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.

It’s a shock when we realise our parents aren’t managing well at home.

Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed.

You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what?

Here are four things to consider.

1. Start with more help at home

Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move.

Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both.

Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety.

Call My Aged Care to discuss your options.

2. Be prepared for multiple conversations

Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made.

Ideally, the older person feels supported rather than attacked during these conversations.

Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice.

Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”.

3. Understand the options when help at home isn’t enough

If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be considering a nursing home (also known as residential aged care in Australia).

Every person has a legal right to choose where we live (unless they have lost capacity to make that decision).

This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”.

It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational).

Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else?

Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space.

Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission.

Research suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control.

Mum and Dad should be involved in the decision-making process about where they live, and when they might move.

Some families start looking “just in case” as it often takes some time to find the right nursing home and there can be a wait.

After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule.

We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions.

For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”.

Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead.

4. Understand the options if a parent has lost capacity to make decisions

If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests.

If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity.

Mum or Dad may have appointed an enduring guardian to make decisions about their health and lifestyle decisions when they are not able to.

An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves.

If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can appoint that person a private guardian (usually a family member, close friend or unpaid carer).

If no such person is available to act as private guardian, a public official may be appointed as public guardian.

Deal with your own feelings

Families often feel guilt and grief during the decision-making and transition process.

Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.

Lee-Fay Low, Professor in Ageing and Health, University of Sydney

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