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Diagnostic efficiency of different amphetamine screening tests – the search for an optimal cutoff

  • Reto Savoca , Katharina M. Rentsch and Andreas R. Huber
Published/Copyright: September 21, 2011
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 42 Issue 9

Abstract

Increased use of designer drugs (amphetamines and amphetamine-like substances) raises the need for fast screening tests in urine in clinical settings, workplace and drug rehabilitation. Immunological assays currently used are subject to unwanted crossreactivities, partly depending on the cutoff concentrations used. The values recommended in Europe and the USA are 500 and 1000 ng/ml, respectively. In Switzerland, the recommended concentration of 300 ng/ml results in a high rate of false-positive urine samples and expensive, time-consuming confirmation testing. Using the Abbott Axsym analyzer, we found numerous false positives from patients in rehabilitation centers due to concomitant medication. Therefore, the diagnostic sensitivity and specificity of the Abbott test at different cutoff concentrations and the sensitivity of the Roche Cobas Integra, Beckman Synchron and Biosite Triage point-of-care test were examined. HPLC Bio-Rad Remedi was chosen as the method of higher hierarchical order. The specificity of the Axsym analyzer (300 ng/ml) was 86%. At 500 ng/ml or 1000 ng/ml the specificity was increased to 99 or 100%, respectively, while the sensitivity only decreased from 97 to 91 or 81%, respectively. In summary, the cutoff concentration for amphetamine screening tests should not be below 500 ng/ml to avoid a high rate of false-positive results.

Keywords: amphetamine; Axsym; cutoff; HPLC; screening test
Corresponding author: Reto Savoca, PhD, Center of Laboratory Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland. Phone: +41-62-838-54-63, Fax: +41-62-838-53-99, E-mail:

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Received: 2004-3-8
Accepted: 2004-6-28
Published Online: 2011-9-21
Published in Print: 2004-9-1

© Walter de Gruyter

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https://doi.org/10.1515/CCLM.2004.213
Keywords for this article
amphetamine; Axsym; cutoff; HPLC; screening test

Articles in the same Issue

  1. ARH missense polymorphisms and plasma cholesterol levels
  2. Genetic and immunological analyses of patients with increased serum butyrylcholinesterase activity and its C5 variant form
  3. Polymorphisms in the P-selectin (CD62P) and P-selectin glycoprotein ligand-1 (PSGL-1) genes and coronary heart disease
  4. Odd-numbered long-chain fatty acids in erythrocyte phospholipids as long-term follow-up parameter in propionic acidemia
  5. Simplified method for the diameter sizing of serum low-density lipoprotein using polyacrylamide gradient gel electrophoresis
  6. In vitro inhibition of fibrinolysis by apolipoprotein(a) and lipoprotein(a) is size- and concentration-dependent
  7. Comparison of cardiac troponin T and I in healthy men and in aortic valve replacement
  8. Evaluation of a shorter methionine loading test
  9. Homocysteine, vitamin B12 and folate in vascular dementia and in Alzheimer disease
  10. The clinical impact of screening for gestational diabetes
  11. Comparison between creatinine and pregnanediol adjustments in the retrospective analysis of urinary hormone profiles during the human menstrual cycle
  12. The measurement of complexed prostate-specific antigen has a better performance than total prostate-specific antigen
  13. Effect of prolonged physical exercise on urinary proANP1-30 and proANP31-67
  14. Diagnostic efficiency of different amphetamine screening tests – the search for an optimal cutoff
  15. Evaluation of a new lithium colorimetric assay performed on the Dade Behring Dimension® X-pand™ system
  16. Reference interval of serum insulin concentrations
  17. Significant decimals and rounding
  18. Questionable results – who directs the EQAS organisers?
  19. Wood WG. Questionable results – who directs the EQAS organisers?
  20. Wood WG. Questionable results – who directs the EQAS organisers?
  21. Wood WG. Questionable results – who directs the EQAS organisers?
  22. Wood WG. Questionable results – who directs the EQAS organisers?
  23. Wood WG. Questionable results – who directs the EQAS organisers? A comment from the point of view of the ECAT Foundation
  24. International Swiss MedLab 2004 and 8th Alps Adria Congress / Laboratory Medicine: From Atomic absorption to Zeta-Globin Lucerne, Switzerland, October 5–9, 2004
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