Whether you call it a lateral flow test, dipstick, rapid test or test strip, they’re all different names for the same sort of test that, in the past, has acquired a somewhat unfair reputation for being too simplistic.
Being a fast-acting test that can be used at the point of care with or without a reader means that they’re easy to use, require little training to use or interpret and are easily deployed in any location.
The way a lateral flow test works is to confirm the presence or absence of a target analyte such as pathogens or biomarkers in humans or animals, or contaminants in water supplies, foodstuff or animal feed.
Lateral flow tests seem to tick a lot of boxes then, so why the bad press?
In the diagnostics segment there’s always a lot of excitement about the next big breakthrough in testing and the latest technology is often all anyone can talk about. Lateral flow tests, on the other hand, are not representative of the latest technology. They’ve been around, in one form or another, for decades but, the reason they have had such longevity is that they work.
Also, as we’re going to explore further here, they’re most likely not as archaic as you may have previously thought.
“People won’t realise that the pregnancy test-type technology is being used to detect the causal plant pathogen of the Irish potato famine”
To gain more insight into the lateral flow market and what the future has in store, I spoke with Malcolm Briggs, Sales & Marketing Executive at lateral flow specialist Abingdon Health. Abingdon are based in York, just down the road from our head office in Leeds, and regularly publish a huge variety of information on their website about the state of the lateral flow market.
The above quote belongs to Malcolm who was speaking about one of Abingdon’s Pocket Diagnostic® tests which identifies the presence of the organism Phytophthora . It was one of the Phytophthora species, Phytophthora Infestans, which caused the devastation of potato crops during the famine in Ireland over 150 years ago and still remains a huge problem for farmers globally.
This represents the versatility of lateral flow testing; the technology has a range of applications across different markets with three of the biggest being food safety, infectious disease and veterinary.
It’s not just the application that can be flexible, either. Today, the tests can take a variety of forms and be qualitative (producing an immediate result) or, when combined with a reader of some sort, provide semi-quantitative or quantitative data.
The readers involved are also evolving. Malcolm mentioned Abingdon’s recently-launched app, which turns the users smartphone into a reader, instantly giving the user access to a large amount of data, which can provide far more detailed insights than a yes or no result. Today, lateral flow can also offer multiplex testing.
Malcolm felt it’s the relatively low-cost innovations like apps that can be integrated into existing technology without the need for sophisticated external readers, that gives lateral flow its appeal. They’re flexible, easy to use and, as result, the market is growing significantly.
More Popular than Ever, Without Breaking the Bank
As mentioned earlier, the wider market is constantly being inundated with the latest headline-busting technology which is undoubtedly incredible but, usually, very expensive. The realisation many companies and labs are having is that, in an increasingly price-conscious market, it’s results that are key and the latest lateral flow technology can often go toe-to-toe with seemingly more complex and much more expensive tests and produce a similar standard of insight or results.
The beauty of these test is that they’re fast which, as Malcolm said, means that they are “fulfilling the requirement of the market which wants quick solutions to certain problems.” One area where this is particularly relevant is in infectious disease cases where rapid detection leads to earlier, potentially lifesaving, diagnosis. In an incident like the Ebola outbreak of 2013-2016, these tests can be easily transported to the affected area and provide rapid insight in locations where access to a lab is likely impossible.
This is partly why the tests are growing in popularity in emerging markets like India and China, or for health services under financial pressure. These different factors are all combining to mean that the market is growing significantly. The global lateral flow assay market was predicted to be worth around $6B in 2018, but likely to be worth $8.7B by 2023. That’s an annual CAGR of 7.7% - not something usually associated with an old or outdated technology.
Today, data is the currency of global business and lateral flow is no different, with a lot of the latest research in the segment being conducted into how big data can be tapped into with remote readers, like those mentioned earlier, as well as increasing the number of biomarkers that can be tested or the sensitivity of an individual assay.
Even the product that lateral flow testing is most widely associated with, the pregnancy test, has evolved significantly. A test no longer just displays just a yes or no. Malcolm told me that the electronic lateral flow tests of today can confirm how pregnant someone is in terms of weeks; providing worthwhile data.
So even if it’s difficult to help detractors of lateral flow to see past it being ‘just’ pregnancy tests, you can say that they’re indicative of seriously advanced technology that demand is growing for around the world today.
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