These phases also exhibit moderate hydrophobicity due to the alkyl linker.Due to the quick equilibration time of the CN bonded phase, it is the best choice for gradient elution in normal phase mode. CN phases can be used as a less polar alternative to Si phases.The material is typically preferred for:<ul><li>Compounds with double bonds</li><li>Cyclic antidepressants</li></ul><img src="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/KNAUER_CN_4fff7a1e28.webp" alt="KNAUER: CN" srcset="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/thumbnail_KNAUER_CN_4fff7a1e28.webp 130w," sizes="100vw" width="358" height="428"><blockquote>Stationary phase Eurospher II 100 CN is provided in these column types: analytical, semi-preparative and preparative.</blockquote>Eurospher II 100 CN Preparative Standard Columns are available with these parameters:<ul><li>Column length (mm): 50, 150, 250</li><li>Column ID (mm): 20, 30, 50</li><li>Particle size (µm): 5, 10, 15</li></ul>Eurospher II 100 CN Preparative dAX Columns with dynamic axial compression are available with these parameters:<ul><li>Column length (mm): 50, 150, 250</li><li>Column ID (mm): 25, 30, 50</li><li>Particle size (µm): 5, 10, 15</li></ul><h3>KNAUER Preparative HPLC Columns</h3>The right choice for all dimensions from semi-prep to batch chromatography to SMB.<ul><li>Modifications: Reversed Phase, HILIC, Normale Phase</li><li>Max. Pressure: 400–600 bar</li><li>Column Inner Diameter (ID): 16–50 mm in our shop, more on request</li><li>Column Brands: Eurospher, Eurospher II</li><li>Safe Investment: Robustness and durability based on superior technology</li><li>Application: Easy upscaling, as all materials are available from ultra high performance to preparative scale HPLC. You can also use our upscaling calculator.</li><li>Customizable: Standard flanged hardware &amp; dAX hardware with static or dynamic axial compression available</li></ul><img src="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/KNAUER_Preparative_HPLC_Columns_31bc2477c3.webp" alt="KNAUER: KNAUER Preparative HPLC Columns" srcset="https://storage.googleapis.com/labrulez-bucket-strapi-h3hsga3/thumbnail_KNAUER_Preparative_HPLC_Columns_31bc2477c3.webp 221w," sizes="100vw" width="1024" height="724"><h5>Preparative HPLC column hardware</h5>Preparative HPLC columns can be offered with two different hardware types:<ul><li>Versatile standard flanged hardware for nearly any application task in batch chromatography</li><li>dAX Hardware with static and dynamic axial compression for an extended lifetime and multi-column chromatography like SMB processes</li></ul>

Products from category CN HPLC columns distributed by KNAUER - page 1

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News from LabRulezLCMS Library - Week 26, 2026

How to Choose the Right Membrane for Your Syringe Filter

Accelerating Biomarker Discovery and Validation: From Discovery to Clinical Utility