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Assessing the utility of drug screening in the emergency: a short report
  1. Anees Bahji,
  2. Tegan Hargreaves,
  3. Susan Finch
  1. Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
  1. Correspondence to Dr Anees Bahji; 0ab104{at}queensu.ca

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Introduction

Exposure to illicit drugs and alcohol is a major cause for visits to the emergency department (ED).1 For most drugs of abuse intoxication, ED physicians are sceptical to rely on the results of drug screens because immunoassays, although rapid and relatively cheap, have limitations in their sensitivity and specificity, and also carry relatively high rates of false positives and negatives.2 However, as it is often difficult to obtain the history from intoxicated patients, drug screens are still frequently ordered. With the emergence of Choosing Wisely, clinicians are becoming increasingly aware of the need to reduce the ordering of unnecessary tests.3 In this retrospective study, we explored the utility of drug screening in an acute care hospital ED to determine the frequency, patterns, indication and impact of drug screening for patients presenting with a mental health or addiction (MHA) chief complaint.

Methods

Ethics approval was granted by the institutional review board of the primary research site. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines for observational studies were followed.4 The charts of patients seen in the ED of a local hospital with an MHA chief complaint …

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