Latest news with #BMJ
Irish Examiner
21 hours ago
- Health
- Irish Examiner
Shop-bought health tests not always fit for purpose, researchers warn
Off-the-shelf health tests for issues such as high cholesterol, vitamin deficiency, fertility and prostate problems are not always fit for purpose, experts have warned. A team from the University of Birmingham examined tests that people can buy in supermarkets and shops and which they then use at home. They found the tests risked giving people the wrong result, could delay diagnosis, and most of them recommended follow-up with a doctor anyway, regardless of the result. The researchers called for much tighter regulation of the sector. "In the absence of guidance from healthcare professionals, individuals might use tests inappropriately or without a clear understanding of the implications of the results. "False positive test results can lead to unnecessary anxiety, increased healthcare usage, and additional costs, whereas false negative test results may delay appropriate treatment or engagement with... screening programmes. "Test errors can stem from inherent limitations in the accuracy of the test, as well as user-related issues such as sampling errors, incorrect processing, and difficulties in interpreting the results." However, the team said that in the future, home tests could have great potential for patient care. Professor Jon Deeks, from the University of Birmingham, said: "A plethora of new health self-tests have emerged in recent years and are available to buy from many high street supermarkets and pharmacies in the UK. "While these kits have been approved for sale, they are not subject to the same stringent regulations as pharmaceutical products. "Our recent research raises concerns about the suitability, accuracy and usability of many of the self-testing products available that require users to sample, test and interpret results themselves. "In some cases, it is unclear how accuracy claims are supported, and there is no requirement of manufacturers to share the evidence behind these claims." Prof Deeks said much of the literature contained with tests was "not easy to understand", while some of the results could lead to a "wrong diagnosis". In one example, he said the self-tests for prostate-specific antigen (PSA) levels, a marker of prostate health, were fixed at a certain concentration level. However, "if you're age 70 you need to have your PSA done at a very different level to when you're 20", he said. Overall, 30 self-tests were included in the study, published in the British Medical Journal (BMJ). The tests covered 19 different conditions, including vitamin deficiency, blood sugar levels, cholesterol, thyroid function, prostate health, HIV, menopause and bowel cancer. Researchers said only eight of the 30 tests provided information about who should or should not use the test, while four specified the presence of symptoms. Less than half of the test boxes (14) included any statement about test accuracy.
Yahoo
21 hours ago
- Health
- Yahoo
Can't Sleep? These 4 Exercises Could Help, New Study Suggests
Reviewed by Dietitian Emily Lachtrupp, M.S., RD Sleep can feel elusive sometimes. Stress, poor sleep hygiene—like not having a healthy bedtime routine—and even medications can interfere with sleep quality and quantity. If you struggle with getting enough quality sleep, you're not alone. About 12% of Americans have been diagnosed with insomnia. Defined as trouble falling asleep, staying asleep or getting good quality sleep, insomnia can be short-term or chronic. Besides causing exhaustion and daytime sleepiness, chronic insomnia can also affect memory and concentration, as well as increase the risk of heart disease, high blood pressure, diabetes and cancer. Healthy sleep habits and cognitive behavioral therapy (CBT) can be effective treatments for insomnia. CBT can help calm the nervous system and prepare it for sleep. Healthy sleep habits include things like creating a healthy sleep environment, avoiding alcohol or caffeine near bedtime and maintaining a consistent sleep routine. Of course, there are also sleep medications, but they can have unwanted side effects. In an attempt to find drug-free interventions, there is evidence that suggests that exercise may act as a sleep aid. Researchers from China wanted to take a closer look at this possibility and examine more specifically what types of exercise may be most effective. They conducted a systematic review and meta-analysis and published their findings in BMJ Evidence-Based Medicine. How Was This Study Conducted? This was a systematic review and meta-analysis, so researchers searched for previously conducted studies that met their criteria. This included studies using participants with insomnia diagnoses and organized exercise as an intervention. After initially finding almost 10,500 studies that met their criteria, researchers rigorously weeded out those that didn't meet all their standards. They settled on 22 randomized controlled trials, which is considered the gold standard in evaluating cause-and-effect relationships between factors. The total number of participants included in all 22 studies was 1,348. The exercise interventions included yoga, tai chi, walking or jogging, aerobic/cardio exercise plus strength training, strength training alone, aerobic exercise combined with therapy (i.e. CBT) and mixed aerobic exercises. What Did This Study Find? RCTs analyze the data in the studies, including running statistical analyses. In this study, many different criteria were tested, based on various aspects of sleep. These researchers concluded that: Yoga may be helpful for those who want to increase total sleep time. Yoga and tai chi may offer benefits for specific clinical symptoms of insomnia, including low sleep efficiency (the actual amount of time you