Dr Xand van Tulleken admitted to Helen Skelton and Gethin Jones that he is often tempted to pick one up when he sees them in the shop
BBC Morning Live’s Dr Xand van Tulleken has cautioned against at-home testing, warning that it may lead to delayed diagnoses – or even unnecessary panic. Speaking on the show alongside hosts Helen Skelton and Gethin Jones, he noted that while many people have become accustomed to self-testing since Covid, not all tests are reliable.
He explains: “The number of these kits that are available to us in the supermarkets and in the chemist has exploded since Covid. During Covid, we all got familiar with doing important medical tests that were accurate for common and serious health conditions and so this has now entered our consciousness as a thing we can do.
Calling these tests “very appealing” as you don’t have to wait for an appointment, he says he’s “not a very organised shopper and likes to roam around the shops. He said: “So I’ll walk past and I see them and think I’d be interested to get the all clear on a few of those things [illnesses].
“There’s a wide range of different conditions you can test and yet the Royal College of General Practitioners have expressed, really quite extreme reservations, about this. They’ve talked about the effectiveness and the accuracy, and they’re concerned about three things.”
Are at-home health testing kits bad?
Listing the group’s concerns over these at-home test kits, he says anxiety is number one. He notes: “If you get an answer that isn’t what you want, you think it’s quite worrying.
“But that can also lead to unwarranted tests. If you get a false positive you’ll have more tests, more investigations, going to your GP, then go to hospital, investigate and there may be nothing there.
“They’re also worried about false negatives where you’re given false reassurance where you say you’re fine, you don’t need to go and see the GP and actually you do need to go and see the GP.”
He adds: “So there are reservations from lots of healthcare professionals. And yet even the healthcare professionals like me can see the appeal of these tests.”
The doctor says that there’s “a wide variety of concerns” – and listed several such as a “blood test, movement test, muscle test, hair analysis, pulse test, looking for antibodies, skin conductivity measurements.” Dr Xand said “for a lot of those ones that I’ve just named, the British Dietetic Association say they really don’t have any scientific basis at all.
“So there’s some stuff out there that’s just sort of really dodgy and not very scientific and will give you a very inaccurate result.”
Discussing illnesses such as coeliac disease and various cancers, he mentioned that Dame Deborah James, widely known as Bowelbabe, supported at-home testing – but a specific kind. She died on June 28, 2022, at the age of 40.
Her website supports at-home tests which are done “through the NHS screening program, which is totally different”, Dr Xand warned. “So although it looks like a little box that they’ll post and it’s very similar test, it’s used in a way that allows us to save lives.
“There isn’t good evidence that doing tests outside of those quite strict parameters does save life. So I appreciate it’s confusing, I’m not against at-home testing, but doing it through a formal NHS screening program makes the world of difference.”
Are at-home tests accurate?
The expert says that often they may say these tests are 95% accurate. He added: “So I just wanna walk you through the calculation of why these test don’t save lives.”
Noting that “this is general” and stressing “I’m not pointing the finger at an one particular test”, he said “if we imagine a test for a disease like a cancer that affects maybe one in 2,500 people.
“Imagine 100,000 people buy this test from the supermarket and they take it and the test is 95% accurate. Let me walk you through why this isn’t true.
“Out of 100,000 people 40 people will actually have the cancer. Now because the test is 95% accurate it will detect 38 of those people meaning it’s missed two people. There’s two people getting false reassurance and that’s not good.
“That’s a big problem for them because they’ll be slower to be investigated, maybe slower to go and see their GP for symptoms. The big problem is all the false positive because it’s 95% accurate in terms of getting false positive as well so there will be almost 5,000 people getting a false positive result” and getting told they have cancer and having anxiety as a result of it when there is no need to stress over it.
But there’s another issue and that is that “38 people out of 5000 actually have cancer which means if you get a positive result from that cancer test, the odds of that being correct is less than 10%. it’s a very, very small chance that it’s correct”, he said, again stressing that this is very “general” and not one specific test or brand.
Getting a GP appointment is too hard
Some might feel the need to use these tests because getting a GP appointment is difficult. Presenter Helen asked what to do if you can’t get a GP appointment.
Dr. Xand responded that the “NHS is really struggling to meet the demand on services.” However, he emphasised that you should still see your GP.
“I would encourage you to do that [see your GP] because at-home tests, if you want to buy them go ahead and buy them.” However, he warned that at-home testing kits should not “distract you from engaging with your doctor.”