Most diagnostic tests sold directly to consumers in Australia have low clinical utility, while also potentially causing harms of overdiagnosis and false positives, a review has found.
The study of nearly 500 pathology assays commercially marketed for purchase by Australian consumers, highlights the need for stronger regulation and public education on the subject, its investigators say.
Some 484 tests targeting 103 unique medical conditions, analytes or test products were included in the analysis, with only 11% assessed as having potential clinical utility.
A further 31% were determined to have ‘limited clinical utility’, while 42% were non-evidence-based commercial ‘health checks’ and 17% used methods or targeted conditions not recognised by the general medical community, the researchers found.
Concerningly, of the products identified, 56% did not state that they offered pretest or post-test consultation, and 51% did not report analytical performance of the test or laboratory accreditation, they reported in BMJ Open (link here).
“The risks and harms of ordering direct-to-consumer tests, which the TGA review identifies as being particularly relevant for cancers and genetic testing, is that professional guidance and clinical monitoring is lacking,” they noted.
“As the balance of harms and benefits of predictive genetic testing is still unclear for many chronic conditions, the call is for an ongoing development of guidelines, professional knowledge and practice in this field, to ensure caution and ethical considerations when offering such tests to asymptomatic, healthy individuals.”
Beyond that were the financial concerns, with products in the study costing a mean of $198 and the most expensive test priced at an eye-popping $1947 for an antigen leukocyte antibody (ALCAT) study to assess food sensitivities.
The latter was an unproven test of the sort typically associated with on-sale of non-evidence-based treatments also known as “disease mongering”, according to the authors.
Moreover, greater than 40% of the tests found in the study aimed to assess normal, everyday functions such as sleep, ageing, physical activity and hormone levels, they said.