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Medical Forum / General / Laboratory / September 2007

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Is Quest diagnostics reliable ?

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Mike - 30 Aug 2007 15:31 GMT
According to there own website:

   NIDA Five Panel:
   Drug Group EIA Screen Cutoff Level* (ng/mL**)   GC/MS Confirmation
Cutoff Level*  (ng/mL**)
 Amphetamines (amphetamine and methamphetamine)    1,000    500
 Cocaine metabolite
300--------------------------------------------------150
 Marijuana metabolites
50-----------------------------------------------------15
 Opiates (codeine and morphine)
2,000----------------------------------------------2,000
 Phencyclidine
25------------------------------------------------------25

My test results were these numbers, and confirmed by the MRO, but
Quest said I tested "POSITIVE" for "Pot",  the MRO states that there
is other information the Quest uses to make this determination, the
MRO stated he does not have that info , then how could he comfirm ?

Mike
JEDilworth - 30 Aug 2007 17:02 GMT
I used to sell drug screening 20 years ago for a regional reference lab
[not Quest at the time, but it is now part of Quest], but I am by no
means an expert in this field, as my specialty is microbiology. If
anyone familiar with tox testing can add or change my comments, please
feel free to chime in. Quest is one of the largest, if not the largest,
reference labs in the U.S.

I am confused by what you posted - it may be how the newsgroup client
interpreted your spacing, etc. What was your result in
nanograms/milliliter [ng/ml]? Did your employer/prospective employer
specify GCMS confirmation? I went to Quest's website and couldn't find
anything listed under a NIDA Five Panel, so that may be a panel
specifically ordered by an employer. If employers are paying for drug
testing, they are the ones who set up the screening policies with the
laboratory. GCMS confirmation costs extra but provides definitive
testing for each metabolite. Screenings can have interfering substances
(i.e. poppy seeds for one of them - can't remember which one now).

Anyway, there was, at the time, a lot of talk about whether you could
test positive for cannabinoids/marijuana by being in a room where it was
being smoked and not smoke it yourself. Some employers were ordering a
50 ng cutoff to cut out the possibility of passive inhalation. Some
employers were ordering a 20 ng cutoff, which was controversial as to
whether you could produce this amount by just being around pot smokers
or actually inhaling it. The problem with cannabinoids is that they are
fat soluble, so you cannot flush them from your system before drug
testing and, depending on your exposure, they can hang around for up to
30 days.

So, depending on cutoff, depending on exposure, you can test positive
for cannabinoids. If they are confirmed by GC/MS this is definitive. If
you haven't smoked yourself, think about where you've been in the last
month.

This website provides some further information:

http://www.healthy.net/scr/Article.asp?Id=8085

After looking at this website, looks like Quest is screening at 50 and
the GC/MS cutoff is 15.

Judy Dilworth, M.T. (ASCP)
Microbiology

> According to there own website:
>
[quoted text clipped - 10 lines]
>  Phencyclidine
> 25------------------------------------------------------25
John Gentile - 31 Aug 2007 05:00 GMT
I am also a micro specilist, however for the past several years I've
been my lab's quality and computer manager. As such I am involved with
setting the parameters for all our testing including the ones we send
to Quest. From the looks of your message I think that the newsgroup
messed up your lines. But Judy seems to have found the info and if I
look at this correctly you are just listing the different cutoff for
each test and each drug group.

The EIA Screening is just that - a screen test that is done to show a
positive or negative based on the cutoff. There are usually false
positives for some of these grooups like the poppy seeds Judy
mentioned. I think a cold medication with pseudoephedrine might kick
off a false positive too.

The GC/MS is the "gold standard" of drug detection. It is the absolute
chemical footprint for any drug and no false positives or false
negatives.

That being said, you did not give us the values for your tests, so we
can't comment on how your MRO is interpreting the results.

Quest Diagnostics laboratories is one of the largest clinical labs in
our country with a very good reputation. All clinical laboratories must
adhere to extensive regulations by CMS and be inspected by an
accrediting agency such as the College of American Pathology. If you
live in state or city that requires licensing of Clinical Laboratory
Scientists then you should be able to check to see if they are indeed
licensed.

> I used to sell drug screening 20 years ago for a regional reference lab
> [not Quest at the time, but it is now part of Quest], but I am by no
[quoted text clipped - 54 lines]
>>  Phencyclidine
>> 25------------------------------------------------------25

Signature

John Gentile MS, M(ASCP)
Laboratory Information Mgr.
VA Medical Center
Providence, RI
yjgent@cox.net

adair - 05 Sep 2007 22:47 GMT
> I am also a micro specilist, however for the past several years I've
> been my lab's quality and computer manager. As such I am involved with
[quoted text clipped - 92 lines]
>
> - Show quoted text -

I used to know a MRO and they don't have all the data from Quest, and
this guy said that if a company did not want to hire a person for some
reason, that the MRO could just state a "positive" and nobody was
questioned.


aac.florida
 
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