{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T15:28:12Z","timestamp":1787153292434,"version":"build-2736575974"},"reference-count":14,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Screening for alcohol use in a population to treat pain and substance use disorders is important for monitoring adherence to treatment plans. Urine screening for ethanol exposure by immunoassay can provide a cost-effective testing option, with a faster turnaround time to result in comparison to LC-MS\/MS. The purpose of this study was to compare two ethyl glucuronide (EtG) immunoassays to determine which method would be better suited for our laboratory work flow and patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two EtG immunoassays were evaluated to assess false-positive results and interference flags for alcohol biomarker testing. The EtG enzyme immunoassays were verified and put into use for patient testing during 2 separate timeframes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both assays compared qualitatively well to LC-MS\/MS for positive EtG (&amp;gt;500\u2005ng\/mL) patient samples. In our patient population, the ARK EtG assay had a presumptive positivity rate of 13.81%, a false-positive rate of 1.35%, and an interference rate of 0.45%. The Immunalysis assay had a 9.87% presumptive positivity rate, a false-positive rate of 0.15%, and a 2.86% interference rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Selecting an assay for the laboratory requires understanding the strengths and limitations of the method. For our work flow, our lab chose the assay with more interferences, since our work flow reflexes presumptive positive immunoassay results and interferences to confirmation by mass spectrometry. For labs that use an immunoassay screen-only approach, selecting an immunoassay that generates a higher rate of interference flags could make result interpretation difficult for the client and raise concerns for specimen adulteration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jalm\/jfag114","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:35:31Z","timestamp":1782862531000},"source":"Crossref","is-referenced-by-count":0,"title":["Increased False Positives vs Increased Interference Flags: Comparison of 2 Ethyl Glucuronide Immunoassays"],"prefix":"10.1093","author":[{"given":"Alexandria N","family":"Jackson","sequence":"first","affiliation":[{"name":"ARUP Institute for Clinical and Experimental Pathology , Salt Lake City, UT ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara P","family":"Wyness","sequence":"additional","affiliation":[{"name":"ARUP Institute for Clinical and Experimental Pathology , Salt Lake City, UT ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia L","family":"La\u2019ulu","sequence":"additional","affiliation":[{"name":"ARUP Institute for Clinical and Experimental Pathology , Salt Lake City, UT ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4935-8930","authenticated-orcid":false,"given":"Jessica M","family":"Boyd","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Utah Health , Salt Lake City, UT ,","place":["United States"]},{"name":"ARUP Institute for Clinical and Experimental Pathology , Salt Lake City, UT ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7943-6784","authenticated-orcid":false,"given":"Kamisha L","family":"Johnson-Davis","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Utah Health , Salt Lake City, UT ,","place":["United States"]},{"name":"ARUP Institute for Clinical and Experimental Pathology , Salt Lake City, UT ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"2026081911031663000_jfag114-B1","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1093\/alcalc\/agh078","article-title":"Ethyl glucuronide: a biomarker to identify alcohol use by health professionals recovering from substance use disorders","volume":"39","author":"Skipper","year":"2004","journal-title":"Alcohol Alcohol"},{"key":"2026081911031663000_jfag114-B2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1093\/jat\/26.4.201","article-title":"Comparison of urinary excretion characteristics of ethanol and ethyl glucuronide","volume":"26","author":"Dahl","year":"2002","journal-title":"J Anal 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medicine","volume":"23","author":"Rosano","year":"2022","journal-title":"Pain Med"},{"key":"2026081911031663000_jfag114-B12","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.forsciint.2009.04.022","article-title":"Unreliable alcohol testing in a shipping safety programme","volume":"189","author":"Helander","year":"2009","journal-title":"Forensic Sci Int"},{"key":"2026081911031663000_jfag114-B13","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1373\/clinchem.2007.089482","article-title":"Postcollection synthesis of ethyl glucuronide by bacteria in urine may cause false identification of alcohol consumption","volume":"53","author":"Helander","year":"2007","journal-title":"Clin Chem"},{"key":"2026081911031663000_jfag114-B14","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1093\/jalm\/jfaa119","article-title":"Demand for interpretation of a urine drug testing panel reflects the changing landscape of clinical needs; opportunities for the laboratory to 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