Increasing access to diagnostics hits the headlines again
Today (27 November, 2014) a commission established by the Lancet has reported that liver disease stands out as a glaring exception to the vast improvements made during the past 30 years in health and life expectancy for chronic disorders such as stroke, heart disease and many cancers.
There are many striking things about this wide ranging and detailed report, but none more shocking than the fact that since the 1970s mortality rates from liver disease have increased 400 per cent, and in people younger than 65 years has risen by almost five-times.
To combat this increasing problem the commission, led by Prof Roger Williams, director of the Institute of Hepatology, calls for radical changes in the diagnosis of liver disease.
Of particular interest, the report suggests that standard liver function tests provided in UK laboratories aren’t helping to detect early liver damage. It also highlights that knowledge and awareness of liver diseases in primary care is low, with an absence of adequate diagnostic methods and training in the diagnosis and management of the early stages of the condition.
This is a common problem across many disease areas and there is a clear role for our industry to play. The reality is that there are a number of easily-accessible non-invasive tests that could be available across the NHS but aren’t.
Liver diseases are diagnosed in four ways, namely via:
· Blood tests
· Imaging tests/scans
· Liver biopsy
In terms of IVDs, an example of a newer test that is not routinely available across primary care is the Enhanced Liver Fibrosis (ELFTM). This test requires only a small blood sample, and can indicate whether a patient suffers from slight, moderate or serious liver disease within an hour.
Nonetheless, as the report highlights, this is not a matter of a single test being better than all the others. It is about optimising a patient’s journey through the NHS by increasing access to a range of diagnostics, as BIVDA and the IVD industry have consistently argued for.
In this regard it is fully in line with NHS England’s thinking, with the NHS Five Year Forward View stressing the importance of increasing access to diagnostics. This will not only help improve patient outcomes and save the NHS money, but as noted by the commission’s report, can also improve a patient’s health in the short term. Early diagnosis resulted in 65 per cent of patients identified as having early liver disease stopping drinking at harmful or dependent levels simply as a result of being informed of their diagnosis.