Abstract:
CONTEXT.—:Urine drug testing is frequently ordered by health care providers. Immunoassays are widely used for drug testing, yet have potential limitations, including variable cross-reactivity. The last decade has seen worsening of a prescription drug abuse epidemic. OBJECTIVE.—:To use data from a College of American Pathologists proficiency testing survey, Urine Drug Testing, Screening, to determine and summarize the characteristics, performance, and limitations of immunoassays. DESIGN.—:Seven years of proficiency surveys were reviewed (2011-2017). RESULTS.—:Rapid growth was seen in participant volumes for specific immunoassays for synthetic opioids (eg, buprenorphine, fentanyl, oxycodone) and 3,4-methylenedioxymethamphetamine ("ecstasy"). Participant volumes remained high for immunoassays targeting less commonly abused drugs such as barbiturates and phencyclidine. For opiate immunoassays, the number of laboratories using a 2000 ng/mL positive cutoff remained stable, and an increasing number adopted a 100 ng/mL cutoff. Opiate and amphetamine immunoassays showed high variability in cross-reactivity for drugs other than the assay calibrator. Assays targeting a single drug or metabolite generally performed well on drug challenges. CONCLUSIONS.—:Survey results indicate strong clinical interest in urine drug testing and some adoption of new assays. However, urine drug testing availability does not parallel prevailing patterns of drug prescribing and abuse patterns. In particular, specific immunoassays for synthetic opioids and a lower positive cutoff for opiate immunoassays may be underused, whereas immunoassays for barbiturates, methadone, propoxyphene, and phencyclidine may be overused. Laboratories are encouraged to review their test menu, cutoffs, and assay performance and adjust their test offerings based on clinical needs and technical capabilities.
journal_name
Arch Pathol Lab Medjournal_title
Archives of pathology & laboratory medicineauthors
Krasowski MD,McMillin GA,Melanson SEF,Dizon A,Magnani B,Snozek CLHdoi
10.5858/arpa.2018-0562-CPsubject
Has Abstractpub_date
2020-02-01 00:00:00pages
177-184issue
2eissn
0003-9985issn
1543-2165journal_volume
144pub_type
杂志文章abstract::Granular cell tumors occur in a variety of sites, including the breast (6%). Origins from histiocytic, myogenic, fibroblastic, and neurogenic elements have been proposed. Female predominance suggests that estrogenic hormones are involved. Four granular cell tumors of the breast and one in an axillary lymph node were s...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/0003-9985(1999)123<1023:LDOHST>2.0.CO;2
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abstract::In this article, I review the submicroscopic organization of the human spermatozoon, the functional role of its individual organelles in motility, penetrating ability, and fusogenic and fertilizing competence, and its pathology as a cause of male infertility. ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-04-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
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更新日期:1986-09-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
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doi:10.1043/0003-9985(2001)125<1448:CKCRIE>2.0.CO;2
更新日期:2001-11-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.5858/arpa.2013-0089-CR
更新日期:2014-08-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 指南,杂志文章
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::Four instances (8%) of inflammatory fibroid polyp (IFP) with concomitant adenocarcinoma or adenoma, in the same area, were noted among 50 cases of IFP of the stomach. Adding two cases from other sources, four cases of gastric IFP concomitant with an adenocarcinoma and two of gastric IFP concomitant with an adenoma wer...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.5858/arpa.2017-0494-OA
更新日期:2019-02-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/2009-0326-CP.1
更新日期:2010-08-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2006)130[1073:PBLIAE]2.0.CO;2
更新日期:2006-07-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.5858/arpa.2014-0453-OA
更新日期:2016-01-01 00:00:00
abstract::Cytomegalovirus (CMV) pneumonitis is an important cause of morbidity and mortality in lung transplant patients and requires timely and accurate diagnosis. This study compares the diagnostic utility of the evaluation of transbronchial biopsy by histology, immunohistochemistry, and simultaneous culture of bronchoalveola...
journal_title:Archives of pathology & laboratory medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::Tumoral calcinosis is a rare ectopic calcification syndrome characterized by irregular soft tissue masses originally described as being found mainly in large joints. We report 3 cases of tumoral calcinosis that occurred in unusual locations, the metacarpophalageal and proximal interphalangeal joints of the hand. The p...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2006)130[548:TCOTHT]2.0.CO;2
更新日期:2006-04-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/0003-9985(1999)123<0622:COTVGT>2.0.CO;2
更新日期:1999-07-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1976-12-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
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更新日期:2008-11-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,多中心研究,评审
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更新日期:2003-04-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1983-12-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
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更新日期:2009-07-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
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更新日期:1988-08-01 00:00:00
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更新日期:2000-09-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
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更新日期:2005-10-01 00:00:00