{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:22:57Z","timestamp":1793643777058,"version":"4.5.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:00:00Z","timestamp":1580342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rapid identification of fentanyl at the point-of-care is critical. Urine fentanyl concentrations in overdose cases start at single-digit nanograms per milliliter. No fentanyl point-of-care assay with a cutoff at single-digit nanograms per milliliter is available.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A competitive lateral flow assay (LFA) was developed using gold nanoparticles and optimized for rapid screening of fentanyl in 5\u2009minutes. Urine samples from 2 cohorts of emergency department (ED) patients were tested using the LFA and LC-MS\/MS. The 2 cohorts consisted of 218 consecutive ED patients with urine drug-of-abuse screen orders and 7 ED patients with clinically suspected fentanyl overdose, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The LFA detected fentanyl (\u22651\u2009ng\/mL) and the major metabolite norfentanyl (\u226510\u2009ng\/mL) with high precision. There was no cross-reactivity with amphetamine, cocaine, morphine, tetrahydrocannabinol, methadone, buprenorphine, naloxone, and acetaminophen at 1000\u2009ng\/mL and 0.03%, 0.4%, and 0.05% cross-reactivity with carfentanil, risperidone, and 9-hydroxyrisperidone, respectively. In 218 consecutive ED patients, the prevalence of cases with fentanyl \u22651\u2009ng\/mL or norfentanyl \u226510\u2009ng\/mL was 5.5%. The clinical sensitivity and specificity of the LFA were 100% (95% CI, 75.8\u2013100%) and 99.5% (95% CI, 97.3\u201399.9%), respectively. The positive and negative predictive values were 92.3% (95% CI, 66.7\u201398.6%) and 100% (95% CI, 98.2\u2013100%), respectively. The concordance between the LFA and LC-MS\/MS was 100% in the 7 suspected fentanyl overdose cases (5 positive, 2 negative).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The LFA can detect fentanyl and norfentanyl with high clinical sensitivity and specificity in the ED population with rapid fentanyl screening needs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/clinchem\/hvz023","type":"journal-article","created":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T08:56:59Z","timestamp":1580374619000},"page":"324-332","source":"Crossref","is-referenced-by-count":33,"title":["Development and Clinical Validation of a Sensitive Lateral Flow Assay for Rapid Urine Fentanyl Screening in the Emergency Department"],"prefix":"10.1093","volume":"66","author":[{"given":"Zhao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, 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