Leickly Emily, McDonell Michael G, Vilardaga Roger, Angelo Frank A, Lowe Jessica M, McPherson Sterling, Srebnik Debra, Roll John M, Ries Richard K
Psychiatry & Behavioral Sciences, University of Washington , Seattle, WA , USA and.
Am J Drug Alcohol Abuse. 2015 May;41(3):246-50. doi: 10.3109/00952990.2015.1011743. Epub 2015 Feb 19.
Immunoassay urine drug screening cups that detect use for two or more days are commonly used in addiction treatment settings. Until recently, there has been no comparable immunoassay test for alcohol use in these settings.
The aim of this study was to assess the agreement of a commercially available ethyl glucuronide immunoassay (EtG-I) test conducted at an outpatient addiction clinic and lab-based EtG mass spectrometry (EtG-MS) conducted at a drug testing laboratory at three cut-off levels. High agreement between these two measures would support the usefulness of EtG-I as a clinical tool for monitoring alcohol use.
Forty adults with co-occurring alcohol dependence and serious mental illnesses submitted 1068 urine samples over a 16-week alcohol treatment study. All samples were tested using EtG-I on a benchtop analyzer and 149 were randomly selected for EtG-MS analysis at a local laboratory. Agreement was defined as the number of samples where EtG-I and EtG-MS were both above or below a specific cut-off level. Agreement was calculated at low cut-off levels (100 and 250 ng/ml), as well as at a higher cut-off level (500 ng/ml) recommended by most by commercial drug testing laboratories.
Agreement between EtG-I and EtG-MS was high across all cut-off levels (90.6% at 100 ng/ml, and 96.6% at 250 and 500 ng/ml).
EtG immunoassays conducted at low cut-off levels in point-of-care testing settings have high agreement with lab-based EtG-MS. EtG-I can be considered a useful clinical monitoring tool for alcohol use in community-based addiction treatment settings.
在成瘾治疗环境中，常用于检测两天或更长时间药物使用情况的免疫分析尿液药物筛查杯很常见。直到最近，在这些环境中还没有用于检测酒精使用情况的类似免疫分析测试。
本研究的目的是评估在门诊成瘾诊所进行的市售乙基葡萄糖醛酸苷免疫分析（EtG-I）测试与在药物检测实验室进行的基于实验室的EtG质谱分析（EtG-MS）在三个临界值水平下的一致性。这两种测量方法之间的高度一致性将支持EtG-I作为监测酒精使用的临床工具的实用性。
在一项为期16周的酒精治疗研究中，40名同时患有酒精依赖和严重精神疾病的成年人提交了1068份尿液样本。所有样本均在台式分析仪上使用EtG-I进行检测，其中149份被随机选择在当地实验室进行EtG-MS分析。一致性定义为EtG-I和EtG-MS均高于或低于特定临界值水平的样本数量。在低临界值水平（100和250纳克/毫升）以及大多数商业药物检测实验室推荐的较高临界值水平（500纳克/毫升）下计算一致性。
在所有临界值水平下，EtG-I和EtG-MS之间的一致性都很高（100纳克/毫升时为90.6%，25０和500纳克/毫升时为96.6%）。
在即时检验环境中以低临界值水平进行的EtG免疫分析与基于实验室的EtG-MS具有高度一致性。EtG-I可被视为社区成瘾治疗环境中监测酒精使用的有用临床监测工具。
