{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:29:15Z","timestamp":1778866155589,"version":"3.51.4"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Department of Pathology and Laboratory Medicine Translational Research Grant"},{"name":"Indiana Clinical and Translational Sciences Institute funded, in part"},{"name":"National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Fentanyl, a highly potent synthetic opioid, has contributed to a rapid rise in opioid-related overdoses and fatalities nationwide. Consequently, the need for accurate and timely testing for fentanyl has become critical. Immunoassay screens, reported as presumptive positive or negative, help address this need. We sought to compare the clinical performance of 2 US Food and Drug Administration (FDA)\u2013approved fentanyl immunoassays\u2014the Thermo Scientific DRI Fentanyl II Drugs of Abuse Assay and the Lin-Zhi International LZI Fentanyl (Q) Enzyme Immunoassay\u2014for detection of fentanyl and its metabolites in urine, using liquid chromatography\u2013tandem mass spectrometry (LC-MS\/MS) as the reference method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 806 urine specimens were screened using 2 FDA-approved fentanyl immunoassays on Beckman Coulter DxC 700 AU Chemistry Analyzer. Of these specimens, 183 that were both positive and negative by immunoassay were further analyzed by LC-MS\/MS for the presence or absence of fentanyl, norfentanyl, and 4-anilino-N-phenethylpiperidine (4-ANPP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 806 specimens, 786 (98%) provided concordant results and 20 (2%) had discordant results between the 2 immunoassays. Concordance between immunoassays and LC-MS\/MS was 97% for the LZI assay and 89% for the DRI assay. Among the 183 specimens tested, 4-ANPP was detected in 13 (7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The 2 assays demonstrated comparable clinical utility for incorporation into a urine drug screen panel.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/labmed\/lmaf079","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T11:42:41Z","timestamp":1764157361000},"source":"Crossref","is-referenced-by-count":2,"title":["Comparison of the DRI II and LZI I fentanyl immunoassays for in vitro clinical diagnostic use"],"prefix":"10.1093","volume":"57","author":[{"given":"Halimat","family":"Olaniyan","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]},{"name":"Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Beckman","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Crosby","sequence":"additional","affiliation":[{"name":"Division of Clinical Chemistry, Indiana University Health Pathology Laboratory , Indianapolis, IN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rejwi A","family":"Dahal","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]},{"name":"Indiana University School of Medicine , Indianapolis, IN,","place":["United States"]},{"name":"Division of Clinical Chemistry, Indiana University Health Pathology Laboratory , Indianapolis, IN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"2026012412513144300_lmaf079-B1","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1097\/ADM.0000000000000323","article-title":"Appropriate use of drug testing in clinical addiction medicine","volume":"11","author":"Jarvis","year":"2017","journal-title":"J Addict Med"},{"key":"2026012412513144300_lmaf079-B2","author":"Provisional drug overdose deaths in the United States, 2021-2022"},{"key":"2026012412513144300_lmaf079-B3","author":"Spencer","year":"2023"},{"key":"2026012412513144300_lmaf079-B4"},{"key":"2026012412513144300_lmaf079-B5","author":"Spencer"},{"key":"2026012412513144300_lmaf079-B6","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1097\/ADM.0000000000001185","article-title":"Fentanyl absorption, distribution, metabolism, and excretion: narrative review and clinical significance related to illicitly manufactured fentanyl","volume":"17","author":"Bird","year":"2023","journal-title":"J Addict Med"},{"key":"2026012412513144300_lmaf079-B7","first-page":"1072","article-title":"Fentanyl metabolism by human hepatic and intestinal cytochrome P450 3A4: implications for interindividual variability in disposition, efficacy, and drug interactions","volume":"25","author":"Labroo","year":"1997","journal-title":"Drug Metab Dispos"},{"key":"2026012412513144300_lmaf079-B8","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.clinms.2020.10.003","article-title":"Analysis of 17 fentanyls in plasma and blood by UPLC-MS\/MS with interpretation of findings in surgical and postmortem casework","volume":"18","author":"Danaceau","year":"2020","journal-title":"Clin Mass