Ferrara S D, Tedeschi L, Frison G, Brusini G, Castagna F, Bernardelli B, Soregaroli D
Centre of Behavioural and Forensic Toxicology, University of Padova, Italy.
J Anal Toxicol. 1994 Sep;18(5):278-91. doi: 10.1093/jat/18.5.278.
This study deals with the experimental and statistical comparison of six immunochemical techniques, including noninstrumental on-site and instrumental formats (EIA-EMIT and EZ-SCREEN; FPIA-ADx; RIA-Coat-A-Count; LI-Abuscreen ONTRAK; CBI-Triage), and three chromatographic techniques (TLC-Toxi-Lab; HPLC; HPLC-REMEDi drug profiling system), using GC-MS as a reference technique for analyzing amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, and opiates in the urine of various kinds of drug users. The study reports (a) the values of sensitivity, specificity, false-positive rates, and false-negative rates of each technique; (b) the results of bayesian statistical analysis, which are based on prevalence values of the samples examined and expressed as positive and negative predictive values and cumulative predictive values for each single technique and for combinations of paired immunochemical and chromatographic techniques; and (c) the results of a rough classification of the various degrees of predictability of these techniques. Lastly, this study proposes a decision-making process for establishing the best combination of analytical techniques for the goals in question, according to the characteristics and facilities of each laboratory.
本研究涉及六种免疫化学技术的实验和统计比较，包括非仪器现场检测和仪器检测形式（酶免疫测定 - 酶放大免疫测定技术和EZ - 筛查；荧光偏振免疫分析 - ADx；放射免疫分析 - Coat - A - Count；乳胶免疫比浊法 - Abuscreen ONTRAK；化学发光免疫分析 - Triage），以及三种色谱技术（薄层色谱 - Toxi - Lab；高效液相色谱；高效液相色谱 - REMEDi药物剖析系统），使用气相色谱 - 质谱联用仪作为参考技术，用于分析各类吸毒者尿液中的苯丙胺类、巴比妥类、苯二氮䓬类、大麻素类、可卡因、美沙酮和阿片类药物。该研究报告了：（a）每种技术的灵敏度、特异性、假阳性率和假阴性率的值；（b）贝叶斯统计分析的结果，该结果基于所检测样本的患病率值，并表示为每种单一技术以及成对免疫化学和色谱技术组合的阳性和阴性预测值以及累积预测值；（c）这些技术不同程度可预测性的粗略分类结果。最后，本研究根据每个实验室的特点和设备，提出了一个决策过程，以确定针对相关目标的最佳分析技术组合。
