Clinical and forensic toxicology proficiency testing (EQA) catalogue 2011/2012 Contents

Introduction

• Promoting excellence through 3 proficiency testing

• Aim of proficiency testing 3

• Quality standards 3

• Benefits of proficiency testing 4

• Who should participate in 4 proficiency testing schemes?

• Who participates in LGC Standards 4 proficiency testing schemes?

• Why choose LGC Standards as 4 your proficiency testing provider?

• Why do I need proficiency testing? 4

• PT/EQA schemes for clinical and 5 forensic toxicology

• Benefits of participation in 5 HEATHCONTROL PT/EQA schemes

Clinical and forensic PT schemes

• HEATHCONTROL – Therapeutic 6 Drug Monitoring (TDM)

• HEATHCONTROL – Toxicology (TOX) 8

• HEATHCONTROL – Drugs of Abuse 9 in Urine (DAU)

• HEATHCONTROL – Drugs in Oral 10 Fluid (DOF)

• QUARTZ – Forensic blood 11 toxicology scheme

• FORENSICS PT trial scheme 12

• Confidentiality 13

• Reports 13

• Other PT services 13

• Product development 13

• Reference materials 14

• Summary 14

Tel: +44 (0)161 762 2500 Fax: +44 (0)161 762 2501 Introduction

LGC Standards Aim of proficiency testing Promoting excellence through Proficiency testing is defined in ISO/IEC 17043 proficiency testing as the evaluation of participant performance LGC Standards is an accredited international against pre-established criteria by means of provider of proficiency testing (PT) services interlaboratory comparisons. The terms “External also known as External Quality Assessment Quality Assessment or EQA” are often used for (EQA). We have over twenty five years proficiency testing in the medical/clinical area. experience in all aspects of providing PT services LGC Standards Proficiency Testing provides to laboratories undertaking clinical, chemical, a wide range of schemes designed to improve microbiological, and physical measurements. the quality of analysis in those sectors covered. LGC Standards operates 39 proficiency testing The schemes involve the regular distribution schemes serving more than 7,000 laboratories. of test materials in order for participants to test We produce in excess of 100,000 test materials for defined parameters, and to have their results which are distributed to over 140 countries statistically analysed. Participation provides worldwide. laboratories with a means of assessing the accuracy and comparability of their results We offer an unprecedented breadth of clinical, with peer laboratories over time. chemical, microbiological and physical testing schemes across a wide range of industries When performed within the context of a including clinical and forensic, pharmaceutical comprehensive quality assurance programme, and phytochemical sectors, meat, dairy and other proficiency testing is an independent means food sectors, water, soil and other environmental of assuring the quality of test and calibration sectors, brewing, distilling, malting, sugar and results, as described in ISO/IEC 17025 and other beverage sectors, cosmetics, toys and ISO 15189. other consumer safety sectors. Quality standards In addition to the variety of schemes offered, LGC Standards Proficiency Testing is committed LGC Standards can also provide managed to continual improvement in quality and solutions for in-house proficiency testing providers efficiency through procedures based upon and training for participants and their customers. quality assurance. This commitment is demonstrated through certification to ISO 9001 for all its activities and accreditation to ISO/IEC 17043 for the operation, management and design of proficiency testing schemes. LGC Standards Proficiency Testing is accredited by the United Kingdom Accreditation Service (UKAS, certificate number: 0001). Clinical schemes are currently accredited to the UK Clinical Pathology Accreditation (CPA) guidelines reference number 028/0054, 0028/0055, 028/0060, 028/0315. A copy of our current scope of accreditation is available on our website: www.lgcpt.com

