Re: Open letter to EtG testing companies-request for feedback, editing, etc.

[Guest guest]

Dr. DiBona,

I am a not-so-active member of this group; I hadn't

logged on for a few days, and when I did, this morning, I was floored!

Where did you come from? Who is that masked man? I am so happy to know

that there is someone else here to keep up with Lorie-God knows I

can't! (No offense, , Robin, Marsha, Isanah...you all keep up

much better than I do).

I am saving the letters you have posted, and will be sending them,

along with the WSJ article, to the California Dept. of Consumer

Affairs to be included in my investigation record.

Also, it is very refreshing to hear someone extoll the INTEGRITY of

this group. I myself have never known a more honest,

sincere,hardworking group of recovering addicts. They make me proud to

be one of them!

Thanks again. To you and all my colleagues here.

~~~~~~~~~~~~~~KEEPING THE FAITH~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Eva

>

>

> OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

>

> Please refer to the File section of the Group, EthylGlucuronide

> <../../../> for access to " Statistical Mistakes Made by EtG Testing

> Companies. "

>

> I respectfully request the immediate revision of your advertised use of

> urine EtG testing to include:

>

> * Routine reporting of urine EtG values standardized to a urine

> creatinine of 100mg/L

> * Identification of the sex of the tested subject, and if

> female, a disclaimer stating it currently appears women are known

> to produce more EtG than men for any given exposure, thus reducing

> the predictive value of any of their positive tests at any level.

> * A routine disclaimer stating many medications, including

> common over the counter medications (such as acetaminophen)

> permitted for use by all people in recovery are known to upregulate

> the enzyme system producing EtG, thereby amplifying the urine EtG

> test result by as much as forty fold.

> * A routine disclaimer stating that in the presence of any of

> the above modifiers (female or enzyme upregulation) that any urine

> EtG100 test result below 5000ng/ml cannot be confidently considered

> proof of alcohol consumption, even in small quantities.

> * A routine warning that inhalation of ethanol fumes impossible

> to avoid routinely produces overlap of urine EtG results occurring

> with consumed ethanol.

> * Removal of all references to EtG representing proof of consumed

> ethanol.

>

>

> The status of revision to your companies marketing and materials

> distributed to assist with the interpretation of urine EtG testing is

> being closely documented and monitored on a daily basis. A list of

> companies refining their advertising and interpretation instructions

> will be updated daily at the Group, EthylGlucuronide. Companies

> not voluntarily changing and posting their information will be

> considered formally for every legal remedy available. Compliance with

> the above requests does not remove liability for past statements, but

> prevents further incurred liability.

>

>

> In addition to the above, I also request your company to immediately

> post on your website a copy of the letter you send to all of your

> clients containing the following:

>

> * Notification of the revisions made above.

> * A specific request for your client to review their records,

> and that if adverse action were taken against a person solely

> because of a positve urine EtG that it be immediately rescinded.

> * An apology.

> * A list of the clients you sent the letter.

>

>

> Your website will be monitored on a daily basis. Companies not

> voluntarily posting the above information will be formally considered

> for every legal remedy available. Compliance with this request does not

> remove liability for past actions, but prevents further incurred

> liability.

>

>

> Respectfully,

>

> J. DiBona, M.D. (or, if there is some way, a list of those of us

> with positive EtGs in the absence of consumption.)

>

[Guest guest]

remember the cartoon underdog?? HERE HE COMES TO SAVE THE DAY I

cannot get that tune outof my head ..Im showing my age I know LOL---

In Ethylglucuronide , " curlyquiz " <curlyquiz@...>

wrote:

>

> Dr. DiBona,

> I am a not-so-active member of this group; I hadn't

> logged on for a few days, and when I did, this morning, I was

floored!

> Where did you come from? Who is that masked man? I am so happy to

know

> that there is someone else here to keep up with Lorie-God knows I

> can't! (No offense, , Robin, Marsha, Isanah...you all keep up

> much better than I do).

> I am saving the letters you have posted, and will be sending them,

> along with the WSJ article, to the California Dept. of Consumer

> Affairs to be included in my investigation record.

> Also, it is very refreshing to hear someone extoll the INTEGRITY

of

> this group. I myself have never known a more honest,

> sincere,hardworking group of recovering addicts. They make me proud

to

> be one of them!

> Thanks again. To you and all my colleagues here.

> ~~~~~~~~~~~~~~KEEPING THE FAITH~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Eva

>

>

>

>

>

> >

> >

> > OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

> >

> > Please refer to the File section of the Group,

EthylGlucuronide

> > <../../../> for access to " Statistical Mistakes Made by EtG

Testing

> > Companies. "

> >

> > I respectfully request the immediate revision of your advertised

use of

> > urine EtG testing to include:

> >

> > * Routine reporting of urine EtG values standardized to

a urine

> > creatinine of 100mg/L

> > * Identification of the sex of the tested subject, and if

