Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb 26;321(8):739-740.
doi: 10.1001/jama.2019.0286.

Potential Excessive Testing at Scale: Biomarkers, Genomics, and Machine Learning

Kenneth D Mandl  1   2 , Arjun K Manrai  1   3
Affiliations

Potential Excessive Testing at Scale: Biomarkers, Genomics, and Machine Learning

Kenneth D Mandl et al. JAMA. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Manrai reported receiving personal fees from doc.ai outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Pathways That Promote Increased Application of Biomarkers
A, Statin treatment recommendations changed substantially between the 2004 Adult Treatment Panel (ATP) and the 2013 American College of Cardiology–American Heart Association (ACC/AHA) guidelines. For primary prevention among patients without diabetes and with a 10-year cardiovascular disease risk of 7.5% or more, the guidelines switch amounts to lowering the low-density lipoprotein (LDL) cholesterol threshold from 190 to 70 mg/dL (to convert LDL from mg/dL to mmol/L, multiply by 0.0259). Survey-weighted estimates from the Centers for Disease Control and Prevention National Health and Nutrition Examination Survey (NHANES) 2013–2014 cohort show substantial increases in the population defined as having the risk factor. B, New digital biomarkers are entering clinical care settings. Even with nearly identical testing characteristics, 2 machine learning algorithms to detect diabetic retinopathy using different thresholds along their respective receiver operating characteristic curves will drive substantially different numbers of ophthalmology referrals and possibly treatments.
See this image and copyright information in PMC

References

    1. Schwartz LM, Woloshin S. Medical marketing in the United States, 1997–2016. JAMA 2019;321(1): 80–96. doi:10.1001/jama.2018.19320 - DOI - PubMed
    1. Pencina MJ, Navar-Boggan AM, D’Agostino RB Sr, et al. Application of new cholesterol guidelines to a population-based sample. N Engl J Med 2014;370 (15):1422–1431. doi:10.1056/NEJMoa1315665 - DOI - PubMed
    1. Redberg RF. The medicalization of common conditions. JAMA Intern Med 2016;176(12):1863. doi:10.1001/jamainternmed.2016.6210 - DOI - PubMed
    1. Gill J, Obley AJ, Prasad V. Direct-to-consumer genetic testing: the implications of the US FDA’s first marketing authorization for BRCA mutation testing. JAMA 2018;319(23):2377–2378. doi:10.1001/jama.2018.5330 - DOI - PubMed
    1. van Tulleken C Overdiagnosis and industry influence: how cow’s milk protein allergy is extending the reach of infant formula manufacturers. BMJ 2018;363:k5056. doi:10.1136/bmj.k5056 - DOI