Email: [email protected] Website: www.lgcpt.com 3 Introduction • regulations. international • aninterestinqualityassurance. • ortraining requirements. • againstothers. performance • inproficiencytestingwill: Participation process.accreditation competently; essentialinthelaboratory tests toperform theirability to confirm participants andenables to goodperformance commitment alaboratory’s as itdemonstrates tool Proficiency testingisanessentiallaboratory proficiency testing Benefits of 4 quality assurance process. results tokey inthe indicators performance monitoring andmanylinkPT laboratories of asanessentialpart view PTschemes monitoring orothersectors, many regulators beverages,food, pharmaceutical, environmental value. forensic, intheclinical, Whetheroperating inthemarketreputation and,ultimately, brand of -becausequality schemes inPT/EQA participate the qualityof Anyone whoneedstoindependentlydemonstrate testing schemes? Who should participate in proficiency inproficiency shouldparticipate Who of acrossagroup • directlytoqualityof resultsrelates Provide sourceof avaluable tocomplywith anability Demonstrate andreinforce Encourage goodperformance Give of indication anearly tomeasuretheir participants Enable Provide themeanstomeasure consistency theiranalyticalresultsshould laboratories. potentialproblems information. product,

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Tel: +44(0)161 7622500Fax: +44(0)161 7622501 • asinglesupplier. • proficiency testing provider? Why choose LGC Standards asyour coverschemes upto200laboratories. requirements. Thesespecial their particular companiestomeet forschemes multi-national LGC Standardsmanages anumberof inoperation. currently acrossthe39schemes 7,000 participants contract laboratories. Atpresentwe have over organisations,research commercialand food manufacturers, agencies, majorinternational companies, governmentpharmaceuticals hospitalsandclinics, include Our customers of to inspectionorganisations base ranges fromsinglesmall enterprises 140 countriesworld-wideandourcustomer LGC inover tolaboratories Standardsexports proficiency testingschemes? inLGC participates StandardsWho PT canassessthewholequalitysystem. which astheyPT schemes aretheonlyqualitytool inappropriate participate laboratories that bodiesstronglyrecommend Accreditation Why doIneedproficiency testing? • • and negative performance. frombothpositive tolearn allowing laboratories and canbeusedasatoolfor staff iseducational inaPTscheme Participation of assist inthevalidation of performance tocompareandcontrast the the laboratory withpeerlaboratories. Itallows performance andanonymously compares performance of Rapid turnaround Access toawiderange of andsupport. Local representation andadvice. support Access toexpert

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independentmeasure of truly analyticalmethodsandcan results. newmethods. from schemes globalrepute. training, laboratory bespoke

Introduction

PT/EQA schemes for clinical Benefits of participation in HEATHCONTROL and forensic toxicology PT/EQA schemes

LGC Standards, recently acquired Cardiff HEATHCONTROL is a respected name in the Bioanalytical Services Ltd and now operates field of EQA with over 450 participants in more the range of HEATHCONTROL (EQA) schemes than 36 countries. for laboratories and screening clinics covering: By participating in the HEATHCONTROL • Therapeutic Drug Monitoring (TDM). schemes each participant gains the benefits • Toxicology (TOX). of a global proficiency testing scheme: • Drugs of Abuse in Urine (DAU). • The schemes are a truly independent • Drugs in Oral Fluid (DOF). assessment of measurement quality, which The definitive aim of PT/EQA schemes in a enables laboratories to demonstrate their clinical setting is improvement in analytical competence and compliance with respect performance in support of improved patient care. to regulatory standards. • Performance assessments obtained in the schemes are recognised as a demonstration of laboratory quality by a range of ‘third parties’, such as, customers, regulators and accreditation bodies. • The comprehensive scheme reports provide invaluable feedback on laboratory performance and are widely used as a training tool for laboratory personnel. • Performance assessment by method provides a mechanism for laboratories to compare their measurements with others using similar techniques and assists in the evaluation and development of methods and instrumentation. • Wide variety of analytes from one supplier for all your needs. • Significant numbers of participants worldwide means statistically robust results.

