Direct-to-consumer testing as consumer initiated testing: compromises to the testing process and opportunities for quality improvement: an opinion paper from the EFLM DTCT-Taskforce : opinion paper

Direct-to-consumer testing (DTCT) refers to commercial laboratory tests initiated by laypersons without the involvement of healthcare professionals. As this market grows in size and variety of products, a clear definition of DTCT to ground the conceptualization of their harms and benefits is needed....

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Main Authors: Shih, Patti (Author) , Sandberg, Sverre (Author) , Balla, Jan (Author) , Basok, Banu Isbilen (Author) , Brady, Jennifer J. (Author) , Croal, Bernard (Author) , Vos, Nathalie De (Author) , Karlsson, Mathias (Author) , Kedars, Piret (Author) , Ozben, Tomris (Author) , Pijanovic, Marina (Author) , Plebani, Mario (Author) , Orth, Matthias (Author)
Format: Article (Journal)
Language:English
Published: 2. Januar 2025
In: Clinical chemistry and laboratory medicine
Year: 2024, Volume: 63, Issue: 2, Pages: 1-8
ISSN:1437-4331
DOI:10.1515/cclm-2024-0876
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1515/cclm-2024-0876
Verlag, kostenfrei, Volltext: http://www.degruyterbrill.com/document/doi/10.1515/cclm-2024-0876/html
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Author Notes:Patti Shih, Sverre Sandberg, Jan Balla, Banu Isbilen Basok, Jennifer J. Brady, Bernard Croal, Nathalie De Vos, Mathias Karlsson, Piret Kedars, Tomris Ozben, Marina Pijanovic, Mario Plebani and Matthias Orth

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520 |a Direct-to-consumer testing (DTCT) refers to commercial laboratory tests initiated by laypersons without the involvement of healthcare professionals. As this market grows in size and variety of products, a clear definition of DTCT to ground the conceptualization of their harms and benefits is needed. We describe how three different modalities of DTCT (home self-testing, self-sampled tests, and direct access tests) present caveats to the traditional testing process (‘brain-to-brain loop’), and how this might differ between medical vs. non-medical laboratories. We make recommendations for ways to improve quality and reduce errors with respect to DTCT. The potential benefits and harms of DTCT will invariably depend on the context and situation of individual consumers and the types of tests involved. Importantly, implications for both consumers and the healthcare system should be considered, such as the effects on improving health outcomes and reducing unnecessary testing and use of clinical resources. ‘Consumer initiation’ must be a central defining characteristic of DTCT, to clearly demarcate the key drawbacks as well as opportunities of this type of testing from a laboratory specialists’ perspective. The concept of ‘consumer initiated testing’ should also help define DTCT regulation, and provide a locus of efforts to support consumers as the main decision-makers in the purchasing and conducting of these tests in the absence of clinician gatekeeping. 
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