> > female, a disclaimer stating it currently appears women are

known

> > to produce more EtG than men for any given exposure, thus

reducing

> > the predictive value of any of their positive tests at any

level.

> > * A routine disclaimer stating many medications,

including

> > common over the counter medications (such as acetaminophen)

> > permitted for use by all people in recovery are known to

upregulate

> > the enzyme system producing EtG, thereby amplifying the

urine EtG

> > test result by as much as forty fold.

> > * A routine disclaimer stating that in the presence of

any of

> > the above modifiers (female or enzyme upregulation) that any

urine

> > EtG100 test result below 5000ng/ml cannot be confidently

considered

> > proof of alcohol consumption, even in small quantities.

> > * A routine warning that inhalation of ethanol fumes

impossible

> > to avoid routinely produces overlap of urine EtG results

occurring

> > with consumed ethanol.

> > * Removal of all references to EtG representing proof of

consumed

> > ethanol.

> >

> >

> > The status of revision to your companies marketing and materials

> > distributed to assist with the interpretation of urine EtG

testing is

> > being closely documented and monitored on a daily basis. A list

of

> > companies refining their advertising and interpretation

instructions

> > will be updated daily at the Group, EthylGlucuronide.

Companies

> > not voluntarily changing and posting their information will be

> > considered formally for every legal remedy available. Compliance

with

> > the above requests does not remove liability for past statements,

but

> > prevents further incurred liability.

> >

> >

> > In addition to the above, I also request your company to

immediately

> > post on your website a copy of the letter you send to all of your

> > clients containing the following:

> >

> > * Notification of the revisions made above.

> > * A specific request for your client to review their

records,

> > and that if adverse action were taken against a person solely

> > because of a positve urine EtG that it be immediately

rescinded.

> > * An apology.

> > * A list of the clients you sent the letter.

> >

> >

> > Your website will be monitored on a daily basis. Companies not

> > voluntarily posting the above information will be formally

considered

> > for every legal remedy available. Compliance with this request

does not

> > remove liability for past actions, but prevents further incurred

> > liability.

> >

> >

> > Respectfully,

> >

> > J. DiBona, M.D. (or, if there is some way, a list of those

of us

> > with positive EtGs in the absence of consumption.)

> >

>

[Guest guest]

Wow, we don't want much do we? lol, Great letter all that needs to

be addressed and done concerning the use of this test. This will be

very interesting! Dan, did you intend to repeat in the letter the

same sentence concerning liability, perhaps you did it for emphasis,

just pointing it out.

>

>

> OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

>

> Please refer to the File section of the Group,

EthylGlucuronide

> <../../../> for access to " Statistical Mistakes Made by EtG

Testing

> Companies. "

>

> I respectfully request the immediate revision of your advertised

use of

> urine EtG testing to include:

>

> * Routine reporting of urine EtG values standardized to a

urine

> creatinine of 100mg/L

> * Identification of the sex of the tested subject, and if

> female, a disclaimer stating it currently appears women are

known

> to produce more EtG than men for any given exposure, thus

reducing

> the predictive value of any of their positive tests at any

level.

> * A routine disclaimer stating many medications, including

> common over the counter medications (such as acetaminophen)

> permitted for use by all people in recovery are known to

upregulate

> the enzyme system producing EtG, thereby amplifying the urine

EtG

> test result by as much as forty fold.

> * A routine disclaimer stating that in the presence of

any of

> the above modifiers (female or enzyme upregulation) that any

urine

> EtG100 test result below 5000ng/ml cannot be confidently

considered

> proof of alcohol consumption, even in small quantities.

> * A routine warning that inhalation of ethanol fumes

impossible

> to avoid routinely produces overlap of urine EtG results

occurring

> with consumed ethanol.

> * Removal of all references to EtG representing proof of

consumed

> ethanol.

>

>

> The status of revision to your companies marketing and materials

> distributed to assist with the interpretation of urine EtG

testing is

> being closely documented and monitored on a daily basis. A list of

> companies refining their advertising and interpretation

instructions

> will be updated daily at the Group, EthylGlucuronide.

Companies

> not voluntarily changing and posting their information will be

> considered formally for every legal remedy available. Compliance

with

> the above requests does not remove liability for past statements,

but

> prevents further incurred liability.

>

>

> In addition to the above, I also request your company to

immediately

> post on your website a copy of the letter you send to all of your

> clients containing the following:

>

> * Notification of the revisions made above.

> * A specific request for your client to review their

records,

> and that if adverse action were taken against a person solely

> because of a positve urine EtG that it be immediately

rescinded.

> * An apology.

> * A list of the clients you sent the letter.

>

>

> Your website will be monitored on a daily basis. Companies not

