Emergency Department Drug Surveillance (EDDS) hospital’s urinalysis results compared with expanded re-testing by an independent laboratory, a pilot study

Most hospital urine toxicology screens detect a fixed, limited set of common substances. These tests are fast and accurate but may miss emerging trends in substance use in the community and clinical acumen alone is insufficient for identifying new substances. This prospective cohort study examined de-identified urine specimens obtained from patients visiting the Emergency Department (ED) at Prince George’s Hospital Center (PGHC), between October 15, 2019 to November 6, 2019 and tested positive for one or more substances. The Emergency Department Drug Surveillance System (EDDS) collects quarterly exports from de-identified electronic health records (EHRs) containing urinalysis results for drug related ED visits. We performed a feasibility study of a new urine specimen submission by collecting a stratified sample of 151 urine specimens from PGHC ED patients. The specimens were tested for 240 drugs using liquid chromatography-tandem mass spectrometry (LC-MS/MS). This paper presents a comparison between the PGHC and expanded testing results. The expanded urinalysis panel found more cocaine (37% vs. 20%; p