{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:24:08Z","timestamp":1787009048118,"version":"build-2736575974"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Benzodiazepines are commonly prescribed medications frequently linked to instances of abuse and overdose. Historically, FDA-cleared benzodiazepine urine immunoassays cross-react poorly with glucuronidated benzodiazepine metabolites, leading to false negatives. Clinical laboratories have addressed this deficiency by creating laboratory-developed tests (LDTs) that incorporate a beta-glucuronidase hydrolysis step to increase the clinical sensitivity of these assays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Performance characteristics of 2 FDA-cleared benzodiazepine urine immunoassays (Benzodiazepines Plus, no glucuronidase and Benzodiazepines II, with glucuronidase; Roche Diagnostics) and a previously described benzodiazepine immunoassay LDT (with glucuronidase) were evaluated using 258 clinical urine specimens. The positive immunoassay cutoff was set at 200 ng\/mL of nordiazepam and results were compared to an LC-MS\/MS benzodiazepine LDT. Clinical sensitivity, specificity, precision, and immunoassay cross-reactivity were determined for all 3 immunoassays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Benzodiazepines II and LDT immunoassays exhibited greater clinical sensitivity (100% and 95.2%) compared to the Benzodiazepines Plus assay (66.7%). Clinical specificity of 100% was observed for all 3 assays. Immunoassay response of the Benzodiazepines II assay was greater across the range of concentrations tested (100\u20131000 ng\/mL) relative to the other immunoassays and was the most sensitive immunoassay for the detection of lorazepam glucuronide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Benzodiazepines II immunoassay demonstrated the greatest clinical and analytical sensitivity compared to the Benzodiazepines Plus and LDT immunoassays. The incorporation of beta-glucuronidase was crucial, as the Benzodiazepines II and LDT immunoassays demonstrated superior clinical sensitivity when compared to the Benzodiazepines Plus immunoassay that does not incorporate a beta-glucuronidase hydrolysis step.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jalm\/jfae083","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T02:24:54Z","timestamp":1721269494000},"page":"964-976","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of a Benzodiazepine Immunoassay for Urine Drug Testing in Clinical Specimens"],"prefix":"10.1093","volume":"9","author":[{"given":"Mengyuan","family":"Ge","sequence":"first","affiliation":[{"name":"Department of Pathology, UC San Diego Health , San Diego, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adekunle","family":"Alabi","sequence":"additional","affiliation":[{"name":"Department of Pathology, UC San Diego Health , San Diego, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Kelner","sequence":"additional","affiliation":[{"name":"Department of Pathology, UC San Diego Health , San Diego, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6050-8525","authenticated-orcid":false,"given":"Robert L","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Pathology, UC San Diego Health , San Diego, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T","family":"Suhandynata","sequence":"additional","affiliation":[{"name":"Department of Pathology, UC San Diego Health , San Diego, CA ,","place":["United States"]},{"name":"Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego Health , La Jolla, CA ,","place":["United 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