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Medical Review Officer (MRO)

What is a Medical Review Officer (MRO)?

A medical review officer (MRO) is a licensed physician who generally subcontracts out their services through a certified laboratory to evaluate cases of adulterated, diluted, or substituted urine specimens before ruling positive or negative test results. An MRO helps establish the integrity of all drug testing parameters while also arbitrating matters of positive test results that donors may take issue over to eliminate discrepancies. 

The U.S. Department of Transportation (DOT) introduced the position of the MRO in 1988 to help coordinate an interdependent network of drug testing protocol that involves the donor, employer, and certified laboratory specialists for questionable drug specimens. Although urinalysis is the most common method of drug testing in Canada, many individuals may resort to tampering with a urine specimen to bypass a positive test result, skewing analyses to the extent that confirmatory testing is mandatory. In situations where a positive test result occurs, an MRO serves as the appropriate liaison to cross-reference the subject’s medical history, detailing any prescriptions that could indicate a false positive.  

Adulterating or substituting urine specimens can lead to false negative test results, presenting conflicting evidence where the biochemical nature of the sampling meets or exceeds the cutoff threshold value. Extensive laboratory testing follows a chain of custody procedure that relies on the MRO to note comparative differences between the original non-negative sample and additional testing methods, factoring into their definitive analysis.

The MRO is required to harness full knowledge covering the pharmacology and toxicology aspects related to prescription medicine and illicit substances per Drug Enforcement Agency (DEA) guidelines based on the sensitivity of their work.

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