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Evaluating the evidence: direct-to-consumer screening tests advertised online
Kimberly M Lovett1, Timothy K Mackey, Bryan A Liang
1Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, San Diego, CA, USA. klovett@ucsd.edu
Journal of Medical Screening
|October 25, 2012
Summary
Direct-to-consumer (DTC) medical screening tests advertised online often lack evidence-based support. Most DTC tests are not recommended by guidelines, risking inaccurate self-diagnosis and wasted health resources due to limited oversight.
Area of Science:
- Medical screening tests
- Direct-to-consumer (DTC) health services
- Evidence-based medicine
Background:
- Unsupervised direct-to-consumer (DTC) access to medical services has expanded to screening tests.
- The evidence basis for these DTC screening tests has not been critically evaluated.
- This expansion necessitates an assessment of their validity and potential risks.
Purpose of the Study:
- To identify the scope of online-advertised DTC screening tests.
- To outline the evidence supporting the use of available DTC testing.
- To suggest regulatory reforms for DTC medical testing.
Main Methods:
- Observational study of DTC testing websites (April-June 2011).
- Assessed tests offered, advertised indications, and availability of counselling/follow-up.
- Compared advertised indications with US Preventive Services Task Force recommendations and specialty guidelines.
Main Results:
- 127 DTC screening tests identified; only 15% (19/127) supported by guidelines.
- 30% (38/127) were against recommendations, 23% (29/127) had insufficient evidence, 50% (64/127) had no guidance.
- 95% of companies did not clearly offer pre- and post-test counselling or follow-up.
Conclusions:
- Most DTC medical tests lack support from evidence-based guidelines for screening.
- Limited oversight of DTC testing may lead to inaccurate self-diagnosis and treatment.
- There is a need for regulatory reform to ensure the safety and efficacy of DTC medical tests.
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