At-home medical tests too often produce false-positive results. Yet these tests are appealing because of their ease and convenience. Want to avoid a colonoscopy or check for thyroid disease or high blood sugar? From the comfort of your own home, you can swab, prick, poop and urinate to get important medical information. But you may not be able to interpret the results or get reliable measurements, doctors say.
Yet many Americans are using it, especially older ones. The University of Michigan’s recent National Poll on Healthy Aging found that three in four adults ages 50 to 80 thought home testing was more convenient than visiting a doctor or health care provider.
Many people have started testing at home during the pandemic, getting tested for the coronavirus, said Matthew Weissman, a professor of internal medicine and pediatrics at the Icahn School of Medicine at Mount Sinai in New York City. But testing for other diseases is often more complicated.
“It’s a good thing in the sense that it saves doctor visits,” Weissman said. “But in most cases, it still requires a doctor,” whether to prescribe medication or help interpret the data.
Home tests may be especially helpful to the thousands of Americans who can’t see a doctor, said Michael Hochman, an internal medicine physician in Long Beach, California.
Whether telemedicine or not, home testing is most effective when you do it with your doctor’s approval, Pochapin said. “You have to say to your doctor, ‘I’m thinking about doing this test. Is this appropriate?'” he added.
But that may not be the case. According to Jeffrey T. Kullgren, a physician and director of the National Poll on Healthy Aging at the University of Michigan, only 55 percent of people who purchased and used a home screening test shared the results with their primary care physician. “That suggests that older adults are using these tests as a substitute for a doctor visit,” Kullgren said.
You can buy most home tests online or at your local pharmacy. Few are covered by insurance. We asked doctors about the effectiveness of some commonly available tests:
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Urinary tract infection:
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Method: You urinate on a strip (or in a cup and dip a strip in the urine).
Cost:Around $11 (not covered by insurance).
What there is to know: “They’re basically testing for things that are associated with UTIs like nitrates and leukocyte esterase, which are two things that are commonly seen in UTIs,” said Ivan Grunberger, director of strategic initiatives in urology at Lenox Hill Hospital in New York City. But that’s not the same as doing a urine culture to determine which antibiotic will best fight your infection.
Who is this best suited for: “It’s not a bad thing for people who have frequent infections, who are somewhat familiar with their symptoms and who have had a reaction to antibiotics in the past to do a home test and then contact their doctor.”
Method:Urine on a test strip for five consecutive days, transmit your results to an app that will collect other data about you. Log in to receive the results.
Cost:Around $20 (not covered by insurance).
What there is to know: Menopause tests promise to tell users whether they are in perimenopause, a stage just before menopause. Manufacturers claim the product promotes communication between the user and doctor, but most doctors say there is no link between urine hormone levels and symptoms.
Who is this best suited for: Many doctors say these tests aren’t helpful for most women. “This test alone isn’t going to give you a diagnosis,” said Asima Ahmed, chief medical officer and co-founder of Carrot Fertility, a global fertility delivery platform. “It’s really important to look at all the factors and then review those results with a menopause specialist or someone who cares for postmenopausal women.”
Method:Collect a stool sample. For the stool DNA test called Cologuard, which looks for DNA changes and small amounts of blood in the stool, you’ll need to send it to a lab. Results take about two weeks. A fecal immunochemical test (FIT), such as Second Generation, looks for hidden blood in the stool. It involves taking a stool sample and adding a solution, and you get the results in minutes.
Cost:A FIT test can cost anywhere from $30 to $120 and is sometimes covered by insurance. The $500 Cologuard test is covered by most insurance plans, but must be ordered by your doctor and may require a copay or deductible. Some private insurance plans cover both at-home tests, but if you get a positive result, your follow-up colonoscopy may not be covered since insurance considers at-home testing a screening procedure.
What there is to know: “When patients want to do these tests, I explain to them that it is possible for the result to be false positive,” Pochapin said, adding that the tests detect the presence of blood in the stool, which can be due to diseases other than cancer. “So if the result is positive, it does not mean you have cancer.”
Who is this best suited for: Pochapin added that the tests are intended for healthy people who have no symptoms. If you have rectal bleeding, don’t use a home test; instead, see your doctor immediately, he said.
Method:Prick your finger to draw blood and send it to a lab for results, which take about two weeks.
Cost:$49 to $150. Some insurance plans will pay.
What there is to know: The tests may not be as accurate as your doctor’s. And the results need to be interpreted correctly. “A1C is a three-month average of blood sugar. If someone is checking it, say weekly, monthly, or daily, without realizing that these gradual changes are not something you should be using to guide your management, it could be harmful, even life-threatening,” said Michael B. Natter, an endocrinologist at NYU Grossman School of Medicine.
Who is this best suited for: If you have diabetes, this tool can be helpful in tracking your blood sugar, but you should not change your insulin or diabetes regimen without consulting a doctor.
Method:Depending on the kit you buy, you can go to a lab to have a blood draw and then get electronic results via an app, or you can prick your finger and draw blood that you send to a lab.
Cost: $50 to $500 depending on the number of allergens measured. Insurance generally does not cover the cost.
What there is to know: “Allergy testing has a high rate of false-positive results,” said Eric M. Macy, a fellow of the American Academy of Allergy, Asthma and Immunology and an allergist at Kaiser Permanente Southern California. “It would waste time, effort and money trying to avoid irrelevant allergens.”
Who is this best suited for: You can use the test for a specific allergen, such as cat hair, Macy explained. But, he added, “you can also easily, cheaply and more accurately determine that you are allergic to cats by petting your cat and then rubbing your eyes or nose, because the cat allergen is on the fur and one of the sources is the cat’s saliva.”
Method:Prick your finger to send blood to a lab, with results available in about a week. Most of these tests look at several biomarkers related to thyroid disease.
Cost:Approximately $21 to $235. Generally not covered by insurance.
What there is to know: “I don’t know if I would trust him,” Natter said. “I think it’s a little premature. It opens the door a little bit to potential risks if patients feel encouraged to self-manage, which could lead to misuse of medications and inappropriate care.”
Who is this best suited for: ““If you don’t really know what your biochemical status is, in terms of TSH or free T4, it can be beneficial to have access to that at home,” Natter said. “But you have to work in tandem with a healthcare professional to make the next management decisions based on that data.”
The FDA has created a list of reliable at-home medical tests, but doctors still recommend caution. While at-home tests can be useful and convenient, it’s important to remember that a number of variables, including the lab that performs the tests, can affect the quality of the results, said Donald Karcher, president of the College of American Pathologists and professor of pathology at George Washington University Medical Center.
It’s important to follow the instructions carefully and make sure the sample was collected correctly, he said. “Not all home tests are the same,” Karcher said.