False-positive drug test results in patients taking psychotropic drugs. A literature review

Context Immunohistochemistry has become an indispensable ancillary technique in anatomic pathology laboratories. Standardization of every step in preanalytic, analytic, and postanalytic phases is crucial to achieve reproducible and reliable immunohistochemistry test results. Objective To standardize immunohistochemistry tests from preanalytic, analytic, to postanalytic phases. Data Sources Literature review and Geisinger (Geisinger Medical Center, Danville, Pennsylvania) experience. Conclusions This review article delineates some critical points in preanalytic, analytic, and postanalytic phases; reiterates some important questions, which may or may not have a consensus at this time; and updates the newly proposed guidelines on antibody validation from the College of American Pathologists Pathology and Laboratory Quality Center. Additionally, the article intends to share Geisinger's experience with (1) testing/optimizing a new antibody and troubleshooting; (2) interpreting and reporting immunohistochemistry assay results; (3) improving and implementing a total immunohistochemistry quality management program; and (4) developing best practices in immunohistochemistry.

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Three Years of Experience With Random Urinary Homovanillic and Vanillylmandelic Acid Levels in the Diagnosis of Neuroblastoma

PEDIATRICS ◽

10.1542/peds.79.2.203 ◽

1987 ◽

Vol 79 (2) ◽

pp. 203-205

Author(s):

Mendel Tuchman ◽

Margaret L. R. Ramnaraine ◽

William G. Woods ◽

William Krivit

Keyword(s):

False Positive ◽

Homovanillic Acid ◽

False Negative ◽

False Negative Rate ◽

Urine Samples ◽

Vanillylmandelic Acid ◽

Test Results ◽

Upper Limit ◽

Positive Results ◽

Rule Out

During the last 3 years, random urine samples from 408 patients were tested for elevated homovanillic acid (HVA) and vanillylmandelic acid (VMA) levels to rule out the diagnosis of neuroblastoma. Thirty-seven of these patients had elevated HVA and/or VMA levels, and neuroblastoma was subsequently diagnosed. In three additional patients with negative test results (normal HVA and VMA levels), tumors were subsequently diagnosed (false-negative rate of 7.5%). Ten percent of the patients with neuroblastoma had normal HVA and 27.5% had normal VMA levels at the time of diagnosis. Only one patient (2.5%) with neuroblastoma had elevated VMA levels in the presence of normal HVA levels. More than 60% of the patients with neuroblastoma had urinary HVA and/or VMA levels higher than twice the upper limit of normal. No false-positive results were encountered. Age and stage distributions of the patients are shown, and the significance of the results is discussed.

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KUALITAS AUDIT DAN AUDIT TENURE

Jurnal Riset Akuntansi dan Keuangan ◽

10.21460/jrak.2014.101.180 ◽

2014 ◽

Vol 10 (1) ◽

pp. 61

Author(s):

Reygen Pramana Jati

Keyword(s):

Logistic Regression ◽

Literature Review ◽

Empirical Model ◽

Audit Quality ◽

Empirical Test ◽

Binary Logistic Regression ◽

Negative Influence ◽

Test Results ◽

Financial Report ◽

Earnings Benchmarks

Audit quality is determined by auditor’s competence to find misstatements in financial report and report the findings in the audit report that makes auditor’s independency strongly affect audit quality, in addition to auditor’s competency in performing their duties. Auditor’s independency is related to lengthy audit engagement with client. This study aims to obtain empirical evidence about the influence of lengthy audit engagement to audit quality. Based on the literature review, the hypothesis proposed in this study is the length of the audit engagement negatively affects audit quality. This study uses earnings benchmarks as proxy of audit quality developed from Carey and Simnett (2006). To test the hypothesis, an empirical model was developed and tested with binary logistic regression technique. Empirical test results indicate a significant negative influence of lengthy audit engagements to audit quality. It means that lengthy audit engagement deteriorates audit quality, indicated by the failure to meet earnings benchmark. Keywords: Audit Tenure, Audit Quality, Earnings Benchmark

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Tapentadol is the least common opioid found in admission urine drug-test results at an intensive outpatient opioid-use disorder treatment program in Ohio: A brief report

Journal of Opioid Management ◽

10.5055/jom.2021.0610 ◽

2021 ◽

Vol 17 (1) ◽

pp. 13-17

Author(s):

Adam Rzetelny, PhD ◽

Diana Meske, PhD ◽

Parag Patel, MD, FACOG, FASAM ◽

Steven Passik, PhD

Keyword(s):

Treatment Program ◽

Opioid Use Disorder ◽

Common Finding ◽

Prescription Opioid ◽

Test Results ◽

Opioid Use ◽

Drug Test ◽

Urine Drug ◽

Urine Drug Test ◽

Dispensing Data

Background: Previous data suggest that tapentadol, an atypical opioid with a putative dual mechanism of action, has relatively low rates of abuse. A better understanding of the rates of abuse among different prescription opioids may help clinicians when considering their potential risks and benefits. The results of urine drug tests (UDTs) may provide a unique opportunity to help answer this question.Method: To investigate different rates of prescription-opioid abuse in this retrospective study, we examined urine drug test results from patients seeking treatment at four facilities of an opioid-use-disorder (OUD) treatment program in Ohio. Urine specimens were collected on admission, one from each patient, in the regular course of care. The opioids reviewed in the present study were tapentadol, hydrocodone, oxycodone, hydromorphone, oxymorphone, and tramadol. Drug dispensing data, including morphine-milligram equivalents (MME) dispensed, were examined to adjust for the relative prevalence of each opioid being examined.Results: Data from 4,162 patients were examined. Tapentadol was the least common finding in UDT results in this cohort and remained so after adjusting for drug availability. The percentage of specimens positive for a given opioid ranged from 0.12 percent (tapentadol) to 7.04 percent (oxycodone). The availability and MME adjustments resulted in a change of rank order, with tapentadol remaining the lowest but tramadol replacing oxycodone as the prescription opioid with the highest rate of abuse.Conclusions: In this sample of UDT results from patients seeking treatment at an OUD program in Ohio, tapentadol was the least frequent finding among the opioids examined, and this remained true when adjusting for dispensing data. Factors potentially contributing to this difference may include pharmacological properties unique to tapentadol. Several important limitations notwithstanding, these findings are consistent with previous real-world evidence and warrant an ongoing line of inquiry.

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