Lateral flow tests are an example of how technology can adapt to move a laboratory-based system into the home and the hands of everyday user, thus allowing quicker, easier, and more frequent testing. You can read more about the importance of good instructions for home-based testing here. The problem with mass testing is that it invariably creates mass waste. For each home lateral flow test I do, I have a plastic test kit, Tyvek pouch for the test kit, silica sachet, plastic ampule, swab, swab packaging and plastic bag for disposal.
Home testing is not new.
Pregnancy tests are a great example of a mass-based home testing kit that has adapted for ease of use and is so ubiquitous it probably isn’t seen as a home diagnostic. My guess is that most women in the Western world have used a home pregnancy test with the hope of a positive or negative result at least once in their adult life. Pregnancy tests have, of course, come a long way since when they were first available in the 1970s, both in terms of speed of results, reduction of steps and clear information to the user. You can read an interesting history of pregnancy tests here and there is a great recreation of using a home pregnancy test in the 1980s in the Netflix series Glow:
Ruth’s test in the Glow series probably took about 20 to 30 minutes compared with 2 minutes for a modern test and there are now no complex steps or mixing. “Just” pee (of course accuracy is needed) on a stick and wait. The potential for error is now in the interpretation of the results. In the film Juno, the main character re-did her pregnancy test over and over claiming that they must be “defective” or the “plus sign looked more like a division sign”. I know from personal experience that I had to double check what the different symbols meant. Is plus good or bad? It depends what you want the outcome to be of course.
I was obviously not the only one who was getting confused or lacking in confidence of the results. Marketers latched on and now many pregnancy tests have the code printed on the outside and of course you can a get a digital pregnancy test that will tell you whether you are pregnant by displaying the words “pregnant” or “not pregnant” on digital display to avoid any confusion.
Working in a technology consultancy I learnt that the internal workings of the digital pregnancy tests were the same. The digital ones just used the electronics to interpret the results of a normal test kit rather than doing the actual test. The BBC also a wrote about this in 2020 here. So when I was potentially pregnant with my second child I bought the cheapest pregnancy test strips you can get, which just comprise of a paper strip with no plastic housing. There was no single use battery and electronics and extra plastic and an overall smaller package. Of course it did require me to have the confidence that something so simple would give me the same results as the fancy test that cost over 10 times as much, which I had because I knew people who had worked in that industry. And it did require a bit more reading of the instructions, which I did because I was invested in getting the right results based on my decision to choose that type of test. But given the overall “cheapness” of the packaging and rarity in supermarkets or pharmacies I’m probably one of the few people who go down that route.
I was reminded of this experience in considering the waste for the lateral flow tests. The pregnancy test falls into a consumer-based choice where customers are enticed by “quicker”, “easier” etc. But at what cost? Both to the consumer and the environment. As more tests are sent to home users these are questions, we need to consider carefully whether they are in response to a global pandemic or for mass screening. Meaning there is even greater need to consider how design both of a home test kit and the instructions can make the end user feel confident about the results but also minimise waste and avoid unnecessary packaging.
If you want to learn more about developing and testing good instructions for use see our services here.