The analytical performance of six urine drug screens on cobas 6000 and ARCHITECT i2000 compared to LC-MS/MS gold standard

Mohamed Abou El Hassan, David Colantonio, Sergei Likhodii, Bassam A. Nassar

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: Immunoassays provide a rapid tool for the screening of drugs-of-abuse (DOA). However, results are presumptive and confirmatory testing is warranted. To reduce associated cost and delay, laboratories should employ assays with high positive and negative predictive values (PPVs and NPVs). Here, we compared the results of urine drug screens on cobas 6000 (cobas) and ARCHITECTi2000 (ARCHITECT) platforms for six drugs against LC-MS/MS to assess the analytical performance of these assays. Methods: Eighty nine residual urine specimens, which tested positive for amphetamine, THC-COOH, benzoylecgonine, EDDP, opiates and/or oxycodone during routine drug testing, were stored frozen until later confirmation by LC-MS/MS. Immunoassays were performed on cobas and ARCHITECT using a split sample. A third aliquot from these samples was tested by LC-MS/MS to assess the percentage of false positive, false negative, true positive and true negative results and calculate the PPVs and NPVs for each immunoassay. Results: The PPVs of THC-COOH and EDDP assays were 100% on both platforms. Suboptimal PPVs were achieved for oxycodone (cobas, 57.1% vs ARCHITECT, 66.7%), amphetamine (77.8 vs. 100%), opiates (80.0 vs. 84.6%) and benzoylecgonine (88.9 vs. 84.2%) assays. The NPV was 100% for cobas and ARCHITECT oxycodone assays. Lower NPVs were achieved for THC-COOH (cobas, 28.6% vs ARCHITECT, 25.0%), EDDP (72.7% for both assays), benzoylecgonine (74.4% vs 73.8%), amphetamine (83.3% vs 82.8%) and opiates (100% vs 85.3%). Conclusion: Overall, cobas and ARCHITECT urine drug screens have comparable analytical performance. Confirmatory testing is warranted for positive test results especially for oxycodone, amphetamine, opiates and cocaine. Negative drug screen results must be interpreted with caution especially for THC-COOH, EDDP, benzoylecgonine, amphetamine and opiates.

Original languageEnglish
Pages (from-to)99-103
Number of pages5
JournalClinical Biochemistry
Volume93
DOIs
Publication statusPublished - Jul 2021

Bibliographical note

Funding Information:
The authors thank Donna Stanley and Amber McAree at Clinical Chemistry Division, Provincial Laboratory Services, Queen Elizabeth Hospital in Charlottetown, Prince Edward Island, Canada, for collecting patient samples and participating in the method comparison.

Publisher Copyright:
© 2021 The Canadian Society of Clinical Chemists

ASJC Scopus Subject Areas

  • Clinical Biochemistry

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article

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