> voluntarily posting the above information will be formally

considered

> for every legal remedy available. Compliance with this request

does not

> remove liability for past actions, but prevents further incurred

> liability.

>

>

> Respectfully,

>

> J. DiBona, M.D. (or, if there is some way, a list of those

of us

> with positive EtGs in the absence of consumption.)

>

[Guest guest]

None of the links worked on the file letter for the labs linked.

Perhaps it is just my computer, or somehow are links are being

blocked from this site...???

> >

> >

> > OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

> >

> > Please refer to the File section of the Group,

> EthylGlucuronide

> > <../../../> for access to " Statistical Mistakes Made by EtG

> Testing

> > Companies. "

> >

> > I respectfully request the immediate revision of your advertised

> use of

> > urine EtG testing to include:

> >

> > * Routine reporting of urine EtG values standardized to

a

> urine

> > creatinine of 100mg/L

> > * Identification of the sex of the tested subject, and

if

> > female, a disclaimer stating it currently appears women are

> known

> > to produce more EtG than men for any given exposure, thus

> reducing

> > the predictive value of any of their positive tests at any

> level.

> > * A routine disclaimer stating many medications,

including

> > common over the counter medications (such as acetaminophen)

> > permitted for use by all people in recovery are known to

> upregulate

> > the enzyme system producing EtG, thereby amplifying the

urine

> EtG

> > test result by as much as forty fold.

> > * A routine disclaimer stating that in the presence of

> any of

> > the above modifiers (female or enzyme upregulation) that

any

> urine

> > EtG100 test result below 5000ng/ml cannot be confidently

> considered

> > proof of alcohol consumption, even in small quantities.

> > * A routine warning that inhalation of ethanol fumes

> impossible

> > to avoid routinely produces overlap of urine EtG results

> occurring

> > with consumed ethanol.

> > * Removal of all references to EtG representing proof of

> consumed

> > ethanol.

> >

> >

> > The status of revision to your companies marketing and materials

> > distributed to assist with the interpretation of urine EtG

> testing is

> > being closely documented and monitored on a daily basis. A list

of

> > companies refining their advertising and interpretation

> instructions

> > will be updated daily at the Group, EthylGlucuronide.

> Companies

> > not voluntarily changing and posting their information will be

> > considered formally for every legal remedy available.

Compliance

> with

> > the above requests does not remove liability for past

statements,

> but

> > prevents further incurred liability.

> >

> >

> > In addition to the above, I also request your company to

> immediately

> > post on your website a copy of the letter you send to all of your

> > clients containing the following:

> >

> > * Notification of the revisions made above.

> > * A specific request for your client to review their

> records,

> > and that if adverse action were taken against a person

solely

> > because of a positve urine EtG that it be immediately

> rescinded.

> > * An apology.

> > * A list of the clients you sent the letter.

> >

> >

> > Your website will be monitored on a daily basis. Companies not

> > voluntarily posting the above information will be formally

> considered

> > for every legal remedy available. Compliance with this request

> does not

> > remove liability for past actions, but prevents further incurred

> > liability.

> >

> >

> > Respectfully,

> >

> > J. DiBona, M.D. (or, if there is some way, a list of

those

> of us

> > with positive EtGs in the absence of consumption.)

> >

>

[Guest guest]

With regards to having the labs report normalized EtG values, I've received the following response from one lab director:

As per College of American Pathologists regulations (one of our accrediting bodies) we are required to perform a creatinine level on all urines that we test for drugs. However, we are required to NOT express the EtG (or any other drug) in any units other than mass per unit volume.Since the creatinine level is on every report, a $7 calculator and 10 seconds is all an MRO needs to have to interpret normalized results.The issue of normalization to creatinine has been going on for 20 years and CAP and SAMHSA both have regulated the reporting of normalized results by the lab as a no no.

Recommend giving the web address of the discussion group, so if they'd like to monitor activity here, they can easily do so. I think I can change the group to "public", so archives could be accessible w/o membership. Is that something I should do? Beware, however, that that will open up the discussion to spam and other possible abuses. Need feedback!

I have a list of everyone who has reported EtG w/o alcohol consumption; However, I don't have their permission to use their name in a letter. Would you like those who would like their name included sent to you, Dan?

Extremely impressive letter, Dr. Dan. You continue to amaze me!

>> > OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING> > Please refer to the File section of the Group, EthylGlucuronide> <../../../> for access to "Statistical Mistakes Made by EtG Testing> Companies."> > I respectfully request the immediate revision of your advertised use of> urine EtG testing to include:> > * Routine reporting of urine EtG values standardized to a urine> creatinine of 100mg/L> * Identification of the sex of the tested subject, and if> female, a disclaimer stating it currently appears women are known> to produce more EtG than men for any given exposure, thus reducing> the predictive value of any of their positive tests at any level.> * A routine disclaimer stating many medications, including> common over the counter medications (such as acetaminophen)> permitted for use by all people in recovery are known to upregulate> the enzyme system producing EtG, thereby amplifying the urine EtG> test result by as much as forty fold.> * A routine disclaimer stating that in the presence of any of> the above modifiers (female or enzyme upregulation) that any urine> EtG100 test result below 5000ng/ml cannot be confidently considered> proof of alcohol consumption, even in small quantities.> * A routine warning that inhalation of ethanol fumes impossible> to avoid routinely produces overlap of urine EtG results occurring> with consumed ethanol.> * Removal of all references to EtG representing proof of consumed> ethanol.> > > The status of revision to your companies marketing and materials> distributed to assist with the interpretation of urine EtG testing is> being closely documented and monitored on a daily basis. A list of> companies refining their advertising and interpretation instructions> will be updated daily at the Group, EthylGlucuronide. Companies> not voluntarily changing and posting their information will be> considered formally for every legal remedy available. Compliance with> the above requests does not remove liability for past statements, but> prevents further incurred liability.> > > In addition to the above, I also request your company to immediately> post on your website a copy of the letter you send to all of your> clients containing the following:> > * Notification of the revisions made above.> * A specific request for your client to review their records,> and that if adverse action were taken against a person solely> because of a positve urine EtG that it be immediately rescinded.> * An apology.> * A list of the clients you sent the letter.> > > Your website will be monitored on a daily basis. Companies not> voluntarily posting the above information will be formally considered> for every legal remedy available. Compliance with this request does not> remove liability for past actions, but prevents further incurred> liability.> > > Respectfully,> > J. DiBona, M.D. (or, if there is some way, a list of those of us> with positive EtGs in the absence of consumption.)>

[Guest guest]

EXCELLENT!!! You may certainly add my name ( RN)....They

might recognize it from the WSJ article. I think you are right about

adding names...it will give more power behind it....we are a group.

>

>

> OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

>

> Please refer to the File section of the Group,

EthylGlucuronide

> <../../../> for access to " Statistical Mistakes Made by EtG Testing

> Companies. "

>

> I respectfully request the immediate revision of your advertised

use of

> urine EtG testing to include:

>

> * Routine reporting of urine EtG values standardized to a

urine

> creatinine of 100mg/L

> * Identification of the sex of the tested subject, and if

> female, a disclaimer stating it currently appears women are

known

> to produce more EtG than men for any given exposure, thus

reducing

> the predictive value of any of their positive tests at any

level.

> * A routine disclaimer stating many medications, including

> common over the counter medications (such as acetaminophen)

> permitted for use by all people in recovery are known to

upregulate

> the enzyme system producing EtG, thereby amplifying the urine

EtG

> test result by as much as forty fold.

> * A routine disclaimer stating that in the presence of any

of

> the above modifiers (female or enzyme upregulation) that any

urine

> EtG100 test result below 5000ng/ml cannot be confidently

considered

> proof of alcohol consumption, even in small quantities.

> * A routine warning that inhalation of ethanol fumes

impossible

> to avoid routinely produces overlap of urine EtG results

occurring

> with consumed ethanol.

> * Removal of all references to EtG representing proof of

consumed

> ethanol.

>

>

> The status of revision to your companies marketing and materials

> distributed to assist with the interpretation of urine EtG testing

is

> being closely documented and monitored on a daily basis. A list of

> companies refining their advertising and interpretation instructions

> will be updated daily at the Group, EthylGlucuronide.

Companies

> not voluntarily changing and posting their information will be

> considered formally for every legal remedy available. Compliance

with

> the above requests does not remove liability for past statements,

but

> prevents further incurred liability.

>

>

> In addition to the above, I also request your company to immediately

> post on your website a copy of the letter you send to all of your

> clients containing the following:

>

> * Notification of the revisions made above.

> * A specific request for your client to review their

records,

> and that if adverse action were taken against a person solely

> because of a positve urine EtG that it be immediately

rescinded.

> * An apology.

> * A list of the clients you sent the letter.

>

>

> Your website will be monitored on a daily basis. Companies not

> voluntarily posting the above information will be formally

considered

> for every legal remedy available. Compliance with this request

does not

> remove liability for past actions, but prevents further incurred

> liability.

>

>

> Respectfully,

>

> J. DiBona, M.D. (or, if there is some way, a list of those

of us

> with positive EtGs in the absence of consumption.)

>

[Guest guest]

I believe