spend asleep while in bed), difficulty falling asleep and frequently waking up in the middle of the night. Tai chi may extend sleep time, both in the short-term and long-term (after one or two years of follow-up). Walking or jogging may help mitigate daytime sleepiness. Though researchers used rigorous standards when choosing the studies to include in this meta-analysis, there are still a few limitations. First, some of the studies tested at moderate or high levels regarding bias. There was also an absence of exercise 'dose'—including frequency and intensity—in some of the studies, so researchers are unable to say how much and at what intensities these exercise types may be most helpful. How Does This Apply to Real Life? If you're having sleep issues, one of the first things to consider is your sleep hygiene. What does your bedtime routine look like? Ideally, you want to spend an hour before your head hits the pillow preparing your body for sleep. This includes getting off devices, dimming the lights and engaging in relaxing activities, like reading, journaling or listening to calming music. Having a bedtime routine that feels familiar is a healthy trigger for your brain to start preparing for sleep. That routine may be as simple as washing up, flossing and brushing your teeth and getting into pajamas. Your sleep environment is key, too. Having a dark room allows your body to produce melatonin, the hormone that signals your body that it's time to go into sleep mode. It's also important to have your bedroom on the cool side, as being too warm inhibits sleep, and make sure your pillows, mattress and sheets are comfortable for you. Many people also find that white noise, like a fan or the sound of rain, helps with sleep. As this study suggests, it's not just what you do at bedtime that influences sleep; what you do during the day matters, too. Yoga, tai chi, walking and jogging all seem to improve sleep quality and quantity. Even getting outside into natural light during the afternoon may help you sleep better. But what about the timing of exercise? Recent research suggests that vigorous exercise done within four hours of bedtime may disrupt sleep quality and length. This research suggests opting for light, relaxing exercise if done in the evening, or making sure your vigorous workouts are reserved for earlier in the day and are no closer than four hours before bedtime. It's also important to avoid caffeine, nicotine, alcohol and large meals too close to bedtime, and try to keep a consistent bedtime, even on the weekends. If you nap in the afternoon, limit its length if you find it prevents you from falling asleep at bedtime. And if you find you get up at night to pee, take a break from the fluids earlier in the evening. While eating a large meal too close to bedtime can interrupt sleep, a rumbling belly sure doesn't help either. If you're hungry before bedtime, choose a sleep-friendly snack. Some ideas include banana with almond butter, Greek yogurt with sprouted pumpkin seeds and tart cherries or a turkey and apple roll-up. Our Expert Take This systematic review and meta-analysis suggests that yoga, tai chi, walking and jogging may help you sleep better. While this study can't say how much or at what intensity of each activity helps the most, you can experiment with that. The important thing is that whichever activities you choose, do them consistently over a long period of time for the greatest benefits. Read the original article on EATINGWELL
The Independent
a day ago
- Health
- The Independent
High street self-tests for bowel cancer and menopause may be unfit for purpose, researchers warn
High street self-tests for vitamin deficiencies, menopause and bowel cancer may not be fit for purpose, researchers have warned. There are many products available to UK customers without the need for a doctor's appointment. But concerns have been raised about the quality, appropriateness and safety of these kits, with doctors warning they could be 'dangerous' and cause 'false reassurance'. The researchers called for much tighter regulation of the sector, warning the NHS may face additional demand after people self-test. The market for self-tests is booming and is expected to reach a projected revenue of £660m by 2030 in the UK. To put these readily available health checks to the test, researchers at the University of Birmingham reviewed 30 self-tests bought from local supermarkets, pharmacies and health and wellbeing shops. The findings published in the BMJ on Wednesday show that most self-tests lack essential information about who should use them, how to interpret the results, and what actions to take next. Researchers looked at tests that covered 19 conditions including vitamin D deficiency, blood sugar, thyroid function, prostate health, HIV, menopause and bowel cancer. However, out of the 30 tests, less than half made any statement about accuracy, and only eight had information on the box about who should or should not use the test. Just seven of the at-home tests told users what to do after getting their results. Just 16 tests explicitly stated they were for screening, diagnosis, or monitoring, while nine did not indicate the symptoms or risk factors for their use. However, nearly all tests (27 out of 30) recommended follow-up with a healthcare professional if results were positive or abnormal, and 14 regardless of the result. Around half (14) claimed an accuracy of 98 per cent, but study authors highlighted that the evidence to back these claims was either not publicly available or was of low quality, which they said raised ethical concerns. Researchers also said 18 of the tests were 'high risk' due to the quality of the testing equipment, sampling process, or instructions and interpretation of the results. The authors acknowledge that the study sample was restricted