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Clinical Notes / Evolutionary mismatch — what can a test actually show?

Understanding your care

Evolutionary mismatch — what can a test actually show?

Evolutionary mismatch is a perspective on differences between today’s environment and conditions in which biological traits evolved. It is not a laboratory diagnosis. A test result needs assessment based on what the test measures and how well it has been validated.

An explanatory model is not an individual test result

The perspective can raise questions about food, movement, sleep and exposures. But a plausible general story does not identify the cause of one person’s symptoms.

Neither a result outside a reference range nor a large number of tests proves that the root cause has been found. Results need to be related to symptoms, probabilities and other clinical information.

Three questions about any test

Analytical reliability concerns whether a test measures its intended target accurately. Clinical validity concerns the association with a condition. Clinical utility concerns whether the information improves care decisions.

A test can measure something real without evidence supporting the treatment subsequently proposed. Ask both what the result can show and what it cannot determine.

Set boundaries for interpretation

A personalised result does not necessarily imply a proven personalised treatment. Genetic variants, microbiome profiles and nutrient markers have different uses and limitations.

Start with the question you need answered. A consultation can review previous results before considering more tests. Established assessment of warning symptoms should not be delayed by a broader explanatory model.

Sources and further reading

This is general information and does not replace an individual medical assessment.

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