{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:36:30Z","timestamp":1790876190590,"version":"4.1.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"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":[[2025,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immunoassay drug screens provide rapid analysis of urine for the presence of therapeutics and drugs of abuse. Compared to definitive (confirmatory) methods, immunoassays are prone to false-positive and -negative results. Laboratories generally rely on manufacturers\u2019 claims regarding method sensitivity and specificity; few have the resources to independently verify performance. In this study, we review the performance of our opioid immunoassay drug screens in comparison to a definitive method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Results of 859 urine samples tested via opioid immunoassay screens for buprenorphine, fentanyl, methadone metabolite (2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine; EDDP), opiates, and oxycodone were compared to definitive results obtained via liquid chromatography\u2013tandem mass spectrometry (LC-MS\/MS). The data examined here included multiple samples from individual patients. Our quantitative LC-MS\/MS method includes 19 opioid compounds (parent drugs plus metabolites).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Immunoassay sensitivity and specificity ranged from 96% to 100% and 84% to 99%, respectively. The sensitivity and specificity of these screens were similar to manufacturers\u2019 claims with some exceptions. The opiates immunoassay had poor performance when limiting the comparison to its target compound, morphine, but improved when including all compounds listed in the manufacturer\u2019s instructions for use (IFU). While demonstrating good sensitivity, the buprenorphine immunoassay demonstrated lower specificity than stated in the IFU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The opioid immunoassay screens in use at our facility compared favorably to a definitive LC-MS\/MS method. The urine fentanyl screen had the lowest sensitivity (96%) and had a specificity of 97%. The urine buprenorphine assay was the least specific (84%) and had a sensitivity of 99%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jalm\/jfae169","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T23:28:56Z","timestamp":1735255736000},"page":"559-571","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of Immunoassay Performance for the Detection of Opioids in Urine"],"prefix":"10.1093","volume":"10","author":[{"given":"Michael E","family":"Walsh","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center , Lebanon, NH ,","place":["United States"]},{"name":"Department of Pathology and Laboratory Medicine, The Geisel School of Medicine at Dartmouth , Hanover, NH ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5388-1217","authenticated-orcid":false,"given":"Michael T","family":"Kelliher","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center , Lebanon, NH ,","place":["United States"]},{"name":"Department of Pathology and Laboratory Medicine, The Geisel School of Medicine at Dartmouth , Hanover, NH ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline A","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center , Lebanon, NH ,","place":["United States"]},{"name":"Department of Pathology and Laboratory Medicine, The Geisel School of Medicine at Dartmouth , Hanover, NH ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5116-3780","authenticated-orcid":false,"given":"Mark A","family":"Cervinski","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center , Lebanon, NH ,","place":["United States"]},{"name":"Department of Pathology and Laboratory Medicine, The Geisel School of Medicine at Dartmouth , Hanover, NH ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"2025050206371240700_jfae169-B1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/s41572-019-0137-5","article-title":"Opioid use disorder","volume":"6","author":"Strang","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"2025050206371240700_jfae169-B2","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4065\/83.1.66","article-title":"Urine drug screening: practical guide for clinicians","volume":"83","author":"Moeller","year":"2008","journal-title":"Mayo Clin 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