Fig. 1: Organization of a workflow for reliable and timely biomarker scoring in a general single-center or multi-center trial.

Personnel at individual centers scan the slides after processing by the local pathology department. Digital slides are uploaded to a central web-based repository, such as Slide Score. A study-specific identifier is assigned to each sample. The central manager is notified by the system when new slides are available and requests pathologists to review it. When a consensus score is obtained, the trial office is notified for randomization of the patient.