How can consumers be sure a genetic test is valid and useful?

Before undergoing genetic testing, it is important to be sure that the test is valid and useful. A genetic test is valid if it provides an accurate result. Two main measures of accuracy apply to genetic tests: analytical validity and clinical validity. Another measure of the quality of a genetic test is its usefulness, or clinical utility.

• Analytical validity refers to how well the test predicts the presence or absence of a particular gene or genetic change. In other words, can the test accurately detect whether a specific genetic variant is present or absent?

• Clinical validity refers to how well the genetic variant being analyzed is related to the presence, absence, or risk of a specific disease.

• Clinical utility refers to whether the test can provide information about diagnosis, treatment, management, or prevention of a disease that will be helpful to a consumer.

All laboratories that perform health-related testing, including genetic testing, are subject to federal regulatory standards called the Clinical Laboratory Improvement Amendments (CLIA) or even stricter state requirements. CLIA standards cover how tests are performed, the qualifications of laboratory personnel, and quality control and testing procedures for each laboratory. By controlling the quality of laboratory practices, CLIA standards are designed to ensure the analytical validity of genetic tests.

CLIA standards do not address the clinical validity or clinical utility of genetic tests. The Food and Drug Administration (FDA) requires information about clinical validity for some genetic tests. Additionally, the state of New York requires information on clinical validity for all laboratory tests performed for people living in that state. Consumers, health providers, and health insurance companies are often the ones who determine the clinical utility of a genetic test.

It can be difficult to determine the quality of a genetic test sold directly to the public. Some providers of direct-to-consumer genetic tests are not CLIA-certified, so it can be difficult to tell whether their tests are valid. If providers of direct-to-consumer genetic tests offer easy-to-understand information about the scientific basis of their tests, it can help consumers make more informed decisions. It may also be helpful to discuss any concerns with a health professional before ordering a direct-to-consumer genetic test.

For more information about determining the quality of genetic tests:

The Centers for Disease Control and Prevention (CDC) provides an explanation of the factors used to evaluate genetic tests, including analytical validity, clinical validity, and clinical utility, as part of their ACCE project. Additional information about the ACCE framework is available in an interactive tutorial from the PHG Foundation.

A brief overview of the regulation of genetic testing is available from the Genetics & Public Policy Center.

The Genetic Alliance offers information about the quality of genetic tests and current public policy issues surrounding their regulation.

An interactive tutorial about clinical utility is available from the PHG Foundation.

The U.S. Centers for Medicare and Medicaid Services (CMS) provide an overview of the Clinical Laboratory Improvement Amendments (CLIA).

Additional information about the oversight of genetic testing in the United States is available from a Report of the Secretary’s Advisory Committee on Genetics, Health, and Society (SACGHS).

Next: What do the results of genetic tests mean?