the final copy should not have redundancy. Thanks for the close

reading. I think it’s important to generate a comprehensive list of

companies offering EtG testing, websites extolling it’s use and

organizations (such as treatment centers, boards, agencies and regulatory

authorities) claiming urine EtG to be proof positive of ethanol

ingestion. I’ll need some help here for a couple of reasons.

First, it’s plain and simple a lot of work. Second, having multiple

copies of the same information ensures it’s stability and integrity.

So, for those who have tested positive

without consuming, now is the time to hit the web, print to PDF and email to

me. Keep copies for yourself. I’ll consolidate all snapshots

emailed to me and forward to Lorie and .

Once I have a comprehensive list generated

(Monday? Kind of depends when you all believe it is done), I intend to

email a second copy of my WSJ response and a copy of the “Open Letter”.

Besides emailing, I will mail with return receipt requested a paper copy to

each of the facilities. (It’s cheaper than certified mail, return

receipt, and I’m doing this out of my pocket.)

Also if anyone currently has legal representation

consider privately emailing me your attorney’s name, address and

contact information. I’m willing to testify for free over the

telephone to the authenticity of my writing.

I know that some will consider what I am

doing so far as aggressive. I consider it respectful and courteous.

I’m not anywhere close to aggressive yet, and I prefer not to be.

We’ll see. I am well-defended, as any of the entities who approach

me will discover.

I have worked my entire life to establish

unquestionable sobriety and integrity. I’ll not stand idly by and

accept so much as an attempted blemish of it. Honestly, I do not believe

a thing is going to occur with me at the Texas Medical Board regarding a

positive EtG of 103ng/ml (EtG100=48ng/ml). When I got on this site, read

the posts and the WSJ article I was impressed by two things: The integrity of

the people posting, and the statistical smoke and mirrors being used by the EtG

testing companies for fraudulent and predatory marketing.

Dan

Re:

Open letter to EtG testing companies-request for feedback, editing, etc.

Wow, we don't want much do we? lol, Great letter all that needs to

be addressed and done concerning the use of this test. This will be

very interesting! Dan, did you intend to repeat in the letter the

same sentence concerning liability, perhaps you did it for emphasis,

just pointing it out.

>

>

> OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

>

> Please refer to the File section of the Group,

EthylGlucuronide

> <../../../> for access to " Statistical Mistakes Made by EtG

Testing

> Companies. "

>

> I respectfully request the immediate revision of your advertised

use of

> urine EtG testing to include:

>

> * Routine reporting of urine EtG values standardized to a

urine

> creatinine of 100mg/L

> * Identification of the sex of the tested subject, and if

> female, a disclaimer stating it currently appears women are

known

> to produce more EtG than men for any given exposure, thus

reducing

> the predictive value of any of their positive tests at any

level.

> * A routine disclaimer stating many medications, including

> common over the counter medications (such as acetaminophen)

> permitted for use by all people in recovery are known to

upregulate

> the enzyme system producing EtG, thereby amplifying the urine

EtG

> test result by as much as forty fold.

> * A routine disclaimer stating that in the presence of

any of

> the above modifiers (female or enzyme upregulation) that any

urine

> EtG100 test result below 5000ng/ml cannot be confidently

considered

> proof of alcohol consumption, even in small quantities.

> * A routine warning that inhalation of ethanol fumes

impossible

> to avoid routinely produces overlap of urine EtG results

occurring

> with consumed ethanol.

> * Removal of all references to EtG representing proof of

consumed

> ethanol.

>

>

> The status of revision to your companies marketing and materials

> distributed to assist with the interpretation of urine EtG

testing is

> being closely documented and monitored on a daily basis. A list of

> companies refining their advertising and interpretation

instructions

> will be updated daily at the Group, EthylGlucuronide.

Companies

> not voluntarily changing and posting their information will be

> considered formally for every legal remedy available. Compliance

with

> the above requests does not remove liability for past statements,

but

> prevents further incurred liability.

>

>

> In addition to the above, I also request your company to

immediately

> post on your website a copy of the letter you send to all of your

> clients containing the following:

>

> * Notification of the revisions made above.

> * A specific request for your client to review their

records,

> and that if adverse action were taken against a person solely

> because of a positve urine EtG that it be immediately

rescinded.

> * An apology.

> * A list of the clients you sent the letter.

>

>

> Your website will be monitored on a daily basis. Companies not

> voluntarily posting the above information will be formally

considered

> for every legal remedy available. Compliance with this request

does not

> remove liability for past actions, but prevents further incurred

> liability.

>

>

> Respectfully,

>

> J. DiBona, M.D. (or, if there is some way, a list of those

of us

> with positive EtGs in the absence of consumption.)

>

[Guest guest]

It’s

important to not release names without their permission in writing. An

