As the new LDT rules get reviewed by the courts, a new study points to another concern with LDTs; the extreme social media promotion of these tests. Are these tests improperly promoted on social media leading to their overuse and overdiagnosis? How do those concerns play into the regulatory concerns raised by the FDA in proposing LDT regulation as conventional FDA-approved or -cleared tests?
Social media is a powerful tool to discuss medical information in an informal setting. There is practically no regulation of promotion, disguised as “discussion” or “user opinion”, for non-prescription products and testing services. Social media influencers monetize their channels to promote products with impunity. When it comes to medical information, that promotion could lead to harm, directly by hiding negative information or indirectly by encouraging useless tests.
Social media marketing for 5 popular medical tests over 10 years was evaluated. The tests selected were full-body magnetic resonance imaging, the multicancer early detection test, and tests for antimullerian hormone, gut microbiome, and testosterone. All these tests are either LDTs or used in ways beyond how they were cleared by the FDA. The authors selected 982 social media posts for these tests from influencers with a total of more than 194 million followers. More than 87% of the posts on average mentioned benefits (ranging from 80-100% depending on the test) but less than 15% (ranging from 5-25% depending on the test) mentioned harms. For three of these tests, almost 100% of the posts were overtly promotional (for the other two it was about 75%) versus neutral or negative tones. Only about 2-5% of the posts used scientific evidence to support their claims, while almost 34% used personal anecdotes. About half of the posts urged their followers to get the test. Not surprisingly 50-90% of the posters (depending on the tests) had financial interest in the tests they were promoting. An interesting observation was made that posts by physicians were more likely to mention harms and less likely to have an overall promotional tone.
The FDA restricted from regulating most social medial advertisement for non-prescription products. This study highlights how this loophole is exploited by manufacturers to promote their tests to the consumer by using influencers they trust. The findings of the study are not surprising and are obvious. Misleading promotion of diagnostic tests is a real problem with only a regulatory solution
