In Reply Despite the problems and issues involved with DTC medical testing as it currently exists, such testing certainly can play a potentially important and evidence-based role in health care delivery.
As Dr Gronowski and colleagues point out, tests such as over-the-counter (OTC) HIV testing and pregnancy testing have played a positive role in screening for these conditions, supporting patient privacy during the screening process, and permitting patients to screen as often as they think necessary without having to pay and wait for an office visit with their clinician. Likewise, home glucose monitoring has played an important role in routine monitoring and management of diabetes mellitus. Unlike many DTC medical tests, however, the indications and utility of OTC HIV, OTC pregnancy, and home glucose testing are easily understood by a large segment of the population. For example, it is easy to understand that an OTC pregnancy test is of greater utility to a fertile woman who is sexually active than a woman well past the age of fertility or to a man. The relative ease of understanding the test results is, in part, because of the high specificity and the binary implications of the results (ie, a positive test means the target condition is detected; a negative test means the target condition is not detected).
Rockwell KL. Improving Direct-to-Consumer Medical Testing—Reply. JAMA. 2017;318(16):1613–1614. doi:10.1001/jama.2017.13756
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