Dubious Diagnostic Tests

Stephen Barrett, M.D.

Four things should be considered when evaluating whether a test is useful:

Most of the tests listed below have little or no diagnostic value. A few are legitimate for some purposes but are used improperly for others. Those marked with an asterisk (*) are done primarily or exclusively by chiropractors. If you encounter a practitioner who uses or abuses any of these tests, you should seek advice elsewhere. Practitioners who do live cell analysis, biological terrain assessment, dental sensitivity testing, and cytotoxic testing in their offices are required to have CLIA approval for high-complexity testing. Except for freestanding commercial laboratories, blood banks, hospitals, and large medical offices, very few facilities have high-complexity approval. Only a few states restrict the use of unestablished laboratory tests. Nevertheless, if you encounter a practitioner who does these four tests and is not obviously running a laboratory, please ask your state laboratory department to investigate.

The FDA has expressed concern about laboratory-developed tests (LDTs), which it defines as tests performed only by the laboratories that develop them. CLIA, the primary laboratory regulator, examines how tests are performed but does not consider how their results are interpreted. Widely used diagnostic tests require FDA clearance or approval, but the agency has not attempted to regulate LDTs. In 2014, the FDA expressed concern about LDTs that are used to guide treatment decisions and drafted a regulatory framework that would includepre-market review. In 2015, it reported on 20 LDTs, noting that some of them can cause patients to undergo unnecessary treatments and potentially delay diagnosis of their true condition. Unfortunately, it has taken no further action in the direction of greater regulation.

Blood Tests

Saliva Tests

Urine Tests

Hair Tests

Stool Tests

Dubious Devices

Imaging Procedures

Physical Examination Procedures

Skin Tests


Genetic Testing


Internet Testing

Questionable (Nonstandard) Laboratories
Federally Sanctioned Laboratories [1996] [1997] [1998] [1999] [2000]
[2001][2002] [2003] [2004] [2005] [2006] [2007] [2008] [2009] [2010]
[2011] [2012] [2013] [2014] [2015] [2016] [2017] [2018]

This page was revised on June 10, 2019.

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