Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty
Background: On an initial urine screening test for illegal substances, if the concentration of a substance is at or above the determined legislative threshold, it is reported as positive. Repeating testing with the same sample to verify it before reporting is a common practice in clinical laboratori...
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Format: | Article |
Language: | English |
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Society of Medical Biochemists of Serbia, Belgrade
2023-01-01
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Series: | Journal of Medical Biochemistry |
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Online Access: | https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2023/1452-82582304616H.pdf |
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author | Huysal Kagan Üstündağ Yasemin Çağlak Hatice Azra Rümeysa Yeşil Meryem |
author_facet | Huysal Kagan Üstündağ Yasemin Çağlak Hatice Azra Rümeysa Yeşil Meryem |
author_sort | Huysal Kagan |
collection | DOAJ |
description | Background: On an initial urine screening test for illegal substances, if the concentration of a substance is at or above the determined legislative threshold, it is reported as positive. Repeating testing with the same sample to verify it before reporting is a common practice in clinical laboratories. This study aimed to determine whether measurement uncertainty (MU) results can be used to detect a grey zone to reduce repeat testing. Methods: A retrospective study was conducted using data from the laboratory information system between January 1, 2020, and July 1, 2022. Samples studied twice within one hour before reporting for the same urine sample were analyzed. The MU values for urinary amphetamine, cannabinoid, cocaine, and opioid parameters were calculated using ADVIA Chemistry reagents on a Siemens ADVIA 1800 chemical analyzer. The grey zone was defined as the cut-off value ± MU. Results: Urine samples, 319 amphetamine, 198 cannabinoid, 112 cocaine, and 125 opiate tests were repeated from 31.839 patients (16-65 years). Ten amphetamine, 12 can - nabinoid and 2 cocaine test results changed from positive to negative or negative to positive on retesting, all within the grey zone level defined by the MU value. Mean biases bet - ween the repeated test results were -7.64 (95% CI: -13.71 to -1.57) ng/mL for the amphetamine and 1.16 (95% CI: 0.31 to 2.01) ng/mL for the cannabinoid results. Conclusion: Repeating only values within the grey area for each illicit substance may be useful to reduce unnecessary duplicate measurements. |
first_indexed | 2024-03-09T00:50:52Z |
format | Article |
id | doaj.art-c5225dc4d3ff43f8a55b9ac42b657e0a |
institution | Directory Open Access Journal |
issn | 1452-8258 1452-8266 |
language | English |
last_indexed | 2024-03-09T00:50:52Z |
publishDate | 2023-01-01 |
publisher | Society of Medical Biochemists of Serbia, Belgrade |
record_format | Article |
series | Journal of Medical Biochemistry |
spelling | doaj.art-c5225dc4d3ff43f8a55b9ac42b657e0a2023-12-11T17:15:36ZengSociety of Medical Biochemists of Serbia, BelgradeJournal of Medical Biochemistry1452-82581452-82662023-01-0142461662010.5937/jomb0-417771452-82582304616HReducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertaintyHuysal Kagan0Üstündağ Yasemin1Çağlak Hatice Azra2Rümeysa Yeşil Meryem3University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Department of Clinical Biochemistry, Bursa, TurkeyUniversity of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Department of Clinical Biochemistry, Bursa, TurkeyUniversity of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Department of Clinical Biochemistry, Bursa, TurkeyUniversity of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Department of Clinical Biochemistry, Bursa, TurkeyBackground: On an initial urine screening test for illegal substances, if the concentration of a substance is at or above the determined legislative threshold, it is reported as positive. Repeating testing with the same sample to verify it before reporting is a common practice in clinical laboratories. This study aimed to determine whether measurement uncertainty (MU) results can be used to detect a grey zone to reduce repeat testing. Methods: A retrospective study was conducted using data from the laboratory information system between January 1, 2020, and July 1, 2022. Samples studied twice within one hour before reporting for the same urine sample were analyzed. The MU values for urinary amphetamine, cannabinoid, cocaine, and opioid parameters were calculated using ADVIA Chemistry reagents on a Siemens ADVIA 1800 chemical analyzer. The grey zone was defined as the cut-off value ± MU. Results: Urine samples, 319 amphetamine, 198 cannabinoid, 112 cocaine, and 125 opiate tests were repeated from 31.839 patients (16-65 years). Ten amphetamine, 12 can - nabinoid and 2 cocaine test results changed from positive to negative or negative to positive on retesting, all within the grey zone level defined by the MU value. Mean biases bet - ween the repeated test results were -7.64 (95% CI: -13.71 to -1.57) ng/mL for the amphetamine and 1.16 (95% CI: 0.31 to 2.01) ng/mL for the cannabinoid results. Conclusion: Repeating only values within the grey area for each illicit substance may be useful to reduce unnecessary duplicate measurements.https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2023/1452-82582304616H.pdfcut-offgrey zonemeasurement uncertaintyamphetaminecannabinoidcocaine |
spellingShingle | Huysal Kagan Üstündağ Yasemin Çağlak Hatice Azra Rümeysa Yeşil Meryem Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty Journal of Medical Biochemistry cut-off grey zone measurement uncertainty amphetamine cannabinoid cocaine |
title | Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty |
title_full | Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty |
title_fullStr | Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty |
title_full_unstemmed | Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty |
title_short | Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty |
title_sort | reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty |
topic | cut-off grey zone measurement uncertainty amphetamine cannabinoid cocaine |
url | https://scindeks-clanci.ceon.rs/data/pdf/1452-8258/2023/1452-82582304616H.pdf |
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