Not just the classic pregnancy tests or home blood glucose tests; recently, the offer to consumers of self-control products has also extended to the monitoring of conditions that, until recently, could only be studied in the hospital setting.
Among the various commercial offers, we find, for example, tests for the control of blood levels of cholesterol, triglycerides and ferritin; in this regard, it is sufficient to use a sterile lancing device to take a drop of blood from the fingertip, then putting it in contact with the special test strip that will return the result within a few seconds. Even simpler are the tests for self-control carried out on samples feces or urine; among these, particular relevance assumes that for the search for occult blood in the faeces, which, if present, could be a sign of the presence of an intestinal polyp or colorectal carcinoma. Still in the field of cancer prevention, there are also tests for the dosage of PSA, while parents can check their children by testing for the presence of drugs, such as amphetamines, methamphetamines, cocaine, morphine and THC (cannabis) in the urine.
To complete the picture there are then tests to monitor the functionality of the kidneys (dosage of albumin in the urine) and of the thyroid (dosage of TSH in a drop of blood); other tests are instead useful for checking gastric health (dosage of antibodies anti-helicobacter pylori), to verify immunological protection against tetanus (ie to test if there is a need for a new vaccination) or to search for Escherichia coli infections, etc.
Benefits and risks
Every strong technological innovation brings with it opportunities and dangers: it all depends on the use that you decide to make of it. There is no doubt, for example, that the possibility of testing your health in the comfort of your own home can promote awareness and prevention in the health sector.
We must never forget that, very often, the chances of curing a disease are greater the earlier the diagnosis is, and vice versa. Some of these diseases, such as colon cancer, could even be almost eliminated by extending the screening campaigns to the entire population at risk. Unfortunately, however, early diagnosis can be severely hampered by the lack of individual sensitivity to the problem, by the short time available to go to the doctor, by long waiting lists to undergo examinations or by scarce public health resources. In such a context, home self-monitoring undoubtedly represents a precious opportunity, which also becomes useful in tertiary prophylaxis, that is, in the prevention of complications of an already manifest disease (think for example of glycemic control in diabetic patients and home monitoring of plasma cholesterol in individuals with high cardiovascular risk).
In addition to all these benefits, it is essential that those who decide to rely on these tests also become aware of their limitations and the risks deriving from improper use; in particular, these tests:
- they have no diagnostic value. It means that the task of diagnosing a disease remains exclusively with the doctor, who very often reaches the diagnosis only after an accurate visit and the comparison of several parameters (a single examination is often insufficient). In other words, these tests cannot and must not replace traditional diagnostics; their task, on the other hand, is to help the subject address any specific diagnostic pathways.
- They don't have to slow down the diagnosis. If a subject complains of a significant health problem, it would be good for him to report this immediately to his doctor, avoiding "wasting time" in "home self-control. The potential damage would be even greater if a negative result, within the walls of home, would lead the subject to calm down and ignore the disorder by postponing the medical examination. We remember, in this regard, that the test may not be suitable or sufficiently sensitive to highlight the pathology; in other words, it means that the disease, although present, it may not be detected by the test.
- They cannot be used to modify any pharmacological therapies in progress: once again, it is the doctor's prerogative to decide whether or not to adjust the drug therapy based on the outcome of clinical and laboratory controls.
In any case, if the tests for self-control are planned in agreement with your doctor, they can be a valuable aid for optimal therapeutic management. - They must not trigger unnecessary anxieties and apprehensions: precisely because they have no diagnostic value, it is good to prevent anxieties and apprehensions from taking over if the tests indicate the presence of a possible health problem. For example, the presence of occult blood in the faeces can trivially depend on a contamination of the faecal sample with menstrual or urinary blood, or on the presence of hemorrhoids or anal fissures; therefore, it does not mean that there is necessarily a tumor in the large intestine.
A "possible positivity should therefore be interpreted as a strong invitation to contact the doctor for the necessary investigations. - They are not infallible. Even tests carried out in a hospital setting can miss some cases in which the pathology is present. In such situations, there is talk of false negatives, that is, of individuals who, despite being ill, are healthy according to the results of the test. Furthermore, as seen in the previous point, there is also the opposite risk, that is, that a test identifies as sick a subject who is actually healthy (false positive).
To deepen the subject, we recommend reading the article dedicated to the specificity and sensitivity of diagnostic tests, remembering that these quality parameters should always be checked and taken into consideration when deciding to use a test for home self-control. , it is an indication of the seriousness of the manufacturer to declare the specificity and sensitivity values of the tests in the package insert or on the dedicated website. - They require scrupulous compliance with the instructions for use. It is essential to follow the instructions in the package insert to avoid invalidating the test by using it incorrectly.
- They must be certified and bear the CE mark: very important, especially if the purchase is made online, is the verification that the tests have been validated and certified by third parties and that they comply with the European Community directives.
