HOME TESTING

Home testing generally refers to the use of a test or procedure outside of a professional medical care setting—usually within the privacy of one's own home—to acquire medical knowledge about one's own health. The test might be a laboratory test using a small amount of bodily fluid like saliva, blood from a finger prick, or urine. Perhaps the most commonly used home tests are pregnancy tests and various tests of urine or blood for monitoring diabetes. Because the use of home tests appeals to people who want to be involved in the management of their own illnesses, a large number of tests have been developed and marketed. In addition to home pregnancy and diabetes tests, there are tests for monitoring cholesterol levels, diagnosing urinary tract infections, and for HIV (human immunodeficiency virus) and hepatitis C infections.

Home testing may involve the use of a procedure or medical instrument to monitor health status. For example, people can be taught to take their own blood pressure to monitor treatment for hypertension, or to measure the functioning of their lungs if afflicted with asthma. More recently, home studies of sleep disorders have been carried out by individuals who report their results by computer to their physician for diagnosing or monitoring their conditions.

There are two basic types of home testing. Home collection involves the use of a kit to collect a sample in a person's own home. The sample is then mailed to a professional laboratory for processing. Results are provided to the individual through a confidential telephone service that may include counseling to help the patient interpret the results. Only one HIV and one hepatitis C home collection kit are currently approved by the Food and Drug Administration and available commercially in the United States. The second type of home testing involves doing the test in the home and interpreting the results through a change in color on a test strip, or some other simple device. Tests of this kind include home pregnancy tests and urinary tract infection tests.

There are many advantages to the use of home tests. Individuals can be empowered to take responsibility for their own health, and the immediate results help reinforce the measures used to control an illnesses, such as diabetes. Home testing also ensures privacy and confidentiality, which are important in the case of pregnancy or HIV testing. When there is social sensitivity associated with a disease such as HIV, home collection testing may appeal to certain individuals who wish to remain anonymous and do not want to obtain results in a health care setting.

In addition, health care costs may be reduced, since visits to the physician and the use of expensive laboratory tests can be curtailed. There are disadvantages to home testing, however. Many studies have demonstrated that the performance of tests in the home are subject to more error than those done in a controlled laboratory setting. Even approved and reliable home tests can generate false positive results (a positive/abnormal result when the individual is well) or false negatives (a negative/normal result when the patient is not well) when used by unskilled or untrained individuals. The misinterpretation of test results may generate unnecessary anxiety and stress for the individual.

Ronald K. St. John

(see also: Asthma; Blood Pressure; HIV/AIDS; Pregnancy )