title: Analytical evaluation of four on-site oral fluid drug testing devices.
abstract: The use of oral fluid (OF) as an alternative matrix for the detection of drugs of abuse has increased over the last decade, leading to the need for a rapid, simple, and reliable on-site OF testing device. Four on-site OF drug testing devices (Dräger DrugTest 5000, Cozart DDS, Mavand Rapid STAT, and Innovacon OrAlert) were evaluated on 408 volunteers at drug treatment centers. UPLC-MS-MS results were used as reference to determine sensitivity, specificity and accuracy for each device, applying Belgian legal confirmation cutoffs for benzoylecgonine, cocaine, and THC (10 ng/mL); morphine and 6-acetylmorphine (5 ng/mL); and amphetamine and 3,4-methylenedioxymethylamphetamine (25 ng/mL). Sensitivity for cocaine was 50%, 50%, 27%, and 11% for DrugTest, OrAlert, Rapid STAT, and DDS 806, respectively. For opiates, sensitivities were 84%, 73%, 77%, and 65%, respectively. For THC, the sensitivities were 81%, 23%, 43%, and 28%, respectively. For amphetamines, the sensitivities were 75%, 33%, 17%, and 67%, respectively. Specificity was >88% for opiates and THC, > 90% for amphetamines, and > 97% for cocaine. All tests showed good specificity. DrugTest had the highest sensitivity, although it was still low for some analytes.
authors.affiliation: Department of Clinical Chemistry, Microbiology, and Immunology, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. Sylvie.Vanstechelman@Ugent.be
authors.forename: Sylvie
authors.initials: S
authors.lastname: Vanstechelman
authors.forename: Cristina
authors.initials: C
authors.lastname: Isalberti
authors.forename: Trudy
authors.initials: T
authors.lastname: Van der Linden
authors.forename: Kristof
authors.initials: K
authors.lastname: Pil
authors.forename: Sara-Ann
authors.initials: SA
authors.lastname: Legrand
authors.forename: Alain G
authors.initials: AG
authors.lastname: Verstraete
mesh_terms: D000661:Amphetamine / Q000032:analysis; D002853:Chromatography, Liquid / Q000379:methods; D003042:Cocaine / Q000031:analogs & derivatives / Q000032:analysis; D013759:Dronabinol / Q000032:analysis; D006801:Humans; D008694:Methamphetamine / Q000032:analysis; D009022:Morphine Derivatives / Q000032:analysis; D015203:Reproducibility of Results; D012463:Saliva / Q000737:chemistry*; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000295:instrumentation* / Q000379:methods; D019966:Substance-Related Disorders / Q000175:diagnosis*; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D009022:Morphine Derivatives; D008694:Methamphetamine; C005618:benzoylecgonine; D013759:Dronabinol; D000661:Amphetamine; D003042:Cocaine; C026979:6-O-monoacetylmorphine