What are Laboratory Developed Tests (LDTs)? These are artificial diagnostic tests that are constructed and
used in laboratories to detect diseases and infections. Edward Simpson looks at the matter further...
FDA laboratory
developed tests are different from the standard diagnostic tools that medical
practitioners are used to. Even though these tests have been there for years
now, they have been subject to serious qualms. At present, The Food and Drug
administration (FDA) is focused on regulating laboratory tests and coming up
with FDA approved lab tests.
The reason behind this is that the FDA claims that LDTs may have caused harm to
patients as a direct result of misdiagnosis.
The move to regulate
the diagnostic tests that have been developed in over a hundred laboratories is
picking up quite a debate. The FDA seems to overlook the fact that doctors use
diagnostic laboratory developed tests to determine if their patients are at
risk for developing serious illnesses. It is for this reason that hospitals
strictly use FDA approved kits. However, the a thousand plus single
laboratories in the USA are overly motivated and dedicated to designing and
using their own tests.
When it all Began
Since 1976, the USFood and Drug Administration have the mandate of regulating LabDeveloped Tests.
In the past, the FDA chose not to enforce applicable regulatory requirements
because LDTs were just basic lab tests that were used on restricted cases and
only for rare conditions.
For over 4 decades
now, the FDA has been keeping tabs on several LDTs which are said to pose high
risks. The main concern being that people might get carried away and begin to
administer treatment that might lead to over and/or under treatment.
The fact that we quickly become accustomed to advancement in technology
also means that LDTs are ever evolving. Laboratory developed tests are becoming
more complex and since they are widely used across the country, these tests may
present higher risks to patients especially those diagnosed with cancer and
Alzheimer’s disease.
The FDA made it
publicly known that it intended to issue a draft stipulating its oversight
framework over LDTs. This was on 31st July 2014. Since then, The Food and Drug Administration
decided to focus on what LDTs can do for patients rather than shunning them
just because they are manufactured and designed in a lab. An excerpt of this
draft reads, “The FDA will continue to exercise enforcement discretion for LDTs
that are used for rare diseases…”
Should the FDA oversee all Lab Developed Tests?
In
its quest to start a premarket view for LabDeveloped Tests,
the FDA pays attention to the use of LDTs by observing the
following information
- Whether FDA approved diagnostic tests will give patients an effective diagnosis and treatment option.
- Whether these LDTs are used for diagnosis or screening.
- Whether medical practitioners will go beyond LDT results and find more means for diagnosis and treatment.
- Whether the laboratory developed tests used are intended for high risk diseases or not.
- Whether where LDTs fail, there will be other alternative testing and treatment options used to save lives.
- Whether the adverse effects associated with LDTs is a risk worth taking.
After a recent agency
meeting, the FDA informed Congress that is intends to exercise authority over
LDTs. The agency went ahead to introduce a proposed regulatory framework and
their suggestion to oversee all LDTs elicited a strong response for and
against.
The truth of the matter is,
times have changed and so have LDTs. Compared to some years back, LDTs have now
increased not only in complexity but also in availability hence the urgent need
for a FDA test. Having in mind that LDTs
are now used to diagnoseboth common and serious medical conditions like heart
disease, cancer and Alzheimer’s disease, it is only proper that the FDA oversee
these tests to ensure that patients are safe.
With
all that said, the
answer to the question whether the FDA’s involvement in regulating all LDTs is
good or not, the answer is a big Yes!
Posted by Edward Simpson
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