{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:12:44Z","timestamp":1790251964454,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T00:00:00Z","timestamp":1641427200000},"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":[[2022,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Drug screening by immunoassay is common in pediatric populations. However, false-positive and -negative results due to antibody cross-reactivity and dilute urine are frequent and underappreciated. Accurate ascertainment of drug exposure in children has significant clinical and medico-legal consequences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and Methods<\/jats:title>\n                  <jats:p>We developed and characterized an LC\u2013MS\/MS drug screening assay to supplant immunoassay and detect 38 compounds at the lowest concentrations distinguishable from analytic noise. Once implemented, we conducted a retrospective analysis of 3985 pediatric urine drug screens performed a year before (n\u2009=\u20091663) and after (n\u2009=\u20092322) implementation to examine the frequency and breadth of drug detection in our pediatric population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Using immunoassay, 23% (293\/1269) of samples from the general pediatric and 37% (147\/394) of nursery populations had presumptively positive results. Of the presumptive positive compounds, 85% (288\/338) from the general pediatric population and 40% (65\/162) from the nursery cohort were confirmed by mass spectrometry. After LC\u2013MS\/MS implementation, 31% (628\/2052) of general pediatric, and 18% (48\/270) of the nursery samples were positive for 1 or more compounds. In the nursery population, immunoassays over-detected the presence of THC but under-detected exposure to cocaine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A broadly targeted, analytically sensitive LC\u2013MS\/MS drug screening assay detects a larger number and variety of compounds in a single step compared to a screen-then-confirm approach initiated by immunoassay in our pediatric population. Rapid delivery of accurate results enables timely, appropriate disposition of patients in a variety of settings including the emergency department and labor\/delivery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfab157","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T04:10:05Z","timestamp":1636085405000},"page":"409-420","source":"Crossref","is-referenced-by-count":12,"title":["Development and Implementation of One-Step, Broad-Spectrum, High-Sensitivity Drug Screening by Tandem Mass Spectrometry in a Pediatric Population"],"prefix":"10.1093","volume":"7","author":[{"given":"Merih T","family":"Tesfazghi","sequence":"first","affiliation":[{"name":"Department of Pathology, Rush University Medical Center, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Bardelmeier","sequence":"additional","affiliation":[{"name":"Core Laboratory, St. Louis Children\u2019s Hospital, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al N","family":"Saunders","sequence":"additional","affiliation":[{"name":"Core Laboratory, St. Louis Children\u2019s Hospital, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6267-3038","authenticated-orcid":false,"given":"Sarah M","family":"Riley","sequence":"additional","affiliation":[{"name":"Department of Pathology, St. Louis University, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3978-2858","authenticated-orcid":false,"given":"Stephen M","family":"Roper","sequence":"additional","affiliation":[{"name":"Core Laboratory, St. Louis Children\u2019s Hospital, St. Louis, MO"},{"name":"Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO"},{"name":"Department of Pediatrics, Washington University School of Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis J","family":"Dietzen","sequence":"additional","affiliation":[{"name":"Core Laboratory, St. Louis Children\u2019s Hospital, St. Louis, MO"},{"name":"Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO"},{"name":"Department of Pediatrics, Washington University School of Medicine, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"key":"2022030208031694600_jfab157-B1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1093\/clinchem\/34.3.637","article-title":"Drug testing in the military\u2013technical and legal problems","volume":"34","author":"Irving","year":"1988","journal-title":"Clin Chem"},{"key":"2022030208031694600_jfab157-B2","first-page":"11970","article-title":"Mandatory guidelines for federal workplace drug testing 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