Spectrom"},{"key":"2026012412513144300_lmaf079-B9","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1080\/15563650.2019.1605078","article-title":"Evidence of fentanyl use is common and frequently missed in a cross-sectional study of emergency department patients in Baltimore, Maryland","volume":"58","author":"Dezman","year":"2020","journal-title":"Clin Toxicol (Phila)"},{"key":"2026012412513144300_lmaf079-B10","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1093\/jat\/bku103","article-title":"Cross-reactivity of acetylfentanyl and risperidone with a fentanyl immunoassay","volume":"38","author":"Wang","year":"2014","journal-title":"J Anal Toxicol"},{"key":"2026012412513144300_lmaf079-B11","doi-asserted-by":"publisher","first-page":"1944","DOI":"10.1007\/s10995-023-03664-x","article-title":"Accelerated fentanyl metabolism during pregnancy and impact on prenatal drug testing","volume":"27","author":"Wanar","year":"2023","journal-title":"Matern Child Health J"},{"key":"2026012412513144300_lmaf079-B12","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1093\/jat\/34.8.444","article-title":"Urine drug testing of chronic pain patients. III. Normetabolites as biomarkers of synthetic opioid use","volume":"34","author":"Depriest","year":"2010","journal-title":"J Anal Toxicol"},{"key":"2026012412513144300_lmaf079-B13","doi-asserted-by":"publisher","first-page":"2374289518811797","DOI":"10.1177\/2374289518811797","article-title":"A difficult challenge for the clinical laboratory: accessing and interpreting manufacturer cross-reactivity data for immunoassays used in urine drug testing","volume":"5","author":"Reschly-Krasowski","year":"2018","journal-title":"Acad Pathol"},{"key":"2026012412513144300_lmaf079-B14","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1093\/jalm\/jfae049","article-title":"A comparative analysis of two commonly used FDA-approved immunoassays for fentanyl detection","volume":"9","author":"Lam","year":"2024","journal-title":"J Appl Lab Med"},{"key":"2026012412513144300_lmaf079-B15","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1093\/jalm\/jfaa048","article-title":"Comparison of two commercially available fentanyl screening immunoassays for clinical use","volume":"5","author":"Budelier","year":"2020","journal-title":"J Appl Lab Med"},{"key":"2026012412513144300_lmaf079-B16","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1093\/jalm\/jfae056","article-title":"Performance evaluation of 2 FDA-approved fentanyl immunoassays against LC-MS\/MS reference","volume":"9","author":"Militello","year":"2024","journal-title":"J Appl Lab Med"},{"key":"2026012412513144300_lmaf079-B17","year":"2021"},{"key":"2026012412513144300_lmaf079-B18","year":"2021"},{"key":"2026012412513144300_lmaf079-B19","year":"2014"},{"key":"2026012412513144300_lmaf079-B20","doi-asserted-by":"publisher","first-page":"119995","DOI":"10.1016\/j.cca.2024.119995","article-title":"Clinical implications of opioid parent-metabolite ratios","volume":"565","author":"Liao","year":"2025","journal-title":"Clin Chim Acta"},{"key":"2026012412513144300_lmaf079-B21","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s12954-021-00478-4","article-title":"High concentrations of illicit stimulants and cutting agents cause false positives on fentanyl test strips","volume":"18","author":"Lockwood","year":"2021","journal-title":"Harm Reduct J"},{"key":"2026012412513144300_lmaf079-B22","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1093\/jalm\/jfae036","article-title":"Performance of a norfentanyl immunoassay in specimens with low concentrations of fentanyl and\/or norfentanyl","volume":"9","author":"Uljon","year":"2024","journal-title":"J Appl Lab Med"},{"key":"2026012412513144300_lmaf079-B23","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1007\/s13181-012-0253-z","article-title":"Reliability of postmortem fentanyl concentrations in determining the cause of death","volume":"9","author":"Gill","year":"2013","journal-title":"J Med Toxicol"}],"container-title":["Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/labmed\/article-pdf\/57\/1\/lmaf079\/65535989\/lmaf079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/labmed\/article-pdf\/57\/1\/lmaf079\/65535989\/lmaf079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T17:51:41Z","timestamp":1769277101000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/labmed\/article\/doi\/10.1093\/labmed\/lmaf079\/8343192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,7]]}},"URL":"https:\/\/doi.org\/10.1093\/labmed\/lmaf079","relation":{},"ISSN":["0007-5027","1943-7730"],"issn-type":[{"value":"0007-5027","type":"print"},{"value":"1943-7730","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026]]},"published":{"date-parts":[[2025,11,26]]},"article-number":"lmaf079"}}