Email: [email protected] Website: www.lgcpt.com 5 HEATHCONTROL – Therapeutic Drug There are many factors which influence an Monitoring (TDM) individual’s serum drug levels, these include but are not restricted to the age, sex, and weight of The Therapeutic Drug Monitoring (TDM) the patient; the route of administration of the scheme is designed to provide an independent drug; the drug’s absorption rate, excretion rate, performance assessment for laboratories delivery rate, and dosage; other medications the

PT schemes and clinics who are involved in the routine patient is taking; pregnancy, temporary illness, quantification of therapeutic drugs in serum. Clinical and Forensic infection, emotional and physical stress, The TDM scheme is fully accredited in the U.K. trauma, and surgery; the patient’s compliance by Clinical Pathology Accreditation (CPA). regarding the drug treatment regimen; and the TDM is the measurement of specific drug levels laboratory methods used to measure the drug. (concentrations) at timed intervals in patients, Effective TDM follows these changes and usually through blood samples, and is necessary tailors the dosages to fit the current needs where control of drug concentrations is of the specific patient. required to achieve optimum treatment for Drug concentrations in serum or whole blood the patient. are only meaningful if the correct procedures For most drugs, monitoring is not required are followed regarding the timing of specimens. as they have a wide therapeutic index i.e. the Failure to meet these requirements accounts for difference between a therapeutic and toxic most errors in TDM. It is very important to note concentration is large. Therefore, most individuals the exact time the sample is taken and when will be effectively treated without extreme side each dose of the drug is given as it allows for effects or symptoms of toxicity. accurate interpretation of the measured levels and the patient’s response to their dosing However, drugs with a narrow therapeutic index regimen. may result in a high or low serum concentration if not monitored and controlled. Drug Although serum drug concentrations and the concentrations in the bloodstream that are too therapeutic interval are useful in evaluating drug high have the potential to exert adverse effects therapy, they should not be the only criteria on associated with toxic or even fatal consequences. which treatment is based. Therapeutic drug Drug concentrations below the therapeutic monitoring is a multidisciplinary function, requiring index can lead to poor response to treatment. collaboration between scientists, clinicians, For some drugs, maintaining this steady state nurses and pharmacists in order to ensure that is not as simple as giving a standard dose of best practice in TDM is achieved. The team medication. must remember to always treat the patient, not the level.

The full range and availability of test materials in TDM is determined on an annual basis and further details can be found in the TDM application form and scheme information document.

6 Tel: +44 (0)161 762 2500 Fax: +44 (0)161 762 2501 Immunosuppressive drugs** Human blood/plasma: Antibiotic drugs* Human serum: Anti-cancer drug Human serum: PsychoactiveHuman serum: drugs calf Newborn mixture Cardiac drugs Human serum: AE2 mixture Newer anti-epilepticdrugs Human serum: AE1 mixture Newer anti-epilepticdrugs Human serum: Anti-epileptic drugs Human serum: mixture drug Therapeutic 15analyte Human serum: Test material LGC Standards. by mayoperated through subscribetothescheme ASILtd.Participants covered by theLGC Standardsscopeof **Please notethisisnotaHEATHCONTROL isnot andassuch scheme for antibioticdrugs. scheme withUKNEQAS *These analytesareproducedincollaboration form. application current Note: Test andanalytesmay materials be addedorremoved, please see Website:Email: [email protected] www.lgcpt.com or serum Tacrolimus. Mycophenolate, Sirolimus, Cyclosporin, Everolimus, Tobramycin. vancomycin, Netilmicin,Teicoplanin, Flucytosine, Gentamicinwith Amikacin, Chloramphenicol, Methotrexate. . /norvenlafaxine, /nortrimipramine, , /norsertraline, /HO-risperidone, , , , , /normirtazapine, /normaprotiline, , , , /norfluoxetine, /, (dothiepin) /northiaden, /norcitalopram, /dehydroaripiprazole, , /. /norclozapine, /, /, Flecainide. , Desethylamiodarone, Zonisamide.Vigabatrin, Rufinamide, Tiagabine, Topiramate, Felbamate, Lacosamide, Levetiracetam, Pregabalin. OH-, Gabapentin, Clobazam /Norclobazam. Valproate, Vancomycin. Phenytoin, Primidone, Theophylline, Lamotrigine, Lithium,Phenobarbital, Ethosuximide, Gentamicin, Clonazepam, Digoxin, 10,11-epoxide, Caffeine, Carbamazepine, Analytes Itismanagedand accreditation.