email from their personal account can suffice, but it’s better if they

sign a permission releasing the information and either fax or scan it to you.

I do not think this group should be made

public. It’s easy to join. The numbers of posts is counted

(can you count the post views?). It would also be useful to monitor

the number of file downloads if possible.

It’s too early to tell what kind of

response will occur over the coming weeks. On a personal level, I’ve

prepared for every contingency. At this point in time I do not have any

pending litigation. Should anything happen to me because of my urine EtG,

I plan on explosive and aggressive litigation broadly. I’m building

my “war chest” and securing contingent experts and attorneys should

that eventuality come, but God, I hope not.

My hope is we see the requests I outlined

voluntarily implemented.

As far as the BS about how they are

required to report results…here is my response. It costs nothing to

provide the formula and do it on the same lab slip as a courtesy. There

is no law PREVENTING them from doing this. They just have to show where

their numbers come from, duh.

Dan

Re:

Open letter to EtG testing companies-request for feedback, editing, etc.

·

With regards to having the labs report normalized

EtG values, I've received the following response from one lab director:

As per College of American Pathologists regulations

(one of our accrediting bodies) we are required to perform a creatinine level

on all urines that we test for drugs. However, we are required to NOT

express the EtG (or any other drug) in any units other than mass per unit

volume.

Since the creatinine level is on every

report, a $7 calculator and 10 seconds is all an MRO needs to have to interpret

normalized results.

The issue of normalization to creatinine

has been going on for 20 years and CAP and SAMHSA both have regulated the

reporting of normalized results by the lab as a no no.

·

Recommend giving the web address of the discussion

group, so if they'd like to monitor activity here, they can easily do

so. I think I can change the group to " public " , so archives

could be accessible w/o membership. Is that something I should do? Beware,

however, that that will open up the discussion to spam and other possible

abuses. Need feedback!

·

I have a list of everyone who has reported EtG w/o

alcohol consumption; However, I don't have their permission to use their name

in a letter. Would you like those who would like their name included sent

to you, Dan?

Extremely impressive letter, Dr. Dan. You continue to

amaze me!

>

>

> OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

>

> Please refer to the File section of the Group, EthylGlucuronide

> <../../../> for access to " Statistical Mistakes Made by EtG

Testing

> Companies. "

>

> I respectfully request the immediate revision of your advertised use of

> urine EtG testing to include:

>

> * Routine reporting of urine EtG values standardized to a urine

> creatinine of 100mg/L

> * Identification of the sex of the tested subject, and if

> female, a disclaimer stating it currently appears women are known

> to produce more EtG than men for any given exposure, thus reducing

> the predictive value of any of their positive tests at any level.

> * A routine disclaimer stating many medications, including

> common over! the counter medications (such as acetaminophen)

> permitted for use by all people in recovery are known to upregulate

> the enzyme system producing EtG, thereby amplifying the urine EtG

> test result by as much as forty fold.

> * A routine disclaimer stating that in the presence of any of

> the above modifiers (female or enzyme upregulation) that any urine

> EtG100 test result below 5000ng/ml cannot be confidently considered

> proof of alcohol consumption, even in small quantities.

> * A routine warning that inhalation of ethanol fumes impossible

> to avoid routinely produces overlap of urine EtG results occurring

> with consumed ethanol.

> * Removal of all references to EtG representing proof of consumed

> ethanol.

>

>

> The status of revision to your companies marketing and materials

> distributed to assist with the interpretation of urine EtG testing is

> being closely docu! mented and monitored on a daily basis. A list of

> c ompanies refining their advertising and interpretation instructions

> will be updated daily at the Group, EthylGlucuronide. Companies

> not voluntarily changing and posting their information will be

> considered formally for every legal remedy available. Compliance with

> the above requests does not remove liability for past statements, but

> prevents further incurred liability.

>

>

> In addition to the above, I also request your company to immediately

> post on your website a copy of the letter you send to all of your

> clients containing the following:

>

> * Notification of the revisions made above.

> * A specific request for your client to review their records,

> and that if adverse action were taken against a person solely

> because of a positve urine EtG that it be immediately rescinded.

> * An apology.

> * A list of the clients you sent the letter.

>

> !

> Your website will be monitored on a daily basis. Companies not

> voluntarily posting the above information will be formally considered

> for every legal remedy available. Compliance with this request does not

> remove liability for past actions, but prevents further incurred

> liability.

>

>

> Respectfully,

>

> J. DiBona, M.D. (or, if there is some way, a list of those of us

> with positive EtGs in the absence of consumption.)

>

[Guest guest]

Is everyone having trouble opening those links on the file letter on

