Evaluation of a point-of-care testing product for drugs of abuse; testing site is a key variable

We evaluated the EZ-SCREEN Test Kit (Editek, Inc., Burlington, NC), a point-of-care screening test for the presence of cocaine metabolite (benzoylecgonine; BE), cannabinoids (tetrahydrocannabinol; THC) and opiates in urine. Patient specimens (n = 34) were tested in the laboratory using both Abbott Laboratories ADx (ADx) and EZ-SCREEN (EZS-LAB), and by the nursing staff of an inpatient substance abuse treatment program using the EZ-SCREEN (EZS-RN). We found comparable analytical efficiency between methods used in the laboratory (> 95% for all three analytes with EZS-LAB and ADx) but lower efficiency for THC and BE with point-of-care testing (approximately 82% for EZS-RN). Efficiency for EZS-RN opiates was 100%. We conclude that the EZ-SCREEN Test Kit may not be suitable for use in a busy clinical setting, unless specific measures are taken to insure the accuracy of point-of-care testing (e.g., minimal interruption or distraction, careful training). We recommend that prior to routine use of point-of-care testing products they be evaluated under normal working conditions with personnel who will eventually be required to perform routine testing.