7

Clinical and Forensic PT schemes HEATHCONTROL – Toxicology (TOX) The TOX scheme provides a range of test materials suitable for a variety of clinical and The Toxicology (TOX) scheme is designed to forensic settings: provide an independent performance assessment for laboratories and clinics that provide a • Serum, blood and urine. The blood and pathology service, toxicological service, or serum specimens contain ethanol, paracetamol

PT schemes forensic investigation service for drug and and salicylate (the blood also contains ethanol determination. The TOX scheme is carboxyhaemoglobin). The urine contains Clinical and Forensic fully accredited in the U.K. by Clinical Pathology only. These are result driven samples Accreditation (CPA). and no interpretation is required. • Case study. A case study is provided along Drug and alcohol analyses may be undertaken with relevant serum and urine specimens. for a variety of reasons which include but are Participants analyse the specimens and not restricted to: submit the analytical findings along with the • Determine whether an individual is under the relevant interpretation, which is then marked influence of alcohol and/or drugs that may by an independent scoring panel. require treatment or interfere with any • Toxicological quantitative specimens. Blood medical care necessary (These analyses are test materials containing variable drugs and usually required quickly in order to facilitate compounds that may be monitored in cases effective medical treatment). of possible drug overdose. • Determine whether an individual is under the The full range and availability of test materials influence of alcohol and/or drugs which may in TOX is determined on an annual basis and put their own life or that of others at risk further details can be found in the TOX whilst at work. application form and scheme information • Determine whether an individual may have document. been affected by alcohol and/or drugs whilst either a victim or a suspect in a criminal Test material Analytes offence. Human serum Ethanol, Paracetamol, Salicylate. • Determine whether alcohol and/or drugs may be implicated in a death. Blood Carboxyhaemoglobin, Ethanol, Paracetamol, Salicylate.

Toxicological analyses may be undertaken on a Urine Ethanol. number of biological specimens, predominantly Human serum and urine Various analytes with clinical or blood, serum and urine. In general, analyses forensic scenario.

are commonly undertaken for a range of Blood toxicology analytes , , prescription and non-prescription drugs, illegal Opiates, , Selective Re-uptake Inhibitors drugs and alcohol. The aim of the analyses (SSRIs), , is to establish the identity of any substances and other drugs of interest.

present and at what quantity, and to then Note: Test materials and analytes may be added or removed, please see determine what effect the substance(s) current application form. identified may have had on the individual. The analytical findings would then be subject to interpretation by a suitably qualified individual.

8 Tel: +44 (0)161 762 2500 Fax: +44 (0)161 762 2501 HEATHCONTROL – Drugs of Abuse in Urine (DAU)

The Drugs of Abuse in Urine (DAU) scheme is designed to provide an independent performance assessment of laboratories and clinics that provide routine services for PT schemes detection of drugs of abuse in urine. The DAU Clinical and Forensic scheme is fully accredited in the U.K. by Clinical Pathology Accreditation (CPA).

