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Confirmation Testing

Confirmation Testing

When your Rapid Screening device yields a non-negative result (positive), we recommend that a further laboratory confirmation of that result is conducted. The drug test (Urine or Oral Fluid) will provide you with a qualitative result, and the confirmation test will provide a quantitative (ng/mL cut off levels).

Each laboratory confirmation reaffirms the presence of the drug metabolite(s) and confirms the specific levels of each drug found in the specimen. This is done via one of the following methods:

• GC-MS (Gas Chromatography – Mass Spectrometry)

• GC-MS/MS (Gas Chromatography – Tandem Mass Spectrometry)

• LC-MS/MS (Liquid Chromatography-Tandem Mass Spectrometry)

Drug identification is achieved BOTH by chromatographic retention time and by Mass Spectrometry, which is the “drug fingerprint.” This test is very specific and robust with respect to interference. A GC/MS or LC/MS confirmation test is legally defensible evidence of drug use. The confirmation testing rules out false positive claims like poppy seeds, hemp products and over the counter medications.

The MRO Process

At this point, the positive drug test result is sent from the lab to the Medical Review Officer (MRO). The Medical Review Officer (MRO) provides an impartial and compliant assurance of drug test process and result accuracy. This is where any potential legally prescribed medication is taken into consideration, so there are no false positives. The MRO speaks to the donor letting them know their specimen was positive and asks if there are any legal or medical explanations. If the donor can document a prescription and this is verified by the MRO and this prescription is what caused the positive result at the lab – then the MRO reverses the result to negative and you, the employer, will receive the result as a negative. Now when you get a confirmed, reviewed and verified positive result from the MRO, this is a positive result and appropriate action should be taken based upon your company’s drug-free workplace or drug testing policy. Follow the facts and follow your drug-free workplace policy to stay clear of lawsuits and exposure to liability. You should be 100% consistent. Only highly trained addiction counselors, scientists or medical doctors should be involved in the final interpretation of drug test results.

• If you would like to be set up for confirmation testing, consult your Noble Medical or Noble Diagnostics Account Executive, they will assist in getting you set up with a Lab Account, Chain of Custody Forms and supplies for shipping your samples.

• Confirmation testing is typically priced on a per drug basis, whereas it is possible to have more than one non-negative drug class to confirm from you POCT device.

• The MRO charges on a per test basis, one fee for contacting the donor regardless of the number of drugs confirmed. Your Account Representative will provide specific pricing.

Typical turnaround time for results would be 24 -72 hours dependent (in part) on the need for MRO review and the donor’s cooperation with that process. Results can be reported and tracked through our very robust reporting platform, we will be happy to demonstrate!

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