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Results of CDC Blind Study

Hugh J. Hansen, PhD; Samuel P. Caudill, PhD; D. Joe Boone, PhD

JAMA. 1985;253(16):2382-2387.

Abstract
In response to questions about the reliability of the results of screening urine for drugs, we evaluated the performance of 13 laboratories, which serve a total of 262 methadone treatment facilities, by submitting prereferenced samples through the treatment facilities as patient samples (blind testing). Error rates for the 13 laboratories on samples containing barbiturates, amphetamines, methadone, cocaine, codeine, and morphine ranged from 11% to 94%, 19% to 100%, 0% to 33%, 0% to 100%, 0% to 100%, and 5% to 100%, respectively. Similarly, error rates on samples not containing these drugs (false-positives) ranged from 0% to 6%, 0% to 37% 0% to 66%, 0% to 6%, 0% to 7% and 0% to 10%, respectively. These blind tests indicate that (1) greater care is taken with known evaluation samples than with routine samples, (2) laboratories are often unable to detect drugs at concentrations called for by their contracts, and (3) the observed underreporting of drugs may threaten the treatment process. Drug treatment facilities should monitor the performance of their contract laboratories with quality-control samples, preferably through blind testing.

(JAMA 1985;253:2382-2387)

Author Affiliations
From the Clinical Chemistry and Toxicology Section, Performance Evaluation Branch, Division of Technology Evaluation and Assistance (Drs Hansen and Boone), and Management Development and Consultation Division (Dr Caudill), Laboratory Program Office, Centers for Disease Control, Atlanta. Dr Hansen is now with the National Institute for Occupational Safety and Health, Centers for Disease Control, Atlanta.

Footnotes
Reprint requests to Centers for Disease Control, Bldg 6, Room 316, 1600 Clifton Rd NE, Atlanta, GA 30333 (Dr Boone).

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