Human urine has been used for many years to detect the presence of frequently abused drugs. A urine drug test may be undertaken when ordered by a doctor to monitor a known or suspected substance abuse patient, and whenever a person has symptoms that suggest drug use. Urine drug tests may be requested Drug testing is extremely accurate and reliable for a variety of reasons, including occupational when all aspects of the testing process are monitoring, insurance screening, legal and carried out correctly. However, if poor procedures forensic purposes and in sports. and inadequate testing methods are utilised, the information obtained may be very misleading and For most drugs of abuse testing, results of inaccurate. In order to minimise this risk, clinical initial screening testing are compared with a laboratories should perform routine quality predetermined cut-off. Anything below that control tests and participate in suitable PT/EQA cut-off is considered a negative result. A schemes. negative result does not necessarily mean that the person did not take a drug at some point, The full range and availability of test materials only that the drug was not present at a in DAU is determined on an annual basis and concentration greater than the reporting further details can be found in the DAU application threshold. Anything above the cut-off is form and scheme information document. considered a positive result. If the sample is confirmed as positive after secondary testing Test material Analytes then a “detected” finding is reported. Urine test materials obtained from Amfetamines & stimulants, volunteers, patients and known Cannabinoids, & metabolites drug users which regularly contain Minor tranquillizers, mixtures of drugs and their Non-opiate narcotics, Opiates. metabolites from six major classes

Note: Test materials and analytes may be added or removed, please see current application form.

Email: [email protected] Website: www.lgcpt.com 9 HEATHCONTROL – Drugs in Oral Fluid (DOF)

The Drugs in Oral Fluid (DOF) scheme is designed to provide an independent performance assessment of laboratories and clinics that provide analytical services for drugs in oral

PT schemes fluid. The DOF scheme is fully accredited in the U.K. by Clinical Pathology Accreditation (CPA). Clinical and Forensic

Drug abuse is a global problem affecting many in society. Advances in technology have enabled oral fluid testing for the presence of many drugs, such as the amfetamines and stimulants, benzodiazepines, cannabinoids, cocaine and metabolites, opiates and non-opiate narcotics. Due to the importance of results obtained it is essential that laboratories undertaking the Oral fluid as a testing matrix is increasingly analyses are able to demonstrate the testing being utilised in a range of applications, such they perform is dependable, reproducible and as work place monitoring, clinical toxicology accurate. Participation in the DOF scheme and criminal justice. will provide valuable feedback to laboratories/ The advantages of oral fluid over traditional on-site screening clinics who undertake these fluids such as blood and urine, are that analyses, and a record of results overtime. collection is almost non-invasive, is relatively The full range and availability of test materials easy to perform, and, in forensic situations, can in DOF is determined on an annual basis and be achieved under close supervision to prevent further details can be found in the DOF adulteration or substitution of the samples. application form and scheme information There are now sensitive and reliable analytical document. methods available for oral fluid specimen

collection, point-of-collection testing devices Test material Analytes (POCT), screening and confirmation methods. Oral fluid test materials obtained Amfetamines & stimulants, from volunteers and known drug Benzodiazepines, Cannabinoids, users. These regularly contain Cocaine & metabolites, mixtures of drugs and their Non-opiate narcotics, Opiates. metabolites from six major classes

Note: Test materials and analytes may be added or removed, please see current application form.

10 Tel: +44 (0)161 762 2500 Fax: +44 (0)161 762 2501 QUARTZ – Forensic blood toxicology scheme Test material Analytes

Group A 6MAM (MACM), Amfetamine, QUARTZ is a blood toxicology scheme designed More frequently determined drugs Amisulpride, Amitriptyline, for laboratories undertaking analysis of drugs Benzoylecgonine, Buprenorphine, Carbamazepine, Chlordiazepoxide, in post-mortem and other blood samples for , Citalopram, toxicological purposes, particularly in a forensic Clomipramine, Clozapine, Cocaine, Codeine, , context. Test materials are prepared using Desmethyldiazepam, Diazepam, PT schemes pre-screened human blood. Target analytes Diclofenac, Dihydrocodeine,

