Direct-to-consumer pathology tests and medical overuse in Australia: Ethical, clinical and public health implications

Abstract

In this session, Dr Shih will present on original research mapping the type and variety of direct-to-consumer (DTC) pathology tests marketed online and their implications for medical overuse, from home self-testing kits to direct access pathology services. This study used a systematic search of Google and Google shopping for DTC tests advertised online in Australia. Items included were categorised and grouped based on potential or limited clinical validity and utility. We identified 484 DTC testing products for sale. Only 11% of the products would have clinical benefit if accessed by underdiagnosed populations (e.g., sexually transmitted infections); a quarter of the products reviewed had limited or no clinical utility, such as non-proven tests for food allergies and gastrointestinal functions; just over half (51%) the tests were aimed at assessing functional markers among healthy consumers, e.g. hormone panels indicating general health, fertility and reproductive health and sports and fitness performance. The clinical utility of these tests were also limited. A/Prof Bell and Prof Carter will be offering perspectives on the clinical, ethical and public health implications of DTC pathology tests, including increased access to tests with limited clinical utility, potential harms to healthy and asymptomatic consumers, and challenges for regulation and governance.