When Kim Kardashian posted on Instagram about having had a full-body MRI, she enthused that the test can be “life saving”, detecting diseases in the earliest stages before symptoms arise.

What Kardashian neglected to say was there’s no evidence this expensive scan can bring benefits for healthy people. She also didn’t mention it can carry harms including unnecessary diagnoses and inappropriate treatments.

With this post in mind, we wanted to explore what influencers are telling us about medical tests.

In a new study published today in JAMA Network Open, we analysed nearly 1,000 Instagram and TikTok posts about five popular medical tests which can all do more harm than good to healthy people, including the full-body MRI scan.

We found the overwhelming majority of these posts were utterly misleading.

5 controversial tests

Before we get into the details of what we found, a bit about the five tests included in our study.

While these tests can be valuable to some, all five carry the risk of overdiagnosis for generally healthy people. Overdiagnosis is the diagnosis of a condition which would have never caused symptoms or problems. Overdiagnosis leads to overtreatment, which can cause unnecessary side effects and stress for the person, and wasted resources for the health system.

As an example, estimates suggest 29,000 cancers a year are overdiagnosed in Australia alone.

Overdiagnosis is a global problem, and it’s driven in part by healthy people having tests like these. Often, they’re promoted under the guise of early screening, as a way to “take control” of your health. But most healthy people simply don’t need them.

These are the five tests we looked at:

The full-body MRI scan claims to test for up to 500 conditions, including cancer. Yet there is no proven benefit of the scan for healthy people, and a real risk of unnecessary treatment from “false alarm” diagnoses.

The “egg timer” test (technically known as the AMH, or anti-mullarian hormone test) is often falsely promoted as a fertility test for healthy women. While it may be beneficial for women within a fertility clinic setting, it cannot reliably predict the chance of a woman conceiving, or menopause starting. However, low results can increase fear and anxiety, and lead to unnecessary and expensive fertility treatments.

Multi-cancer early detection blood tests are being heavily marketed as the “holy grail of cancer detection”, with claims they can screen for more than 50 cancers. In reality, clinical trials are still a long way from finished. There’s no good evidence yet that the benefits will outweigh the harms of unnecessary cancer diagnoses.

The gut microbiome test of your stool promises “wellness” via early detection of many conditions, from flatulence to depression, again without good evidence of benefit. There’s also concern that test results can lead to wasted resources.

Testosterone testing in healthy men is not supported by any high-quality evidence, with concerns direct-to-consumer advertising leads men to get tested and take testosterone replacement therapy unnecessarily. Use of testosterone replacement therapy carries its own risk of potential harms with the long-term safety in relation to heart disease and mortality still largely unknown.

What we found

Together with an international group of health researchers, we analysed 982 posts pertaining to the above tests from across Instagram and TikTok. The posts we looked at came from influencers and account holders with at least 1,000 followers, some with a few million followers. In total, the creators of the posts we included had close to 200 million followers.

Even discounting the bots, that’s a massive amount of influence (and likely doesn’t reflect their actual reach to non-followers too).

The vast majority of posts were misleading, failing to even mention the possibility of harm arising from taking one of these tests. We found:

• 87% of posts mentioned test benefits, while only 15% mentioned potential harms
• only 6% of posts mentioned the risk of overdiagnosis
• only 6% of posts discussed any scientific evidence, while 34% of posts used personal stories to promote the test
• 68% of influencers and account holders had financial interests in promoting the test (for example, a partnership, collaboration, sponsorship or selling for their own profit in some way).

Further analysis revealed medical doctors were slightly more balanced in their posts. They were more likely to mention the harms of the test, and less likely to have a strongly promotional tone.

As all studies do, ours had some limitations. For example, we didn’t analyse comments connected to posts. These may give further insights into the information being provided about these tests, and how social media users perceive them.

Nonetheless, our findings add to the growing body of evidence showing misleading medical information is widespread on social media.

What can we do about it?

Experts have proposed a range of solutions including pre-bunking strategies, which means proactively educating the public about common misinformation techniques.

However, solutions like these often place responsibility on the individual. And with all the information on social media to navigate, that’s a big ask, even for people with adequate health literacy.

What’s urgently needed is stronger regulation to prevent misleading information being created and shared in the first place. This is especially important given social media platforms including Instagram are moving away from fact-checking.

In the meantime, remember that if information about medical tests promoted by influencers sounds too good to be true, it probably is.

Brooke Nickel, NHMRC Emerging Leader Research Fellow, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Ray Moynihan, Assistant Professor, Faculty of Health Sciences & Medicine, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Around one in 20 people has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood.

ADHD is diagnosed when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home.

Some people call the condition attention-deficit disorder, or ADD. So what’s the difference?

In short, what was previously called ADD is now known as ADHD. So how did we get here?

Let’s start with some history

The first clinical description of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still presented a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate.

Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions.

The first DSM, published in 1952, did not include a specific related child or adolescent category. But the second edition, published in 1968, included a section on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder.

In the early 1980s, the third DSM added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder with hyperactivity (ADDH) and attention deficit disorder as the subtype without the hyperactivity.

However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today:

• predominantly inattentive
• predominantly hyperactive-impulsive
• combined.

Why change ADD to ADHD?

ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons.

First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was initially named, little research had been done to determine the similarities and differences between the two sub-types.

The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions?

Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours may not necessarily be disruptive and challenging but are more likely to be forgetful and daydreamers.

Why do some people use the term ADD?

There was a surge of diagnoses in the 1980s. So it’s understandable that some people still hold onto the term ADD.

Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits.

Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed.

How is ADHD currently diagnosed?

The three sub-types of ADHD, outlined in the DSM-5 are:

• predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions
• predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control
• combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive.

ADHD diagnoses continue to rise among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses.

However, some international experts contest the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors.

Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.

Kathy Gibbs, Program Director for the Bachelor of Education, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.