药物和非法药物尿液药物监测中的样本有效性检测：临床意义

Specimen validity testing in urine drug monitoring of medications and illicit drugs: clinical implications.

作者信息

Kirsh Kenneth L, Christo Paul J, Heit Howard, Steffel Katherine, Passik Steven D

机构信息

Millennium Research Institute, San Diego, California; Vice President, Clinical Research and Advocacy, Millennium Health, San Diego, California.

Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

J Opioid Manag. 2015 Jan-Feb;11(1):53-9. doi: 10.5055/jom.2015.0252.

DOI:10.5055/jom.2015.0252

PMID:25750165

Abstract

OBJECTIVE

To discuss the importance of specimen validity testing (SVT) in urine drug testing (UDT) and the clinical role it plays in identifying efforts to subvert the UDT process.

METHODS

A discussion of the clinical impact of SVT is presented.

RESULTS

A discussion of pH, specific gravity, creatinine, and oxidation for monitoring the adulteration of UDT samples is presented along with the clinical significance of such tests.

SIGNIFICANCE

SVT has a significant place in healthcare efforts to measure patient adherence, behavior, and honesty in communication with clinicians. SVT is typically ordered by treating clinicians who use the results to make therapeutic decisions regarding specific medical problems of their patient, including those related to medication and illicit drug use. In the absence of SVT, a healthcare provider may fail to identify a patient's adulteration of their urine sample in an attempt at deceiving the provider. Moreover, the presence of some underlying medical conditions may obfuscate the UDT results.

摘要

目的

探讨样本有效性检测（SVT）在尿液药物检测（UDT）中的重要性及其在识别破坏UDT过程行为方面所起的临床作用。

方法

阐述SVT的临床影响。

结果

介绍用于监测UDT样本掺假的pH值、比重、肌酐和氧化检测，以及此类检测的临床意义。

意义

SVT在医疗保健工作中对于衡量患者与临床医生沟通时的依从性、行为和诚实度具有重要地位。SVT通常由主治临床医生开具，他们利用检测结果就患者的特定医疗问题（包括与药物和非法药物使用相关的问题）做出治疗决策。若没有SVT，医疗保健提供者可能无法识别患者为欺骗提供者而对尿液样本进行的掺假行为。此外，一些潜在的医疗状况可能会使UDT结果变得模糊不清。