[Usefulness of AccuSign in emergency room].
BACKGROUND
TriageDOA is effective for screening patients with methamphetamine intoxication, but false positives also sometimes occur. A definite diagnosis is made by performing an instrumental analysis for methamphetamine intoxication, but this is difficult to conduct in general hospitals. AccuSign using immunochromatography can identify methamphetamine (MET) and amphetamine (AMP) individually. An improvement in the diagnostic accuracy is expected by combining the measurements of both AccuSign MET and AMP. We herein investigated the diagnostic accuracy of AccuSign. THE SUBJECTS AND METHOD: Investigation A: The subjects comprised 115 cases of urine samples that were brought to the crime laboratory of the Gunma prefectural police (hereinafter, crime laboratory) under suspicion of methamphetamine intoxication from January 2006 to April 2009. The outcomes of the measurements of MET from AccuSign MET, AMP and instrumental analyses were compared. Investigation B: The subjects comprised 16 cases in which TriageDOA was positive and AccuSign MET and AMP were performed on patients suspected of methamphetamine intoxication or patients with a disturbance of consciousness in our hospital from July 2009 to October 2010. The outcomes of the measurements of MET and AMP from AccuSign MET, AMP and instrumental analyses were compared.


RESULTS
Investigation A: The results were classified into positive for AccuSign MET as well as AMP, and others. The sensitivity of MET detected by instrumental analyses was 88.8% (40/45), with a specificity of 100% (70/70). Investigation B:The results were classified into positive for AccuSign MET as well as AMP, and others. The sensitivity of MET detected by instrumental analyses was 80.0% (4/5), with a specificity of 100% (11/11).


CONCLUSIONS
A definite diagnosis of methamphetamine intoxication would be possible without using instrumental analyses when both AccuSign MET and AMP are positive.
Advanced Medical Emergency and Critical Care Center, Japanese Maebashi Red Cross Hospital.
Yoshihiko
Y
Nakamura
Minoru
M
Nakano
Eiji
E
Takahashi
Hiroyuki
H
Suzuki
Toshikazu
T
Hasuike
Hisashi
H
Akuzawa
Hideko
H
Yuasa
D000661:Amphetamine / Q000506:poisoning*; D019969:Amphetamine-Related Disorders / Q000175:diagnosis*; D002846:Chromatography, Affinity / Q000295:instrumentation*; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005189:False Positive Reactions; D006801:Humans; D008694:Methamphetamine / Q000506:poisoning*; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000295:instrumentation*
D011933:Reagent Kits, Diagnostic; D008694:Methamphetamine; D000661:Amphetamine