Beynon C M, Sumnall H R, McVeigh J, Cole J C, Bellis M A
Centre for Public Health, Liverpool John Moores University, Liverpool, UK.
Addiction. 2006 Oct;101(10):1413-20. doi: 10.1111/j.1360-0443.2006.01420.x.
Assessment of the sensitivity and specificity of two commercially available 'drug-facilitated sexual assault' drug detector kits, Drink Guard and Drink Detective.
Experimental.
Laboratory.
Gamma hydroxybutyrate (GHB) sodium salt, ketamine hydrochloride, temazepam, flunitrazepam and diazepam were dissolved (Tween added to benzodiazepine solutions) as separate stock solutions and added to 330 ml samples of cola (Pepsi Max), beer (Stella Artois), 'alcopop' (Bacardi Breezer) and placebo (distilled water). The doses used are reported to be common in cases of intoxication. Each kit was tested 10 times for each drink/drug combination. Two blind, independent observers scored each test (presence/absence of drug) in accordance with kit instructions; chi 2 was used to compare the proportion of times raters scored tests correctly and incorrectly. Sensitivity and specificity were calculated overall, for each drink, and sensitivity was calculated for each drug. Inter-observer agreement was evaluated using the kappa statistic.
While both raters were able to score significantly more tests correctly than incorrectly using Drink Detective, and one rater scored similarly using Drink Guard, the overall sensitivity of Drink Detective and Drink Guard was 69.0% (95% CI 64.2-73.5%) and 37.5% (95% CI 30.1-45.5%), respectively. Sensitivity was drink-dependent. Drink Detective was unable to detect our dose of GHB in water, with all tests scored negatively by both raters for this drink/drug combination (n = 20 negative scores). Overall, specificity was 76.6% (95% CI 71.5-81.0%) and 87.9% (95% CI 83.0-91.6%) for Drink Guard and Drink Detective, respectively, but was affected by the beverage. Inter-rater agreement was poor for Drink Guard (kappa = 0.278 +/- 0.069) but excellent for Drink Detective (kappa = 0.894 +/- 0.245). Inter-observer agreement was drug-dependent.
Use of drug detector kits by the public in the night-time environment needs further investigation and may create a false sense of security (false negatives) and undue concern (false positives) among kit users.
评估两种市售“药物辅助性性侵”药物检测试剂盒（Drink Guard和Drink Detective）的灵敏度和特异性。
实验性研究。
实验室。
将γ-羟基丁酸钠盐、盐酸氯胺酮、替马西泮、氟硝西泮和地西泮分别配制成储备液（苯二氮䓬类溶液中添加吐温），并添加到330毫升可乐（百事轻怡可乐）、啤酒（喜力啤酒）、预调酒（百加得冰锐）和安慰剂（蒸馏水）样本中。所使用的剂量据报道在中毒案例中很常见。每种饮料/药物组合对每个试剂盒进行10次测试。两名独立的盲法观察者根据试剂盒说明对每次测试（药物的存在/不存在）进行评分；使用卡方检验比较评分者正确和错误评分的次数比例。总体、每种饮料分别计算灵敏度和特异性，每种药物分别计算灵敏度。使用kappa统计量评估观察者间的一致性。
虽然两名评分者使用Drink Detective进行正确评分的测试次数均显著多于错误评分的次数，一名评分者使用Drink Guard的评分情况类似，但Drink Detective和Drink Guard的总体灵敏度分别为69.0%（95%置信区间64.2 - 73.5%）和37.5%（95%置信区间30.1 - 45.5%）。灵敏度因饮料而异。Drink Detective无法检测出我们在水中添加的GHB剂量，对于这种饮料/药物组合，两名评分者对所有测试的评分均为阴性（n = 20次阴性评分）。总体而言，Drink Guard和Drink Detective的特异性分别为76.6%（95%置信区间71.5 - 81.0%）和87.9%（95%置信区间83.0 - 91.6%），但受饮料影响。Drink Guard的观察者间一致性较差（kappa = 0.278 ± 0.069），而Drink Detective的观察者间一致性极佳（kappa = 0.894 ± 0.245）。观察者间一致性因药物而异。
公众在夜间环境中使用药物检测试剂盒需要进一步研究，可能会在试剂盒使用者中造成虚假的安全感（假阴性）和过度担忧（假阳性）。