the last page? I'm unable to open them and haven't been able to cut

and paste because of when I try, they just link to the unable to

find site, ect. I really think we need to address correcting this

for those reading this site to fully appreciate the file letter's

intentions. Anyone have any suggestions as to why those links

aren't working? I hope we can correct this and the links will be

easy to assess for those coming to this site.

> > >

> > >

> > > OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

> > >

> > > Please refer to the File section of the Group,

> > EthylGlucuronide

> > > <../../../> for access to " Statistical Mistakes Made by EtG

> > Testing

> > > Companies. "

> > >

> > > I respectfully request the immediate revision of your

advertised

> > use of

> > > urine EtG testing to include:

> > >

> > > * Routine reporting of urine EtG values standardized to

> a

> > urine

> > > creatinine of 100mg/L

> > > * Identification of the sex of the tested subject, and

> if

> > > female, a disclaimer stating it currently appears women are

> > known

> > > to produce more EtG than men for any given exposure, thus

> > reducing

> > > the predictive value of any of their positive tests at any

> > level.

> > > * A routine disclaimer stating many medications,

> including

> > > common over the counter medications (such as acetaminophen)

> > > permitted for use by all people in recovery are known to

> > upregulate

> > > the enzyme system producing EtG, thereby amplifying the

> urine

> > EtG

> > > test result by as much as forty fold.

> > > * A routine disclaimer stating that in the presence of

> > any of

> > > the above modifiers (female or enzyme upregulation) that

> any

> > urine

> > > EtG100 test result below 5000ng/ml cannot be confidently

> > considered

> > > proof of alcohol consumption, even in small quantities.

> > > * A routine warning that inhalation of ethanol fumes

> > impossible

> > > to avoid routinely produces overlap of urine EtG results

> > occurring

> > > with consumed ethanol.

> > > * Removal of all references to EtG representing proof of

> > consumed

> > > ethanol.

> > >

> > >

> > > The status of revision to your companies marketing and

materials

> > > distributed to assist with the interpretation of urine EtG

> > testing is

> > > being closely documented and monitored on a daily basis. A

list

> of

> > > companies refining their advertising and interpretation

> > instructions

> > > will be updated daily at the Group, EthylGlucuronide.

> > Companies

> > > not voluntarily changing and posting their information will be

> > > considered formally for every legal remedy available.

> Compliance

> > with

> > > the above requests does not remove liability for past

> statements,

> > but

> > > prevents further incurred liability.

> > >

> > >

> > > In addition to the above, I also request your company to

> > immediately

> > > post on your website a copy of the letter you send to all of

your

> > > clients containing the following:

> > >

> > > * Notification of the revisions made above.

> > > * A specific request for your client to review their

> > records,

> > > and that if adverse action were taken against a person

> solely

> > > because of a positve urine EtG that it be immediately

> > rescinded.

> > > * An apology.

> > > * A list of the clients you sent the letter.

> > >

> > >

> > > Your website will be monitored on a daily basis. Companies not

> > > voluntarily posting the above information will be formally

> > considered

> > > for every legal remedy available. Compliance with this request

> > does not

> > > remove liability for past actions, but prevents further

incurred

> > > liability.

> > >

> > >

> > > Respectfully,

> > >

> > > J. DiBona, M.D. (or, if there is some way, a list of

> those

> > of us

> > > with positive EtGs in the absence of consumption.)

> > >

> >

>

[Guest guest]

The only things that can be opened up for public viewing/access are "Archives" and "Links". Posting to always requires membership. "Files" and "Database" are strictly member features. has no "counter" features for their groups.

RE: Re: Open letter to EtG testing companies-request for feedback, editing, etc.

It’s important to not release names without their permission in writing. An email from their personal account can suffice, but it’s better if they sign a permission releasing the information and either fax or scan it to you.

I do not think this group should be made public. It’s easy to join. The numbers of posts is counted (can you count the post views?). It would also be useful to monitor the number of file downloads if possible.

It’s too early to tell what kind of response will occur over the coming weeks. On a personal level, I’ve prepared for every contingency. At this point in time I do not have any pending litigation. Should anything happen to me because of my urine EtG, I plan on explosive and aggressive litigation broadly. I’m building my “war chest” and securing contingent experts and attorneys should that eventuality come, but God, I hope not.

My hope is we see the requests I outlined voluntarily implemented.

As far as the BS about how they are required to report results…here is my response. It costs nothing to provide the formula and do it on the same lab slip as a courtesy. There is no law PREVENTING them from doing this. They just have to show where their numbers come from, duh.

Dan

-----Original Message-----From: Ethylglucuronide [mailto:Ethylglucuronide ] On Behalf Of LorieSent: Saturday, September 16, 2006 1:32 PMEthylglucuronide Subject: Re: Open letter to EtG testing companies-request for feedback, editing, etc.

