Accuracy of on-site urine drug tests : an experimental study

• Objective: On-site drug tests (ODTs) are frequently used in hospitals to screen the urine of patients admitted for suspected poisoning. The purpose of this study is to evaluate the accuracy of such tests used in emergency departments in Sweden.Methods: Two brands, ColibriCheck™ and Concateno™, were tested for detecting amphetamine, benzodiazepines, opiates and tetrahydrocannabinol (THC) in urine. The results were compared with laboratory screening (CEDIA) and confirmation method (GC-MS). The study was conducted from December 2011 to March 2012 using samples from drug dependence clinics; 400 positive (100 in each drug group) and 200 negative (applied to all drug groups).Results: High specificity (Table 1) implies that most true negative samples are detected, but the risk of missing a true positive sample is high (6–26%). The incidence of false positive test results was low ( 1%). Limitations: inadequate blinding of the analysing procedure, emergency department samples were not included and GC-MS was performed on positive but not negative samples.Conclusion: The implications of this study are that positive ODTs are fairly reliable whereas negative ODTs neglect 6–26% of true drug presence. Consequently patients might be overlooked if treatment depended on the test result. ODTs’ intrinsic problems e.g. cross-reactivity and limited spectrum of analytes1, that are not addressed in our study, could further influence the reliability of test results.Reference1. Krasowski MD, Pizon AF, Siam MG, et al. Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine. BMC Emerg Med 2009; 9:5.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)

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