Diphenhydramine, Dosulepin, Clinical and Forensic are added at an appropriate level and the test Fentanyl, Fluoxetine, Ibuprofen, Imipramine, , material mixed to ensure homogeneity prior Lamotrigine, MDA, MDMA, to despatch. , , Midazolam, Mirtazepine, Morphine, Olanzapine, Oxazepam, Oxycodone, The analytes to be determined in each round Paracetamol, Paroxetine, , are from a list of non-prescription, prescription Phenytoin, , , Propoxyphene, and controlled drugs, as well as other toxins, Quetiapine, Risperidone, Salicylate, compiled by the Advisory Group, which reflects Sertraline, Temazepam,THC, THC-COOH,, Venlafaxine, what participants are likely to encounter in Zolpidem, Zopiclone. forensic casework. Group B Amlodipine, Amobarbital, , Less frequently determined drugs Benzyl (BZP), The test materials are subdivided into two Butobarbital, Clobazam, Clomethiazole, Clonazepam, groups: Dextromoramide, Dipipanone, Gabapentin, Loprazolam, Group A: those drugs that are more frequently Lormetazepam, Mefenamic Acid, , Naltrexone, determined by participants. Pentobarbital, Phenelzine, , Secobarbital, Group B: those drugs that may be less Sildenafil, Thioridazine, Trazadone, Zaleplon. frequently determined by participants. Note: Metabolites of the above substances may also be added. Up to three test materials are provided in each round containing between 0 and 4 drugs. Test material Analytes

Alcohol is major cause of road casualties and Drug Identification Participants will be asked to identify the drug(s) only. The test material deaths and as penalties for drink-driving are will always (if positive) contain one severe it is essential the accuracy of analysis drug from Group A. Up to three other drugs may be in the test can be proven in the legal case. The test material material from either Group A and/ or Group B. comprises 10ml vial of whole blood containing alcohol for analysis. Drug Quantification Participants will be told the identity, or generic classification, of the drug(s), and asked to quantify the The full range and availability of test materials concentration. They will also be in QUARTZ is determined on an annual basis asked to give an interpretation of the results in respect to a case and further details can be found in the QUARTZ study provided. The test material application form and scheme description. will always contain a drug from Group A. Any other drugs present will be from Group A and/or Group B.

Drug Quantification Standard solutions containing drugs for the evaluation of instrumentation.

Alcohol Quantification Participants will be required to quantify the alcohol concentration by their usual methods.

Note: Test materials and analytes may be added or removed, please see current application form.

Email: [email protected] Website: www.lgcpt.com 11 FORENSICS PT trial scheme

LGC Standards Proficiency Testing has developed a range of trials for the Forensic Science sector. These are intended to complement the quality control and quality assurance products already well established in PT schemes these specialised laboratories, in order to help Clinical and Forensic demonstrate the efficacy of these measures.

The trials may comprise:

• Qualitative tests; confirmatory testing and/or identification. • Quantitative tests; analysis of specified component(s). • Post-analytical challenges/scientific conclusion; interpretation based on a case study and analytical data.

Participants may use any method they deem Test material Analytes

appropriate to perform the test or analyse the Alcohol Technical Defence* Participants will be asked to use the data. If the method used influences the result, available information to establish the likely level of intoxication of a it will be possible to identify this through analysis suspect at a given time. Data of the data submitted, and give feedback in provided will include analytical results and an alleged case the report. scenario or witness statement.

The full range and availability of test materials DNA* Participants will be asked to use the available information to establish in FORENSICS PT is determined on an annual the suitability of a mixture of DNA basis and further details can be found in the profiles for designation. Data available may include print outs of FORENSICS PT application form and scheme electrophoretograms from GMID, an excel table of peak data exported description. from GMID, and .fsa files generated by AB Data Collection software.

Drugs* Participants will be asked to use the available information to establish the identity of an unknown powder submitted for drugs profiling. Data provided will include a brief summary of the investigative approach, chromatograms or similar of the suspect powder from appropriate analytical technique (e.g. GC-MS). Results for reference materials/ calibrants analysed simultaneously.

Questioned Documents* Participants will receive a piece of paper with a series of ink marks, and up to three suspect writing implements or comparison documents. The hypothesis to be tested will be described in detail.

Note: Test materials and analytes may be added or removed, please see current application form. *Please note these trials are currently not included in our scope of accreditation.

