Evaluation of direct-to-consumer low-volume lab tests in healthy adults.

BACKGROUND: Clinical laboratory tests are now being prescribed and made directly available to consumers through retail outlets in the USA. Concerns with these test have been raised regarding the uncertainty of testing methods used in these venues and a lack of open, scientific validation of the technical accuracy and clinical equivalency of results obtained through these services. METHODS: We conducted a cohort study of 60 healthy adults to compare the uncertainty and accuracy in 22 common clinical lab tests between one company offering blood tests obtained from finger prick (Theranos) and 2 major clinical testing services that require standard venipuncture draws (Quest and LabCorp). Samples were collected in Phoenix, Arizona, at an ambulatory clinic and at retail outlets with point-of-care services. RESULTS: Theranos flagged tests outside their normal range 1.6× more often than other testing services (P < 0.0001). Of the 22 lab measurements evaluated, 15 (68%) showed significant interservice variability (P < 0.002). We found nonequivalent lipid panel test results between Theranos and other clinical services. Variability in testing services, sample collection times, and subjects markedly influenced lab results. CONCLUSION: While laboratory practice standards exist to control this variability, the disparities between testing services we observed could potentially alter clinical interpretation and health care utilization. Greater transparency and evaluation of testing technologies would increase their utility in personalized health management. FUNDING: This work was supported by the Icahn Institute for Genomics and Multiscale Biology, a gift from the Harris Family Charitable Foundation (to J.T. Dudley), and grants from the NIH (R01 DK098242 and U54 CA189201, to J.T. Dudley, and R01 AG046170 and U01 AI111598, to E.E. Schadt).

Would doubling the human lifespan be a net positive or negative for us, either as individuals or as a society? Point-counterpoint.

There is a significant possibility that over the next few decades science will make discoveries of a kind that might allow the doubling of the average human life span, from roughly 76 years now to 150. This development would, for many, represent the realization of a dream: that of enabling people to live much longer lives than at present, holding back death, which has often been seen as an ancient, unbeatable enemy. It would also raise a large number of unprecedented individual and social problems: Would we really want to live to 150? Is such a goal ethical? What would this putative longevity do to our present social structures and arrangements? Would we get a better society or a worse one?

The pitfalls of planning for demographic change.

As we begin to understand the biology of aging, it will be ever more tempting to try to plan for the social consequences of the coming biomedical interventions in this arena. However, this will remain a daunting task, because the larger consequences of the arrival of antiaging interventions will greatly depend on the relative character and timing of the specific procedures that emerge. Three basic classes of interventions are likely: ones that slow aging in adults, ones that reverse aging in adults, and embryonic interventions that modify the overall trajectory of human aging. The consequences of each will differ significantly in the time required before noticeable demographic shifts begin to manifest in the human population, and in the social and political changes the interventions evoke. The specific societal consequences generally will arrive long before the demographic ones, and will hinge on the technical details of the interventions themselves--their complexity, physiological targets, modes of delivery, costs, unpleasantness, and the character and frequency of side effects.