to the Birmingham area and that their assessments were limited by the lack of access and poor reporting of documentation provided by manufacturers. However, they say this is a robust, reliable evaluation of self-tests available to the UK public. Kristien Boelaert, professor of endocrinology at the University of Birmingham and a consultant endocrinologist, said: 'I actually think it's dangerous. I would like there to be central UK-wide regulation... that prevents these things from coming on the market. I think the biggest potential harm is a false reassurance that, if it's not positive, everything is fine.' Joseph Burt, head of diagnostics and general medical devices at the Medicines and Healthcare products Regulatory Agency (MHRA), said it would review the evidence and 'consider all allegations about device deficiencies'. He added: 'We have strengthened post-market surveillance powers to monitor and act on concerns. These require manufacturers to actively monitor their products and report significant incidents to us, including for CE-marked self-tests. 'We're overhauling the medical device regulations to further strengthen standards for safety, usability and clinical performance, and we're exploring new transparency measures such as requiring published summaries of clinical evidence. 'In the meantime, we strongly encourage anyone using a self-test to check for a CE or UKCA mark, read the instructions carefully, and seek medical advice if they're unsure about their result.' Bernie Croal, president of the Royal College of Pathologists, warned of the knock-on effects for the NHS: 'There are significant risks to patients when poor quality tests are carried out inappropriately, with both false reassurance and unnecessary consequences for the NHS to repeat tests or take additional action.' Since the initial sample in 2023, researchers have continued to track the booming self-test market. A repeat search of the same geographical area in December 2024 identified 63 tests, twice as many as the previous year. 'There is an urgent need for coherent guidance and improved regulation to protect both individuals and healthcare systems from misuse and misinformation,' researchers concluded. Irwin Armstrong, founder and CEO of CIGA Healthcare and Suresign, which provides three of the numerous self-tests studied, criticised the BMJ study. He said: 'We find this blanket condemnation of a small range of home tests available to be unreasonable and unprofessional, since they admit they are content with many of those examined. This is not a clinical approach to a highly scientific subject. 'They also did not confirm that the clinical studies related to our tests were supplied to them, as confirmed to us by the BMJ. Our detailed responses to their questions were not fully reflected in their article. 'They have implicitly criticised the professionalism of notified bodies appointed by the MHRA, when we find them to be very exacting in their audits. We are content [that] our tests give the public access to healthcare screening not easily available with the NHS at the present time.' Mr Armstrong added: 'Suresign tests are intended to be used as screening tests and not for taking medical decisions. They are not intended to replace tests carried out by professionals. Currently, it is difficult to get an appointment with a GP and therefore, these tests provide information to enable users to actively seek a medical opinion if necessary.'
The Guardian
a day ago
- Health
- The Guardian
Many DIY health tests could give false results, studies find
Many DIY health tests available on the high street are unfit for purpose and need better regulation, according to two new studies. Self-tests for high cholesterol, vitamin deficiency, fertility and prostate problems are widely available in supermarkets and pharmacies, with the industry predicted to be worth £655m by 2030. But researchers at the University of Birmingham have found that many tests could give users false results and were not always appropriate or safe. The scientists reviewed 30 DIY health tests costing £1.89-£39.99, covering 19 different health conditions. These included vitamin D deficiency, blood sugar levels, thyroid function, prostate health, HIV, menopause and bowel cancer. The two linked studies, published in the British Medical Journal (BMJ), rated 60% of the tests as 'high risk' over concerns about the testing equipment, sampling process, or instructions and interpretation of the results. Only eight stated who the tests were suitable for, while fewer than half provided any information about accuracy. And of these, much of the evidence to back these claims was not publicly available or was of low quality. With many tests recommending the user followed up with their GP or another healthcare professional regardless of the result, 'this begs the question: 'What's the point of doing the test in the first place?'', said Dr Clare Davenport, an associate clinical professor at the University of Birmingham and co-lead author of the studies. 'The wide range of off-the-shelf tests now available to the public are not endorsed by the NHS and evidence for their benefit is lacking,' she added. 'This is in contrast to well-established self-tests, such as pregnancy tests. 'We are worried that consumers concerned about their health and tempted by the convenience of buying a test over the counter may be harmed if they use these tests in the wrong way.' The studies call for better regulation of DIY health tests to protect patients and prevent misuse. Prof Jon Deeks at the University of Birmingham and co-lead author of the studies said: 'Self-tests have a clear potential to improve public health. However, for them to be beneficial and not harmful, they must be proven to be accurate, easy to use and supported by clear instructions. We hope the MHRA [Medicines and Healthcare products Regulatory Agency] will update the regulatory process to ensure self-tests are effective and safe for everyone.' Joseph Burt, the head of diagnostics and general medical devices at the MHRA, said: 'We take the safety of self-tests very seriously. We will review the evidence presented by the researchers and consider all allegations about device deficiencies. 'We have strengthened post-market surveillance powers to monitor and act on concerns. These require manufacturers to actively monitor their products and report significant incidents to us, including for CE-marked self-tests. 'We're overhauling the medical device regulations to further strengthen standards for safety, usability and clinical performance – and we're exploring new transparency measures such as requiring published summaries of clinical evidence. In the meantime, we strongly encourage anyone using a self-test to check for a CE [Conformité Européene] or UKCA [UK Conformity Assessed] mark, read the instructions carefully and seek medical advice if they're unsure about their result.' Prof Kamila Hawthorne, the chair of the Royal College of GPs, said: 'With the risk of false positives and negatives, and no offer of an interpretation of the results or aftercare, self-testing kits can mean patients experience a significant amount of stress and anxiety – prompting them to seek guidance from their GP to interpret any results. 'This not only negatively impacts our patients, but it can also intensify the enormous pressures that GPs and their teams are currently under. Commercial self-testing kits should not default to NHS general practice as the provider for next steps and aftercare, unless the test was initiated in primary care or as part of a commissioned NHS service.'
Sky News
a day ago
- Health
- Sky News
Off-the-shelf medical tests are failing to back up accuracy promises with evidence, study finds
Off-the-shelf medical tests that promise to diagnose conditions ranging from vitamin deficiencies to cancer are lacking evidence to back up their accuracy, a study has found. Thirty self-testing kits were purchased from a range of mainstream supermarkets, pharmacies and health and wellbeing shops by researchers from the University of Birmingham in 2023. The kits tested for vitamin deficiency, blood cholesterol, menopause and bowel cancer. These tests are often marketed as tools for empowerment and early detection at a time when the NHS is already over-stretched. Accuracy claims were made for 24 of these tests however, and nearly six out of 10 (14) promised 98% accuracy. However, evidence supporting these claims was largely unavailable, according to a series of papers published by the British Medical Journal (BMJ). In addition, 18 of the tests (60%) were found to have errors that could lead to a wrong result. This included 11 that had problems with equipment, 10 showing issues with the sampling process and 15 that had problems with the instructions of interpretation of results. Where information about what types of accuracy methods were available, about a third of those compared their test with another similar test - not a proper, trusted medical test. Most of the tests also did not explain who they tested them on to provide the accuracy data. These types of testing kits are not subject to the same stringent checks that a new medication would have to go through. The University of Birmingham's Professor Jon Deeks, a corresponding author of the study, said: "Our findings highlight concerns about the value of these self-tests because the instructions for use for many of them recommended seeing a doctor regardless of the test result (positive or negative)." Can these tests cause harm? Dr Clare Davenport, co-author of the study, said the benefit of many of these tests "is lacking". "This is in contrast to well-established self-tests, such as pregnancy tests," she said. "We are worried that consumers concerned about their health and tempted by the convenience of buying a test over the counter may be harmed if they use these tests in the wrong way." A false positive on such a test may lead to anxiety, unnecessary investigations and even overtreatment, while a false negative could lead to delays in treatment. Researchers are now calling for better regulation and guidance from manufacturers, retailers and healthcare professionals to protect consumers of off-the-shelf health self-tests. There were some limitations to the test - namely that they were bought two years ago and were not intended to be a sample of what is available across the country. "But given what they do say about where they got the tests, I'd be surprised if they aren't pretty much the same anywhere nowadays," said Professor Kevin McConway, emeritus professor of applied statistics at The Open University. He said the results were "scary and concerning". "I don't doubt the findings of the researchers, that many of the available tests don't make it clear who could make good use of them, how accurate the results might be, or what someone should do in the light of their results." 'History offers cautionary tales' "Self-tests should not be dismissed outright though," wrote Jessica Watson from the Centre for Academic Primary Care, and Margaret McCartney, from the University of St Andrews, in an editorial for the BMJ. "History offers cautionary tales: when home pregnancy tests were first introduced, some doctors argued that women could not be trusted to use them. "Clearly that is not the case. "The use of HIV self-tests has been extensively and carefully evaluated, with decades of research, including large randomised controlled trials." However, they say that these examples are of tests that are "binary" with yes or no answers, and are integrated within healthcare systems, "with clear actions to be taken based on the results".
