What cautions should be observed in reviewing positive biomarker results of individuals mandated to be abstinent?
Biomarkers provide an important indication of drinking status when used appropriately, but they must always be used with a clear understanding of their strengths and potential weaknesses. This is especially true when the consequences of misidentification of alcohol consumption are grave, such as for a healthcare provider whose license, livelihood, and reputation depend on demonstration of abstinence or for an individual who will be ordered to return to jail because of a positive test. Medical review officers and others who investigate positive test results should be especially cognizant of two issues: • Understanding the difference between a test’s sensitivity and positive predictive value. Interpreting even a very good test requires considerable knowledge of both the patient and the population of individuals similar to the patient. Tests should help a provider make a decision based on a variety of sources of information gathered about the patient. The first step is to precisely define
