Accuracy of substance exposure history in patients attending
emergency departments after substance misuse; a comparison with
biological sample analysis

J 2023

Accuracy of substance exposure history in patients attending emergency departments after substance misuse; a comparison with biological sample analysis

VIRMANI, Ishita, Alberto OTEO, Michael DUNN, Daniel VIDLER, Clair ROPER et. al.

Basic information

Original name

Accuracy of substance exposure history in patients attending emergency departments after substance misuse; a comparison with biological sample analysis

Authors

VIRMANI, Ishita (356 India, guarantor, belonging to the institution), Alberto OTEO, Michael DUNN, Daniel VIDLER, Clair ROPER, Jane OFFICER, Gareth HARDY, Paul I. DARGAN, Michael EDDLESTON, Jamie G. COOPER, Simon L. HILL, Rebecca MACFARLANE, Liza KEATING, Mark HADEN, Simon HUDSON and Simon H. L. THOMAS

Edition

Clinical Toxicology, Abingdon, Taylor & Francis, 2023, 1556-3650

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30108 Toxicology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.300 in 2022

RIV identification code

RIV/00216224:14310/23:00130510

Organization unit

Faculty of Science

DOI

http://dx.doi.org/10.1080/15563650.2022.2131566

UT WoS

000878056700001

Keywords in English

Substance use; accuracy; self-reported

Abstract

V originále

Context Acute toxicity caused by illicit substance use is a common reason for emergency department (ED) presentation. Knowledge of the substances involved is helpful for predicting and managing potential toxicity, but limited information is available about the accuracy of patient-reported substance exposure. This study assessed the accuracy of the history of exposure in those reporting use of a single substance by comparison with those identified by detailed toxicological analysis, focusing on synthetic cannabinoid receptor agonists (SCRA). Methods Adults (>= 16 years) presenting between March 2015 and July 2021 to participating UK hospitals with toxicity after reporting use of a single illicit substance were included. Exposure details were documented from medical records and blood and/or urine samples analysed using high-resolution accurate mass liquid chromatography-mass spectrometry (HRAM LCMS). Sensitivity, specificity, and positive and negative predictive values of the exposure history were calculated by comparison with biological sample analysis ("gold standard"). Results Single substance exposure was reported for 474 (median age 33 years, IQR: 18 range 16-75, 80% males) patients. Analysis commonly identified multiple substances (Median 3, IQR 2-5). A history of exposure was documented for 121 of 151 patients where a SCRA or metabolite was detected on analysis (sensitivity 80.1%, 95% CI 72.9, 86.2%). Corresponding proportions were lower for 3,4-methylenedioxymethamphetamine (MDMA, 44/70, 62.9%., 95% CI 50.5%, 74.1%), heroin 41/108 (38.0% 95% CI 28.8-47.8%) and cocaine (22/56, 31.3%, 95% CI 20.9, 43.6%). Conclusions Multiple undeclared substances were detected analytically in most patients reporting single substance use. Clinicians should be alert to the potential presence and toxicity of unreported substances when managing patients presenting after substance misuse.

Links

EF17_043/0009632, research and development project

Name: CETOCOEN Excellence

90121, large research infrastructures

Name: RECETOX RI

Citovat

VIRMANI, Ishita, Alberto OTEO, Michael DUNN, Daniel VIDLER, Clair ROPER, Jane OFFICER, Gareth HARDY, Paul I. DARGAN, Michael EDDLESTON, Jamie G. COOPER, Simon L. HILL, Rebecca MACFARLANE, Liza KEATING, Mark HADEN, Simon HUDSON and Simon H. L. THOMAS. Accuracy of substance exposure history in patients attending emergency departments after substance misuse; a comparison with biological sample analysis. Clinical Toxicology. Abingdon: Taylor & Francis, 2023, vol. 61, No 1, p. 39-46. ISSN 1556-3650. Available from: https://dx.doi.org/10.1080/15563650.2022.2131566.

