Confirmation Testing

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Definition - What does Confirmation Testing mean?

Confirmation testing is an auxiliary drug testing procedure designed to isolate target drug analytes via catabolic breakdown of molecular compounds found in urine or oral fluid specimens, using designated cutoff thresholds per drug class. An immunoassay drug test serves as a preliminary measure in drug screening procedures; however, its inaccuracy to distinguish between various substances within a classified group warrants the use of confirmation testing methodologies.

SureHire explains Confirmation Testing

For many employers, an immunoassay is a cost-effective, efficient, and quick drug testing protocol. However, its blanket approach to combine the different classes and subclasses of drugs often fails to identify single drug metabolites without confirmation testing to boot. A provided urine or oral fluid specimen that falls below or at (or above) the cutoff threshold value range is subject to false negatives or false positives that can otherwise compromise the integrity of drug testing parameters. Incidentally, the Canadian Model for Providing a Safe Workplace aligned with the Department of Transportation (DOT) paradigm lays the groundwork for establishing cutoff values between the initial screening and confirmation testing to compare the difference. Confirmation testing often enlists the use of Gas Chromatography/ Mass Spectrometry (GC-MS) and Liquid Chromatography/Tandem Mass Spectrometry (LC-MS/MS) calibrated equipment to override cross-reactive enzymes from two separate substances, for example, a drug analyte and ingested product (i.e. poppy seeds). A Medical Review Officer (MRO) is a certified physician who evaluates drug testing findings, hedging interpretive analyses contributing to different case scenarios where confirmation test results are necessary as forensic evidence in judicial discrepancies. Confirmation testing covers the urine-based and oral fluid-based bracket for concentration cutoff limit ranges of licit and illicit substances including, but not limited to, the following: amphetamines, cocaine, marijuana, opioids (its derivative compounds), and phencyclidine (PCP).

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