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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.

Competing Interests: All the authors declare that they have no conflict of interest in this work.Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article.

(2023 Kagan Huysal, Yasemin Üstündağ, Hatice Azra Çağlak, Yeşil Meryem Rümeysa, published by CEON/CEES.)

Titel:	Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty.
Autor/in / Beteiligte Person:	Huysal, K ; Üstündağ, Y ; Çağlak, HA ; Rümeysa, YM
Link:	Zum Volltext
Zeitschrift:	Journal of medical biochemistry, Jg. 42 (2023-10-27), Heft 4, S. 616
Veröffentlichung:	2020- : Belgrade : Society of Medical Biochemists of Serbia ; <i>Original Publication</i>: Belgrade : Society of Medical Biochemists of Serbia, 2023
Medientyp:	academicJournal
ISSN:	1452-8258 (print)
DOI:	10.5937/jomb0-41777
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [J Med Biochem] 2023 Oct 27; Vol. 42 (4), pp. 616-620. References: J Med Biochem. 2019 May 11;38(3):317-322. (PMID: 31156342) ; Clin Chem Lab Med. 2016 Nov 1;54(11):e349-e351. (PMID: 27071151) ; Biochem Med (Zagreb). 2019 Jun 15;29(2):020502. (PMID: 31223256) ; Am J Clin Pathol. 2012 Jan;137(1):20-5. (PMID: 22180474) ; Pain Physician. 2017 Feb;20(2S):SE1-SE9. (PMID: 28226337) ; Pain Physician. 2010 May-Jun;13(3):273-81. (PMID: 20495592) ; Crit Rev Clin Lab Sci. 2020 Dec;57(8):548-585. (PMID: 32609540) ; J Gen Intern Med. 2020 Jan;35(1):283-290. (PMID: 31713040) ; J Anal Methods Chem. 2021 May 13;2021:9955990. (PMID: 34055449) ; Int J Mol Sci. 2021 Apr 13;22(8):. (PMID: 33924438) ; J Ethn Subst Abuse. 2022 Jul 29;:1-15. (PMID: 35904897) ; J Appl Lab Med. 2018 Jan 1;2(4):489-526. (PMID: 33636890) ; Am J Clin Pathol. 2018 Feb 17;149(3):247-252. (PMID: 29425259) ; Biochem Med (Zagreb). 2017 Oct 15;27(3):030708. (PMID: 29180916) ; J Med Biochem. 2021 Jun 05;40(3):225-236. (PMID: 34177366) ; Clin Lab Manage Rev. 1998 Jul-Aug;12(4):277-80. (PMID: 10185005) ; Int J Epidemiol. 2003 Apr;32(2):304-13. (PMID: 12714554) ; Mayo Clin Proc. 2017 May;92(5):774-796. (PMID: 28325505) Contributed Indexing: Keywords: amphetamine; cannabinoid; cocaine; cut-off; grey zone; measurement uncertainty ; Local Abstract: [Publisher, Serbian] Ako je koncentracija nedozvoljene supstance na ili iznad utvrđenog zakonskog praga na početnom testu skrininga urina na nedozvoljene supstance, takvi rezultati se prijavljuju kao pozitivni. Ponavljanje testiranja sa istim uzorkom radi verifikacije pre prijavljivanja je uobičajena praksa u kliničkim laboratorijama. Ova studija je imala za cilj da utvrdi da li se rezultati merne nesigurnosti (MU) mogu koristiti za otkrivanje sive zone kako bi se smanjila ponovljena testiranja. [Publisher, Serbian] Sprovedena je retrospektivna studija korišćenjem podataka iz laboratorijskog informacionog sistema između 1. januara 2020. i 1. jula 2022. Analizirani su isti uzorci koji su dvaput proučavani u roku od jednog sata pre nego što su prijavljeni. Vrednosti MU za parametre amfetamina, kanabinoida, kokaina i opioida u urinu su izračunate korišćenjem ADVIA Chemistry reagensa na Siemens ADVIA 1800 hemijskom analizatoru. Siva zona je definisana kao granična vrednost ± MU. [Publisher, Serbian] Kod 31,839 pacijenata je izvršeno ponovljeno uzorkovanje urina, i ponovo je urađeno 319 testova na amfetamine, 198 na kanabinoide, 112 na kokain, kao i 125 testova na opijate (16-65 godina). Deset rezultata testova na amfetamine, 12 na kanabinoide i 2 rezultata testa na kokain su se promenili sa pozitivnih na negativne ili sa negativnih na pozitivne na ponovnom testiranju, sve u okviru nivoa sive zone definisane MU vrednošću. Prosečna odstupanja između rezultata ponovljenih testova bila su -7,64 (95% CI: -13,71 do -1,57) ng/mL za amfetamin i 1,16 (95% CI: 0,31 do 2,01) ng/mL za rezultate kanabinoida. [Publisher, Serbian] Ponavljanje samo onih vrednosti unutar sive zone za svaku nedozvoljenu supstancu moče biti korisno za smanjenje nepotrebnih duplih merenja. Entry Date(s): Date Created: 20231212 Latest Revision: 20231212 Update Code: 20231215 PubMed Central ID: PMC10710810

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Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty.