June 12, 2016

Walking it back

First the headline (Herald, reprinting Daily Telegraph)

Finger-prick test that can show risk of diabetes

then it’s “on the horizon”

The finger-prick test, which could be available at GP surgeries or even chemists, looks for molecules in the blood that indicate diabetes is developing.

but in the present tense. Then

The specific biomarkers involved are being kept a closely guarded secret for now, but once a prototype test has been developed, trials will take place.

This ‘test’ not only hasn’t been evaluated in real patients; it doesn’t even exist yet.

And

Currently, doctors can test for diabetes only by taking blood glucose readings that show whether the disease is already present.

That’s only true if you squint from exactly the right angle. Since 2012, testing for HbA1c, a byproduct of elevated glucose, has been a general screening recommendation in NZ and one of the public health performance indicators. One of the reasons given for screening is

effective screening aims to reduce the incidence of diabetes through detection of people with pre-diabetes

You could argue ‘the disease is already present’ in people with pre-diabetes, but not in the sense that’s relevant to screening.

The current test isn’t all that good, and perhaps when they finish inventing it the new one will be better. But it’s not a test yet; it’s not a ‘health’ story yet; and with so little disclosed information it’s not clear that it’s even a science story yet.

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Thomas Lumley (@tslumley) is Professor of Biostatistics at the University of Auckland. His research interests include semiparametric models, survey sampling, statistical computing, foundations of statistics, and whatever methodological problems his medical collaborators come up with. He also blogs at Biased and Inefficient See all posts by Thomas Lumley »