Background
Exposure to drugs of abuse is frequently assessed using urine drug screening (UDS) immunoassays. Although fast and relatively inexpensive, UDS assays often cross-react with unrelated compounds, which can lead to false-positive
Conclusions
Our findings can help laboratorians and providers interpret presumptive positive UDS results. Our data-driven approach can serve as a model for high-throughput discovery of substances that interfere with laboratory tests.
Methods
Using our institution's EHR data, we assembled a data set of 698651 UDS
Results
Our approach recovered multiple known cross-reactivities. After accounting for concurrent exposures to multiple ingredients, we selected 18 compounds (13 parent drugs and 5 metabolites) to evaluate experimentally. We validated 12 of 13 tested assay-ingredient pairs expected to show cross-reactivity by our analysis, discovering previously unknown cross-reactivities affecting assays for amphetamines, buprenorphine, cannabinoids, and methadone. Conclusions: Our findings can help laboratorians and providers interpret presumptive positive UDS results. Our data-driven approach can serve as a model for high-throughput discovery of substances that interfere with laboratory tests.