Dear Mr. *********,

Great Question !!!!!!!

Drug Screen testing has come a long way, and the advancements are still giving employers better options to obtain a drug free work place while at the same time techniques are more sophiscated to protect the employee from false Positive tests.

Do false Positive tests actually occur? If you ask most any physician whether or not he automatically believes every laboratory test, the answer is going to be No!!!! It is common practice in the health care field to repeat laboratory tests that are Positive in order to make sure that they are really Positive. Sometimes a Positive test can make a big difference to what kinds of treatment options we present to the patient. In reference to drug screens a Positive test can change the employees carrier; with this in mind it is important to give assurances to the employer as well as the employee that a Positive test was confirmed with a second test.

When ever we collect urine to perform an Ec-Screen (quick screen) we use the same collection methodology that is used for an analysis that is sent to one of the reference laboratories. This methodology includes a "Chain of Custody" control form along with all the legal documentation that protects the employee as well as the employer. If we get a Non-Negative result from our Ec-Screen it is never reported as Positive until a second test is performed, and the second test is also Positive.

The Ec-Screen is an immunoassy analysis which is very accurate, quick, and can be reported immediately if it is Negative. If the Ec-Screen is Non-Negative we take part of the colleced urine and send it to our reference laboratory to have the specimen tested with a methodology called Gas Chromatography / Mass Spectrometry. If the specimen is Non-Negative using this methodology as the second test, the results are reported as a "Positive".

Certainly the standard of practice for Federally mandated drug screens includes both immunoassay, and GC/Mass Spec. Federally mandated collections are processed in reference laboratories and can not be done as an office procedure. Most reference laboratories have both Federally mandated and non-Federally mandated screening. The Ec-Screen fits into the category of a non-federally mandated screen. The first part of the screen can be done as an office based methodology and if everything is Negative it can be reported as Negative. If the results are non-Negative the specimen should be sent to a reference laboratory for confirmation.

As an employer it is important for you to have all Non-Negative immunoassay screens confirmed by GC/Mass Spec. If a collection facility or an employer does not have Non-Negative results confirmed by a second methodology, there is a risk of making a faulty decision from a false Non-Negative test. Remember, when immunoassay testing is done by itself it can only be reported as "Non-Negative", or "needs confirmation". At EcCare Health Centers these Non-Negative results are all reported as "needs confirmation".

So what is the advantage of doing an Ec-Screen if the postives have to be sent to a reference laboratory? If as an employer you need immediate results the Ec-Screen is for you. Most of the time our employer clients get the results of the Ec-Screen in their e-mail or fax machine before their employee leaves our facility. If the Ec-Screen is Negative most employers can make the next decision as to hiring a new employee or allowing the employee to continue working in a saftey sensitive environment.

If as an employer you do not need immediate results and can wait 24 to 48 hours for this information using one of the screens sent to the reference laboratory is for you. The reference laboratory also performs the immunoassay screen and if the results are Negative the drug screen will be reported as Negative. If the results are Non-Negative the reference laboratory will automatically use GC/Mass Spec to confirm the results. If the results are confirmed the drug screen will be reported as Positive.

In Summary, if you need to make time sensitive judgments about hiring your staff the Ec-Screen can help. However, if we did not obtain GC/Mass Spec confirmation for your Non-Negatives we would not be able to declare the screen as a Positive so the confirmation process is important to the employer as well as the employee.

Gregory P. Ennis, M.D.
Medical Director, EcCare Health Centers www.EcCare.com
Medical Review Officer www.aamro.com