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COVID Opens Door to Comfort With Rise in At-Home Medical Tests

You save a trip to the doctor’s office. But can you understand the results?

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You wear a cuff to measure not only your blood pressure but also the stiffness of your arteries, among other vascular readings, from home. You conduct your own vision tests for eyeglasses without leaving the house. You pee in your own toilet to capture urine samples you share remotely with your doctor.

Telehealth has brought doctors back into the house virtually via smartphone, computer and tablet screens. Now several health tests that used to require a trip to a doctor’s office or lab are also being done from the comfort of home. Others are on the cusp of being approved.

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You can buy some tests off the shelf at your local pharmacy. Others may require a prescription from your physician, who can then monitor certain conditions from afar.

Health-related tests of one kind or another aren’t entirely new, of course. Women have been able to take home pregnancy tests for decades. Diabetics can prick their finger with a needle to test glucose levels or wear a continuous glucose monitor. Some people share their DNA through 23andMe to screen for hereditary conditions.

COVID makes home testing routine

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Millions have grown accustomed to home diagnostics by sticking a swab up their noses, however unpleasant, to test for COVID-19.

“The pandemic definitely changed a lot of people’s opinions of testing at home,” says virologist Mary Rodgers, principal scientist for diagnostics at Abbott, the North Chicago–based health care company behind the BinaxNOW-branded COVID tests.

Nearly half of adults ages 50 to 80 surveyed in July 2022 as part of the University of Michigan’s National Poll on Healthy Aging have purchased at least one at-home medical test. More than 4 in 5 expressed an interest in using them in the future.

“The people who tend to need these sorts of tests more are probably older people. But I think a lot of this is going to be driven by younger people, [who have] an expectation of convenience probably in a way that we never did,” says David Pride, M.D., professor of pathology and the director of microbiology at UC San Diego.

Your smartphone will play a role

The latest generation of home tests may combine sophisticated sensors and artificial intelligence (AI) analysis, often in sync with a smartphone or smartwatch. These digital health tests cover a wide swath of concerns, as you can see from the following products, many of which were exhibited at the January 2023 CES tech fest in Las Vegas.

• Monitoring urine. Withings has launched U-Scan, which the French company markets as the world’s first at-home, hands-free urine lab. To use it, you urinate onto a pebble-shaped, 3½-inch-diameter rechargeable reader that sits in your toilet bowl.

U-Scan has interchangeable cartridges that can analyze various biomarkers. Among the first are a cartridge to help women track hormonal fluctuations in their cycles, and another that measures nutritional balance around vitamin C, ketones and hydration. Data syncs up via Wi-Fi with a smartphone app. Low-energy radar sensors embedded within the U-Scan reader help it identify your urine as distinct from, say, a family member’s.

U-Scan is slated to go on sale in Europe for €500 (about $535) around midyear but hasn’t yet received regulatory approval from the U.S. Food and Drug Administration.’s Minuteful Kidney test also uses urine to uncover increased risk for chronic kidney disease in its early stages and avert damage that can lead to a kidney transplant or dialysis. The Tel Aviv–based company received FDA clearance last year for its home test kit, which uses a smartphone app to give immediate results.

• Identifying respiratory viruses. Opteev Technologies in Baltimore has developed a battery-powered, multiple-use handheld breath analyzer test called ViraWarn that the company says can detect all COVID variants, as well as respiratory syncytial virus (RSV) and influenza, in less than 60 seconds.

You blow into this electronic device twice. A carbon filter captures larger particles in your breath. Virus particles pass through. A flashing red light signifies a positive result, though the test won’t tell you what you have; a green light indicates a negative.

ViraWarn comes with a removable mouthpiece and replaceable sensor cartridges. It is in clinical trials and will require FDA approval.

• Checking arteries. The Pulse monitor from Conneqt in Newport Beach, California, promises to do more than the typical cuff-based blood pressure machine. It can capture a patient’s central pulse pressure, which is used to identify damage to the brain, heart and kidneys. Among other features, it can also measure augmentation pressure, a marker that indicates how stiff a person’s arteries are.

Pulse is pending FDA approval. It is expected to cost around $300, arrive around midyear and initially be available by prescription only, the company says. Data is pushed to a mobile app and back to the health care provider monitoring the patient’s progress.

“There’s an increased opportunity for people to be more in control of their health data,” says Mark Gorelick, chief product officer of Conneqt parent CardieX. “Trend data is what’s really important: Is there a change over time?”

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• Testing eyesight. EyeQue in Newark, California, sells the portable FDA-registered EyeQue VisionCheck vision kit. You attach the device to your phone using micro-suction tape and an elastic band. After bringing it up to your face, one eye at a time, you’re guided through a series of refraction tests to take measurements you can use to order eyeglasses online.

