Table 2 Potential concerns with self-test diagnostic technologies for influenza

Inaccurate diagnoses

Inaccurate diagnostic kits may lead to individuals undertaking harmful behaviours, either as the result of a false positive or a false negative [15, 16].

Inaccurate understanding

Individuals may misunderstand test results or accuracy of those results [17, 18].

Insufficient pre-test support structures

By enabling individuals to diagnose themselves away from health care settings, self-testing kits may mean individuals undertake test without the pre-test counselling by health care professionals and/or counselling services, potentially leading to psychological harm [14, 19, 20].

Insufficient post-test support structures

By enabling individuals to diagnose themselves away from clinical settings, self-testing kits may mean individuals receive test results without the support of health care professionals and/or counselling services [20, 26].

Deter necessary service interactions

By enabling self-diagnosis, self-tests may lead to individuals consulting clinicians about their health less frequently, meaning conditions other than those being tested for are left undiagnosed for longer.

Undermining obligations to others

By performing tests in private, individuals may be less likely to inform others of diagnosis (e.g. contact tracing) [26].

Undermining relationship to others

By supporting an overly individualistic model of health care, self-testing may be inappropriate for health care, which tends to privilege close relationships and human interdependence [17].

Threat of testing becoming mandatory

Danger of self-testing being made obligatory, either legally or through social pressure (e.g. during an epidemic) thereby infringing individuals’ right ‘not to know’ [14, 59].

Privacy breaches through theft of kit

Individuals’ right to privacy may be infringed through theft and/or misuse of the diagnostic kit [26].

Privacy breaches through use of test data

Where test data is stored and analysed remotely, individuals’ right to privacy may be infringed through misuse of data (including onward sale to third parties).

Cost and unequal access

If the cost of the diagnostic technology is sufficiently high, distribution based on ability to pay may exacerbate existing health inequalities [14, 20].