12 Tel: +44 (0)161 762 2500 Fax: +44 (0)161 762 2501 Confidentiality Other PT services

In order to ensure confidentiality, participants in • Advice and consultancy for potential all schemes are allocated a unique laboratory PT providers. reference number. This number enables results • Consultancy for PT providers in the to be reported without divulging the identities implementation of appropriate quality of participant laboratories. systems. PT schemes • Training courses for PT participants and their

However it should be noted that, where required, Clinical and Forensic customers. the performance of U.K. participants is reported • Prominent role in the development of policy to the National Quality Assurance Advisory and guidance for proficiency testing by Panels for Chemical Pathology and for Medical representing the UK on a number of key Microbiology as appropriate. international committees. Reports Product development If PT/EQA schemes are to be effective in LGC Standards Proficiency Testing is continually facilitating improvements in the testing striving to improve current products and to undertaken by participating laboratories, introduce new test materials and PT schemes analyses of the results need to be returned to where appropriate. New products may be participants quickly. The HEATHCONTROL introduced initially on a trial basis and offered to reports are issued promptly within two - four participants. It will be made clear to participants weeks of the reporting deadline and are when they are participating in a trial. received as paper copies. The content of the reports vary from scheme to scheme but If you have a requirement for a new analyte, includes details of the composition of the test test material matrix, or a whole new scheme materials, the assigned value, the spiked value, please contact: [email protected] performance scores (BIS score) for each laboratory, and tabular and/or graphical representation of participant results.

The QUARTZ scheme and FORENSIC PT Trial results are returned through our electronic reporting software, PORTAL. Full instructions for the use of the PORTAL system are provided on registration; features include result reporting by multiple analysts and using multiple methods. Following evaluation of the results, the QUARTZ and Forensics PT Trial reports are available on the website, or sent by email within 10 - 15 working days, respectively of round closure. Participants will be emailed a link to the report when it is available.

Email: [email protected] Website: www.lgcpt.com 13 Reference materials Summary

Before a correct interpretation can be applied Proficiency testing (or EQA) is widely used to a diagnostic measurement, clinicians must across many scientific disciplines as an integral have confidence that target analytes have been part of the quality control and risk reduction correctly identified and quantified. For many process. Participation in these schemes provides

PT schemes analytical methods, this can only be achieved the analytical laboratory with the ability to assess through the use of appropriately certified and performance on an ongoing basis and Clinical and Forensic characterised reference materials benchmark that performance against other laboratories while maintaining anonymity. As a leading global supplier of reference materials, LGC Standards offers a broad range The ongoing assessment of performance using of measurement standards for routine clinical proficiency testing allows the identification of applications, such as therapeutic drug monitoring, areas for training and improvement and may occupational health, drugs and drugs of abuse, also assist with audit processes. molecular biology and veterinary medicine.

We offer a range of certified reference materials (CRM) to assist, for example, manufacturers complying with the European in vitro diagnostics Directive 98/79/EC. These higher order reference materials are produced by metrological institutes and organisations and are precisely characterised.

For further information or to receive our catalogue, please contact your local office or visit our website: www.lgcstandards.com

14 Tel: +44 (0)161 762 2500 Fax: +44 (0)161 762 2501 LGC Standards clinical and forensic toxicology reference materials LGC Standards has been serving the clinical and forensic toxicology sector for many years, providing a wide range of reference materials in different presentations. Our product range, covering solid materials to solutions, from pure substances to complex multi-component matrix controls, has been assembled to allow laboratories a single source of materials to fulfil their needs.

The collection of materials assembled from manufacturers and suppliers all over the world include: • Parent drugs • Pure substances • Phase 1 metabolites • Matrix materials • Glucuronide and • Isotopically labelled sulphate conjugates internal standards

LGC Standards appreciates that laboratories require reference materials for a wide range of substances and has ensured that the available materials cover all the major drug groups including: • Anti-epileptics • Drugs of abuse • Antibiotics • Anti-cancer drugs • Immunosuppressants • Vitamins • Anti-psychotics • Steroids (endogenous) • Cardiac drugs • Anabolic agents

Our range of materials is constantly expanding. If you are unable to find what you want from our catalogues, please contact your local office who will be able to help you further.

