What should you do about diagnostic screening tests offered for sale on the Internet? The short answer is that you should ignore them because some are scams and the rest are unlikely to represent good value.
To be worth doing, a screening test should be able to detect problems before symptoms occur and should lead to an outcome than is better than would have happened if treatment begins after symptoms appear. At specific ages, certain diagnostic procedures have special significance because they may detect potentially serious problems that are common at those ages and treatable in their early stages. Unnecessary tests are not merely a waste of money. An abnormal result can cause needless worry and lead to more unnecessary tests.
Many scientific panels have studied this issue and reported their findings. The most respected is probably the United States Preventive Services Task Force (USPSTF), which was created in 1984 to determine what types of periodic physical examinations, laboratory tests, and other measures are science-based and cost-effective. Its reports, which evaluate preventive strategies for about 80 diseases and conditions, are updated periodically and posted to the USPSTF Web site.
Several commercial Web sites offer tests that differ considerably from what the USPSTF recommends. One of the most elaborate is the HealthPrint program offered by Your Future Health (YFH), of Taveras, Florida. The company “team” includes Ellie Cullen, R.N.; her husband; their son and daughter; their children’s spouses; and a consultant with credentials in laboratory science. Mrs Cullen is said to have over 25 years in clinical nursing, nutrition, and lifestyle counseling. The consultant is Oscar G. Rasmussen, Ph.D., who, in the early 1980s, was president of the American Society for Elemental Testing Laboratories (ASETL), an organization whose mission was to ensure the accuracy of hair analysis laboratories. (Commercial hair analysis is a bogus test used for prescribing dietary supplements .) Rasmussen has also served on the staff of American International Hospital (now called Cancer Treatment Centers of America), a hospital that has engaged in questionable nutrition practices as well as misleading advertising. The other five team members have no apparent health-related training or credentials .
YFH charges $70 to set up an account, $250 for each “Basic HealthPrint” panel, and extra fees for 15 additional individual tests whose costs are not specified on the Web site. The set-up fee includes a guidebook, a supply of pH strps for urine testing, and various forms for charting progress. The “Basic” panel is composed of 56 individual test scores. However, a close look at its list reveals that 3 of these “tests” are ratios calculated from other results, 9 are the individual components of an automated complete blood count, and 16 are merely the types of cells or cell characteristics that can be observed in a manual examination (also listed as a test) in which the technician examines a blood sample under the microscope. In other words, the actual number of tests is only half the number it appears to be from the list. Of the rest, 18 are individual components of an automated blood chemistry panel; 4 are the components of a lipid profile (to check blood cholesterol levels); and the rest are individual tests (iron, magnesium, zinc, and two liver enzyme tests) for which there is no valid reason to test routinely or annually.
The YFH Web site claims that blood is as unique as fingerprints because. “No one else can ever have the same blood as you. That’s why your blood is such a good indicator of your future health. It is almost like having a crystal ball that you can look into to see how healthy/unhealthy you will be 1 year, 2 years, 10 years from now!” The site also claims that HealthPrint’s “individually optimized health and wellness plan” will help people “optimize” their body and detect serious diseases early enough to improve treatment outcome. The program is claimed to identify individual “optimum ranges” that, if exceeded, can result in acne, allergies, arthritis, blood pressure irregularities, cancer, cholesterol problems, lack of energy, infertility, heart disease, hypoglycemia, diabetes, immune system weakness, migraines, osteoporosis, PMS, sleep problems, weight loss, and weight gain.
These claims are preposterous. The only components of their “Basic” test that can cause future problems are abnormal lipid levels, which, if unmodified, will increase the odds of developing cardiovascular disease.
Repeated testing, YFH asserts, enables HealthPrint to determine “individual Optimal Ranges” for each test so that “you can improve scores . . . simply by changing your diet and supplement plan.” This is doubly wrong. Variations within the normal range are often related to when the blood is drawn, how the blood is drawn, how the blood is handled, how the equipment is calibrated, and other factors that are not related to the patient’s health. Moreover, most of the conditions mentioned above cannot be modified by taking supplements.
Some claims are bizarre:
- The personalized program includes a “list of foods that are correct for your blood type, gender, and symptoms.” [Blood type has nothing to do with nutrition needs.]
- The system “helps you understand the importance of balancing your urine pH and how to do it.” [Urinary pH occasionally reflects the presence of a disease process. Except for certain patients with kidney stones, if treatment is needed, it would be directed against the disease rather than the urinary pH level. Moreover, pH varies throughout the day and “balancing” it is not a medically recognized concept.]
- All clients are assigned a “pH goal based of their blood type.” According to YFH, “balancing your pH” can improve kidney, blood sugar, and cholesterol scores and are useful for managing your weight. [pH has nothing to do with blood type and is not something people need to worry about “balancing.”]
- The system is promised to explains the importance of water including “the different kinds of water and how much is right for you.” [For most people, thirst provides an adequate guide to how much the body needs. Blood tests are unlikely to provided practical information.]
To encourage additional testing, the site lists diseases that supposedly are associated with abnormal test results. Some of the associations are valid, but some are not, and very few of the diseases can be influenced by dietary changes. The main diet-related problem that the test system can detect is a high cholesterol level, but obtaining this test annually would be a very foolish thing for healthy people to do. Science-based guidelines state that the frequency of blood lipid testing should be based on risk factors (the likelihood of a problem developing) and that people at low risk need be tested only once every five years.
YFH would like you to believe that its protocols are more effective and cost-effective than established medical guidelines. I do not believe this is accurate. Among other things, YFH invites clients to judge what they need by interpreting simplistic information without benefit of a medical education. I do not believe that the average client can outthink the average doctor.
YFH recommends obtaining the Basic HealthPrint once or twice a year in order to detect variations that would not be apparent if testing were conducted less often. If everyone over 18 in the United States followed this advice, the total cost would be at least $14 billion for opening their accounts, another $52 billion per year for the Basic HealthPrint test, and another $52 billion if the test is done twice a year. This huge amount of money would be much better spent on proven strategies.
- Barrett S. Commercial hair analysis: A cardinal sign of quackery. Quackwatch Web site.
- Our team. Your Future Health Web site, accessed Feb 21, 2002.
This article was revised on February 21, 2000.