@article{2271042,
   author = {Virmani, Ishita and Oteo, Alberto and Dunn, Michael and Vidler, Daniel and Roper, Clair and Officer, Jane and Hardy, Gareth and Dargan, Paul I. and Eddleston, Michael and Cooper, Jamie G. and Hill, Simon L. and Macfarlane, Rebecca and Keating, Liza and Haden, Mark and Hudson, Simon and Thomas, Simon H. L.},
   article_location = {Abingdon},
   article_number = {1},
   doi = {http://dx.doi.org/10.1080/15563650.2022.2131566},
   keywords = {Substance use; accuracy; self-reported},
   language = {eng},
   issn = {1556-3650},
   journal = {Clinical Toxicology},
   title = {Accuracy of substance exposure history in patients attending emergency departments after substance misuse; a comparison with biological sample analysis},
   url = {https://www.tandfonline.com/doi/full/10.1080/15563650.2022.2131566},
   volume = {61},
   year = {2023}
}

TY  - JOUR
ID  - 2271042
AU  - Virmani, Ishita - Oteo, Alberto - Dunn, Michael - Vidler, Daniel - Roper, Clair - Officer, Jane - Hardy, Gareth - Dargan, Paul I. - Eddleston, Michael - Cooper, Jamie G. - Hill, Simon L. - Macfarlane, Rebecca - Keating, Liza - Haden, Mark - Hudson, Simon - Thomas, Simon H. L.
PY  - 2023
TI  - Accuracy of substance exposure history in patients attending emergency departments after substance misuse; a comparison with biological sample analysis
JF  - Clinical Toxicology
VL  - 61
IS  - 1
SP  - 39-46
EP  - 39-46
PB  - Taylor & Francis
SN  - 15563650
KW  - Substance use
KW  - accuracy
KW  - self-reported
UR  - https://www.tandfonline.com/doi/full/10.1080/15563650.2022.2131566
N2  - Context Acute toxicity caused by illicit substance use is a common reason for emergency department (ED) presentation. Knowledge of the substances involved is helpful for predicting and managing potential toxicity, but limited information is available about the accuracy of patient-reported substance exposure. This study assessed the accuracy of the history of exposure in those reporting use of a single substance by comparison with those identified by detailed toxicological analysis, focusing on synthetic cannabinoid receptor agonists (SCRA). Methods Adults (>= 16 years) presenting between March 2015 and July 2021 to participating UK hospitals with toxicity after reporting use of a single illicit substance were included. Exposure details were documented from medical records and blood and/or urine samples analysed using high-resolution accurate mass liquid chromatography-mass spectrometry (HRAM LCMS). Sensitivity, specificity, and positive and negative predictive values of the exposure history were calculated by comparison with biological sample analysis ("gold standard"). Results Single substance exposure was reported for 474 (median age 33 years, IQR: 18 range 16-75, 80% males) patients. Analysis commonly identified multiple substances (Median 3, IQR 2-5). A history of exposure was documented for 121 of 151 patients where a SCRA or metabolite was detected on analysis (sensitivity 80.1%, 95% CI 72.9, 86.2%). Corresponding proportions were lower for 3,4-methylenedioxymethamphetamine (MDMA, 44/70, 62.9%., 95% CI 50.5%, 74.1%), heroin 41/108 (38.0% 95% CI 28.8-47.8%) and cocaine (22/56, 31.3%, 95% CI 20.9, 43.6%). Conclusions Multiple undeclared substances were detected analytically in most patients reporting single substance use. Clinicians should be alert to the potential presence and toxicity of unreported substances when managing patients presenting after substance misuse.
ER  -

VIRMANI, Ishita, Alberto OTEO, Michael DUNN, Daniel VIDLER, Clair ROPER, Jane OFFICER, Gareth HARDY, Paul I. DARGAN, Michael EDDLESTON, Jamie G. COOPER, Simon L. HILL, Rebecca MACFARLANE, Liza KEATING, Mark HADEN, Simon HUDSON and Simon H. L. THOMAS. Accuracy of substance exposure history in patients attending emergency departments after substance misuse; a comparison with biological sample analysis. \textit{Clinical Toxicology}. Abingdon: Taylor \&{} Francis, 2023, vol.~61, No~1, p.~39-46. ISSN~1556-3650. Available from: https://dx.doi.org/10.1080/15563650.2022.2131566.

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