Self-Testing + Home Monitoring Devices

3 categories of self-testing/home monitoring devices

1. diagnostic self-tests (yes/no health question)

2. home monitoring devices (tracks health over time)

3. OTC hearing devices (restore hearing)

list 5 diagnostic tests

1. pregnancy test

2. ovulation predictor kit

3. UTI self-test strips

4. HIV self-testing

5. fecal occult blood

pregnancy test

detects hCG in urine, best accuracy with first morning urine or day of missed period

**Counsel: testing too early is #1 cause of false negative

ovulation predictor kit

detects LH surge that precedes ovulation by 24-36h

• tested daily, several days in a row, ~mid-cycle

**Counsel: not contraceptive, conditions like PCOS/PMOS can cause misleading results

UTI self-test strips

detects leukocyte esterase and nitrites

• dip and read strip, results in 1-2 min

**REFER for fever, back pain, nausea, vomiting, pregnancy, persisting symptoms (even despite negative test)

HIV self-testing

oral fluid swab, antibody test, results in 20-40 min

• window period limited

• any result is preliminary

fecal occult blood test

detects blood in stool

• Guaiac (gFOBT) = chemical reaction, requires diet/med prep

• Immunochemical (FIT) = antibody-based, no prep (preferred)

**Counsel: positive result means pt needs colonoscopy, not that they have cancer

list 3 home-monitoring devices

1. home BP

2. blood glucose meters

3. thermometers

Home BP monitor

upper arm cuff = accuracy standard— should encircle 80-100% of arm, look for device on validated device listing

what happens to the BP reading if the cuff is too small?

reads falsely high

what happens to the BP reading if the cuff is too large?

reads falsely low

blood glucose meter

fingerstick blood + electrochemical test strip, reports within seconds

• new Dexcom Stelo = first OTC continuous glucose monitor— no fingerstick, no prescription

thermometer

need right device & right site

• digital oral/axillary = standard for adults

• rectal = most accurate, standard for infants

• tympanic = <3mo, fast & convenient but tech sensitive

• temporal artery = fast, non-contact options

are temps comparable across sites/devices?

no

what infant < 3 mo temp requires referral?

104

3 hearing aid options

1. prescription hearing aids

2. OTC hearing aid

3. PSAP

prescription hearing aids

medical device, any age/degree of hearing loss, best for kids/severe loss

OTC hearing aid

medical device, adults 18+ with mild-moderate loss, no exam required

PSAP

Personal Sound Amplification Product

• consumer electronics, no professional involvement

• normal-hearing users

when to refer for hearing loss

• sudden/rapid progression of hearing loss

• active draining from ear

• pain/discomfort in ear

• deformity of ear

• unilateral hearing loss

• foreign body in canal

• acute/chronic dizziness

______ drugs may cause hearing loss

ototoxic (toxic effect on the functioning of the inner ear)

3 places to refer for hearing loss

1. audiologist (diagnostic testing, hearing aid fitting, rehab)

2. hearing instrument specialist (dispense + fit but no diagnosis)

3. ENT