@LGCStds_For www.lgcstandards.com

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LGC Standards Proficiency Testing has dedicated local offices worldwide to help with your needs from placing an order through to specific enquiries. Please see the list below to contact your nearest office.

Brazil Germany Romania Tel: +55 12 3302 5880 Tel: +49 (0)281 9887 0 Tel: +40 364 116 890 Email: [email protected] Email: [email protected] Email: [email protected] Territories served: Brazil. Territories served: Albania, Austria, Territories served: Moldova, Romania, Bosnia-Herzegovina, Cyprus, Germany, Serbia. Bulgaria Greece, Iran, Israel, Japan, Korea, Kosovo, Mongolia, Montenegro, Singapore, Russia Tel: +359 (0)2 971 49555 Switzerland, Vietnam. Email: [email protected] Tel: +7 (812)935 1180 Email: [email protected] Territories served: Bulgaria, Macedonia. Hungary Tel: +36 (06) 26 314 891 Territories served: Russia. China Email: [email protected] Spain Tel: +86 10 8532 4820 Territories served: Croatia, Hungary, Email: [email protected] Slovenia. Tel: +34 (0)93 308 4181 Email: [email protected] Territories served: China, Hong Kong, Macau, Taiwan. India Territories served: Andorra, Argentina, Tel: +91 (0)80 6701 2000 Bolivia, Belize, Chile, Columbia, Costa Czech Republic Email: [email protected] Rica, Ecuador, El Salvador, French Guiana, Guyana, Guatemala, Honduras, Mexico, Tel: +420 543 529 205 Territories served: India. Nicaragua, Panama, Paraguay, Peru, Email: [email protected] Portugal, Spain, Suriname, Uruguay, Venezuela. Territories served: Czech Republic, Italy Slovak Republic. Tel: +39 02 24126 842 Sweden Email: [email protected] Finland Tel: +46 (0)33 20 90 60 Territories served: Italy. Email: [email protected] Tel: +358 (0)2 233 9355 Email: [email protected] Netherlands Territories served: Denmark, Estonia, Greenland, Iceland, Latvia, Norway, Territories served: Finland. Tel: +31 (0)643 775 422 Sweden. Email: [email protected] France Territories served: Netherlands. Turkey Tel: +33 (0)3 88 04 68 91 Tel: +90 216 360 0870 Email: [email protected] Poland Email: [email protected] Territories served: Algeria, Belgium, Benin, Tel: +48 (0)22 751 31 40 Territories served: Turkey. Burkina, Burundi, Cameroon, France, Email: [email protected] Gabun, Ivory coast, Jordan, Lebanon, Libya, Liechtenstein, Luxembourg, Territories served: Armenia, Azerbaijan, United Kingdom Madagascar, Mali, Mauritania, Mauritius, Belarus, Georgia, Kazakhstan, Kyrgyz Tel: +44 (0) 161 762 2500 Monaco, Morocco, Rwanda, Senegal, Republic, Lithuania, Poland, Tajikistan, Email: [email protected] Syria, Tanzania, Tunisia. Turkmenistan, Ukraine, Uzbekistan. Territories served: Australia, Bangladesh, Bermuda, Botswana, Brunei, Canada, Channel Islands, Ethiopia, Ghana, Indonesia, Ireland, Kenya, Kuwait, Malaysia, Malta, Nepal, New Zealand, Nigeria, Oman, Pakistan, Philippines, Qatar, Saudi Arabia, South Africa, Sudan, Tobago, Trinidad, United Arab Emirates, United Kingdom, USA, Yemen, Zambia, Zimbabwe.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any retrieval system, without the written permission of the copyright holder. © LGC Limited, 2011. All rights reserved. 3013/CF/0711