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Urine and Oral Fluid Test Methodology
Screening and confirmation testing are performed using different methodologies that necessitate different cutoff levels. The cutoff levels of an immunoassay screen are typically higher than those of a more sensitive GC-MS or LC-MS/MS confirm test, because they screen for a larger group of parent compounds, metabolites and other structurally similar compounds.
If an immunoassay test detects a drug (above the screening cutoff level) the presumptive positive specimen may be sent to GC-MS or LC-MS/MS confirmation testing. Many times, these individual compounds are present in concentrations much lower than the total immunoassay response, thus resulting for the cutoff levels being lower for the GC-MS or LC-MS/MS test.