UT Researchers Work to Make At-Home Diagnosis Easier Published on Reporting Texas By Kelsey Jukam Researchers at The University of Texas

are developing technology that may soon allow individuals to be tested for a number of infections and diseases without having to make a trip to the doctors office. If we can predict pregnancy at home, why cant we detect lots of other things? said UT biochemistry professor Andrew Ellington during a talk as part of UTs Hot Science Cool Talks public lecture series earlier this month. Peter Allen, a postdoctoral researcher in Ellingtons cellular and molecular biology lab, says at-home diagnostic tests can save patients from costly or time-consuming trips to the doctor or even the emergency room. There is real value in being able to do simple diagnostics at home to ask, Is my kid sick or something with a virus that he just needs to stay in bed, or is he sick with an infection, to where he needs to go to the doctor soon? Allen said. There are already several diagnostic at-home tests on the market including tests for blood pressure, HIV and urinary tract infections. Some tests on the market, such as those that screen for allergies or thyroid conditions, can be laborious, difficult to interpret and pricey. Ellington and his associates hope their research will lead first to an at-home test for tuberculosis and eventually help researchers develop similar tests for diseases such as strep and Celiacs disease and simplify and reduce costs for existing home tests. Scientists at the Ellington Lab are now focusing on developing a test for multidrug-resistant tuberculosis, which primarily occurs in lower- and middle-income countries and is rampant in many nations in Africa and Asia. It is curable and preventable, but left untreated, tuberculosis is deadly and kills more than a million people yearly, according to the World Health Organization. Two years ago, Ellington was awarded a $1.6 million grant by the Bill & Melinda Gates Foundation to develop a cheap and efficient test for tuberculosis. The tests needed to be simple, and something that could quickly get results, like the ubiquitous pregnancy test. But it also has to be complex enough to be able to test for multiple strains at one time, since there are more than a dozen types of multidrug-resistant tuberculosis. In countries with poor infrastructure, testing for multidrug-resistant tuberculosis is difficult. Samples of sputum mucus from the lungs need to be analyzed in a laboratory. Allen compares this analysis to developing film in a photography lab, where the sample is developed over the course of several chemical steps. The test they are hoping to develop is something akin to a Polaroid picture. The sensitive detection eliminates the painstaking tasks required in a lab and produces an instant result, according to Allen.

Researchers believe this same advanced rapid-test technology might be used to diagnose other diseases and conditions. But the technology will first appear outside of the U.S., in resource-poor countries. In India, Allen said, officials are willing to fast-track diagnostics given that they have such a high demand. There are also fewer regulatory issues to overcome in some developing countries. Ellington thinks that now the time is right for a real revolution in the way that individuals take responsibility for our own health care due to a combination of social forces like the high cost of health care and technological innovations such as user-friendly home medical tests. At-home test kits are part of a bigger trend to move care to the lowest level possible thats been going on for the past 20 years, said Kristie Loescher, a lecturer of management in the McCombs School of Business. This trend began when hospital payment systems changed in the 1980s, Loescher said. She said the current payment process has put hospitals and doctors more at-risk, and so they have a vested interest financially in moving has much care as possible outside of the hospital room or doctors office. Loescher also said people are now willing, if not eager to take on more control of their own health care and will welcome more technologies, like diagnostic tests, that can be used at home. Americans are ready for this, Loescher said. We check in ourselves at the airport, we check out our own groceries at the store and we really like that. Since the test for multidrug-resistant tuberculosis has to be used in resource-poor settings, the test needed to be as cheap as possible. Our goal is to have nothing more than a paper strip in somebodys hand, Ellington said in the lecture. After much trial and error, researchers at the lab arrived at a test design that costs about 5 cents to make less than 10 percent of the retail price of the fastest multidrug-resistant tuberculosis test currently on the market. The manufacturing process is so simple, graduate students can easily make the tests in the lab, by printing them on wax paper, and then manually cutting and folding them. Whether that means at-home tests will also be cheap for the American consumer, in the end, is up to whoever decides to manufacture them.
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