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It pairs via Bluetooth with an app on your phone. EyeQue’s vision monitoring kit, including glasses, currently costs $179. The company cautions users that the kit should not replace the need for an eye health exam.

Separately, Visibly in Chicago announced in August 2022 that it became the first company to have an FDA-cleared online visual test.

Are self-tests smart medicine?

Home tests can help you catch problems early and begin treatment. They may keep costs down as well. Moreover, a self-exam at home can calm jitters and reduce the stigma associated with certain tests.

However, some users may experience the opposite. “Oftentimes you have people that are looking for a problem,” Pride says.

Gorelick of CardieX mentions, for example, people who are worried about their sleep habits. They can use an Apple Watch to track their sleep and display detailed information in their iPhone’s included Health app. Users of Android smartwatches such as the Samsung Galaxy Watch 5 can do the same.

“We see individuals who are more nervous because they’re testing their sleep all the time, and now they can’t sleep because of their sleep data,” he says. His company doesn’t currently have its own sleep-focused products.

Here are some important questions to consider about the reliability and validity of home tests:

• Could you mess things up if you don’t follow instructions exactly?

• Are the tests using the latest medical science?

• Is the data kept private and secure?

“To get people to adopt these types of products, … they have to get something in return and understand how data is being used,” says Ray Rosti, chief digital officer at Publicis Health Media, a Philadelphia-based health care marketing company.

Can you trust the results?

Most critically, patients must have confidence that the results of home health tests are accurate — and be able to easily understand them. Patients also need to know when they ought to seek immediate medical attention. And if they have any doubts, they should consult a health care provider.

In general, medical-grade devices that have gone through extensive clinical trials and peer review and have earned the federal government’s blessing are more trustworthy. But lots of devices, even some that may prove beneficial, are categorized under a less well-defined “wellness” umbrella.

What’s more, a positive or negative result is one thing. You presumably have COVID or you don’t. But some tests’ results may be murky or fall into a borderline range.

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Tests have “got to be simple to do and simple to interpret,” Pride says. And occasional false positives are inevitable.

“In my experience, every test is an answer to a question,” Abbott’s Rodgers says. “The more tests that are done, the more answers that are out there and the more accessible health care can become.”

Some products are hybrids. The electrocardiogram feature on an Apple Watch or Fitbit that can detect an irregular heartbeat or atrial fibrillation (AFib) required FDA clearance. Other features in these wearables did not.

“We’ve got to work through that balancing act and learn as a community how much we want to do at home without the doctor and when you reconnect with the health system,” says Australian global futurist Bruce McCabe, who focuses on medicine, AI and other technologies.

Be prepared for more in-home tests

What comes next? Pride at UC San Diego says tests will be available for any simple microbiology-related issue you can think of. “All of those sorts of things are kind of out there, and instead of being at the back of the mind, where they were before, they’re really at the front of the mind.”

But not every area of medicine is ripe for an at-home diagnostic test.

“It’s hard for me to imagine it ever will be black and white for cancer,” Pride says.

Even so, in lieu of an invasive colonoscopy, some people choose to take their own stool sample and send it off to a doctor or a lab through a fecal immunochemical test (FIT), guaiac fecal occult blood test (gFOBT) or FIT-DNA test, such as Cologuard. Most require a prescription. You’ll still need a colonoscopy if you get a positive result.

Further health insights from your voice

McCabe envisions more single tests that can detect four or five different conditions at a time. And he sees an increased role for AI-based chatbots and what he refers to as “unobtrusive diagnostics.”

With devices like Google Home, Amazon’s Alexa and Apple’s Siri, “our home is equipped to listen,” he says. “There is a very straight line you can draw between that and offering diagnostic services [based] on your speech patterns, various intonations [and] word choices.”

Indeed, biometrics monitoring is also on the cutting edge, including the use of voice. The AI-powered HearO app, in clinical trials from an Israeli company called Cordio Medical, can predict when a patient suffering from congestive heart failure has a worsening condition based on real-time speech analysis.

A patient establishes a “vocal signature” as a baseline by speaking to the app, which can then detect an early buildup of fluid in the lungs, ahead of any symptoms. Alerts can be dispatched to the clinician monitoring the patient.

CEO Tamir Tal says the app has a more than 80 percent accuracy rate in predicting a heart failure event 18 days in advance. Research into voice biomarkers is being conducted for Alzheimer’s, cancer, cardiology, cognitive impairment, COVID and Parkinson’s disease.

Meanwhile, insights may also be drawn from cameras. At the CES trade show, Samsung demonstrated how a camera connected to a television can measure a person’s heart rate, heart rate variability, oxygen saturation, respiration rate and stress.

“It doesn’t have to be a wearable,” McCabe says. “We can do a lot of background diagnostics in your home by combining [biometric] factors. To me that is one of the most exciting frontiers of all.”

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