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Impact of Lowering the Screening and Confirmation Cutoff Values for Urine Drug Testing Based on Dilution Indicators

2003· article· en· W2040576063 on OpenAlex
Albert D. Fraser, J. Zámečník

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueTherapeutic Drug Monitoring · 2003
Typearticle
Languageen
FieldPharmacology, Toxicology and Pharmaceutics
TopicForensic Toxicology and Drug Analysis
Canadian institutionsMcMaster UniversityQueen Elizabeth II Health Sciences CentreDalhousie University
Fundersnot available
KeywordsUrineCutoffCreatinineMedicineUrinalysisWorkloadDrugUrine specific gravityUrologyChemistryInternal medicinePharmacologyPhysicsComputer science

Abstract

fetched live from OpenAlex

Many clinical and forensic toxicology laboratories establish criteria for identifying a random urine specimen submitted for drug screening as being "normally concentrated" or "dilute" by incorporating creatinine analysis and/or specific gravity measurement into their testing protocols. The objective of this study is to describe the importance of urine creatinine analysis and specific gravity measurements in the Correctional Service of Canada (CSC) drug-testing program. The CSC program uses the Substance Abuse and Mental Health Services Administration (SAMHSA) creatinine cutoff value (20 mg/dL) mandated for workplace drug testing in the United States. In the CSC program, urine specimens must have a creatinine concentration <20 mg/dL and specific gravity value </=1.003 to be considered dilute. The CSC program also incorporates lower drug/drug metabolite screening and confirmation cutoff values (dilution protocol) for specimens that are administratively defined as dilute. Seventy-nine hundred and twelve urine specimens from 2000 to 2002 (6.8% of total workload) were defined as dilute. Twenty-six percent of all dilute specimens (n = 2054) screened positive for one or more drugs using the SAMHSA cutoff values. The screening-negative dilute specimens were taken through the dilution protocol scheme with lower screening cutoff values and confirmation cutoff concentrations at the lower limits of quantification (LLOQ) for each method. Over 1100 of the 5858 dilute urine specimens (18.8%) confirmed positive for one or more drugs in 2000 to 2002 when taken through the dilution protocol scheme. CSC workload is separated based on whether specimens are referred from institutions or from community settings (such as parolee programs). The positive rate for dilute specimens averaged 18.2% from CSC institutions and 22.3% from specimens collected from parolee specimens in 2000 to 2002. The drugs most often confirmed in dilute specimens from institutions were cannabinoids (annual positive rate ranged from 13.7 to 18%) and codeine and/or morphine (ranged from 0.2 to 2.8%). The drugs most often confirmed in dilute urine specimens from community settings in 2000-2002 were cannabinoids (annual positive rate ranged from 10.3 to 12.5%) and cocaine metabolite (ranged from 6.6 to 10.3%). In conclusion, one can reduce the false-negative rate for drugs of abuse in urine drug testing programs by incorporating lower screening and confirmation cutoff (eg, LLOQ) concentrations for dilute specimens that screen negative for drugs of abuse when using the SAMHSA mandated screening and confirmation cutoff concentrations.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.411
Threshold uncertainty score0.765

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.086
GPT teacher head0.415
Teacher spread0.328 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it