药物检测危机。美国疾病控制与预防中心（CDC）盲测结果

Crisis in drug testing. Results of CDC blind study.

作者信息

Hansen H J, Caudill S P, Boone D J

出版信息

JAMA. 1985 Apr 26;253(16):2382-7.

Abstract

In response to questions about the reliability of the results of screening urine for drugs, we evaluated the performance of 13 laboratories, which serve a total of 262 methadone treatment facilities, by submitting prereferenced samples through the treatment facilities as patient samples (blind testing). Error rates for the 13 laboratories on samples containing barbiturates, amphetamines, methadone, cocaine, codeine, and morphine ranged from 11% to 94%, 19% to 100%, 0% to 33%, 0% to 100%, 0% to 100%, and 5% to 100%, respectively. Similarly, error rates on samples not containing these drugs (false-positives) ranged from 0% to 6%, 0% to 37%, 0% to 66%, 0% to 6%, 0% to 7%, and 0% to 10%, respectively. These blind tests indicate that greater care is taken with known evaluation samples than with routine samples, laboratories are often unable to detect drugs at concentrations called for by their contracts, and the observed underreporting of drugs may threaten the treatment process. Drug treatment facilities should monitor the performance of their contract laboratories with quality-control samples, preferably through blind testing.

摘要

针对有关尿液药物筛查结果可靠性的问题，我们通过将预先设定的样本作为患者样本通过治疗机构提交（盲测），对为总共262个美沙酮治疗机构服务的13家实验室的性能进行了评估。这13家实验室对含有巴比妥类药物、苯丙胺类药物、美沙酮、可卡因、可待因和吗啡的样本的错误率分别为11%至94%、19%至100%、0%至33%、0%至100%、0%至100%以及5%至100%。同样，对不含这些药物的样本（假阳性）的错误率分别为0%至6%、0%至37%、0%至66%、0%至6%、0%至7%以及0%至10%。这些盲测表明，与常规样本相比，对已知评估样本更为谨慎，实验室往往无法检测出其合同要求浓度的药物，而且所观察到的药物漏报情况可能会威胁到治疗过程。药物治疗机构应使用质量控制样本监测其合同实验室的性能，最好通过盲测进行。