If Even Doctors Can’t Read Diagnostics Well, How Can Patients?
[Thursday, October 11, 2018] A review of doctor’s habits for relying on diagnostic tests without fully understanding them shows that doctors increasing use results of diagnostic tests incorrectly. Diagnostic tests are over-prescribed and highly trusted, without appreciating the probabilistic nature of diagnostic tests. If well-trained professionals can be misled by the results of the diagnostic tests, one can argue that general consumers can similarly misread the DTC diagnostics particularly those of predictive nature such as most general health tests like those offered by 23 & Me. There exists extensive data that doctors do not appreciate the false positive data for diagnostic tests. Any given test has a measurable probability of false positive which is generally ignored by the physicians. It could be argued that liability issues prevent doctors to opt against the results of a test even when facing negative odds. This leads to medical decisions that are unnecessary and, in some cases, harmful to patients. To error on the side of caution may not be the best option in these cases. Similarly, it can be argued the consumers can make unnecessary and potentially harmful medical decisions about themselves based on diagnostic tests. FDA has been strongly supportive of general health diagnostic tests in the last few years, encouraging development and marketing of genetic tests and digital health awareness tests marketed directly to consumers but there is a cautionary note that must be included with all such tests making the consumers aware of the inherent probabilistic nature of these tests. The tests should be confirmed with multi-dimensional analysis and critical medical evaluation before medical decisions are made. Otherwise, such tests could do more harm than good.
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