· With regards to having the labs report normalized EtG values, I've received the following response from one lab director:

As per College of American Pathologists regulations (one of our accrediting bodies) we are required to perform a creatinine level on all urines that we test for drugs. However, we are required to NOT express the EtG (or any other drug) in any units other than mass per unit volume.Since the creatinine level is on every report, a $7 calculator and 10 seconds is all an MRO needs to have to interpret normalized results.The issue of normalization to creatinine has been going on for 20 years and CAP and SAMHSA both have regulated the reporting of normalized results by the lab as a no no.

· Recommend giving the web address of the discussion group, so if they'd like to monitor activity here, they can easily do so. I think I can change the group to "public", so archives could be accessible w/o membership. Is that something I should do? Beware, however, that that will open up the discussion to spam and other possible abuses. Need feedback!

· I have a list of everyone who has reported EtG w/o alcohol consumption; However, I don't have their permission to use their name in a letter. Would you like those who would like their name included sent to you, Dan?

Extremely impressive letter, Dr. Dan. You continue to amaze me!

>> > OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING> > Please refer to the File section of the Group, EthylGlucuronide> <../../../> for access to "Statistical Mistakes Made by EtG Testing> Companies."> > I respectfully request the immediate revision of your advertised use of> urine EtG testing to include:> > * Routine reporting of urine EtG values standardized to a urine> creatinine of 100mg/L> * Identification of the sex of the tested subject, and if> female, a disclaimer stating it currently appears women are known> to produce more EtG than men for any given exposure, thus reducing> the predictive value of any of their positive tests at any level.> * A routine disclaimer stating many medications, including> common over! the counter medications (such as acetaminophen)> permitted for use by all people in recovery are known to upregulate> the enzyme system producing EtG, thereby amplifying the urine EtG> test result by as much as forty fold.> * A routine disclaimer stating that in the presence of any of> the above modifiers (female or enzyme upregulation) that any urine> EtG100 test result below 5000ng/ml cannot be confidently considered> proof of alcohol consumption, even in small quantities.> * A routine warning that inhalation of ethanol fumes impossible> to avoid routinely produces overlap of urine EtG results occurring> with consumed ethanol.> * Removal of all references to EtG representing proof of consumed> ethanol.> > > The status of revision to your companies marketing and materials> distributed to assist with the interpretation of urine EtG testing is> being closely docu! mented and monitored on a daily basis. A list of> c ompanies refining their advertising and interpretation instructions> will be updated daily at the Group, EthylGlucuronide. Companies> not voluntarily changing and posting their information will be> considered formally for every legal remedy available. Compliance with> the above requests does not remove liability for past statements, but> prevents further incurred liability.> > > In addition to the above, I also request your company to immediately> post on your website a copy of the letter you send to all of your> clients containing the following:> > * Notification of the revisions made above.> * A specific request for your client to review their records,> and that if adverse action were taken against a person solely> because of a positve urine EtG that it be immediately rescinded.> * An apology.> * A list of the clients you sent the letter.> > ! > Your website will be monitored on a daily basis. Companies not> voluntarily posting the above information will be formally considered> for every legal remedy available. Compliance with this request does not> remove liability for past actions, but prevents further incurred> liability.> > > Respectfully,> > J. DiBona, M.D. (or, if there is some way, a list of those of us> with positive EtGs in the absence of consumption.)>

[Guest guest]

I agree with you, Robin. It does take maony to puruse or defend legal

actions. At this moment, I am not pursuing any legal action. I am

prepared to defend myelf. As it is, I have done nothing that

approach's slander or libel. Also, as this is a private group, only

members can read, so everyone here is protected regardless of what

they write. Posting it on the internet, mass mailings etc, is another

matter. Even with public considerations, I have taken great care to

not cross the line of malice. I have none. I wish no harm to

anything or anyone.

> >

> >

> > OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING

> >

> > Please refer to the File section of the Group,

> EthylGlucuronide

> > <../../../> for access to " Statistical Mistakes Made by EtG

> Testing

> > Companies. "

> >

> > I respectfully request the immediate revision of your advertised

> use of

> > urine EtG testing to include:

> >

> > * Routine reporting of urine EtG values standardized to a

> urine

> > creatinine of 100mg/L

> > * Identification of the sex of the tested subject, and if

> > female, a disclaimer stating it currently appears women are

> known

> > to produce more EtG than men for any given exposure, thus

> reducing

> > the predictive value of any of their positive tests at any

> level.

> > * A routine disclaimer stating many medications, including

> > common over the counter medications (such as acetaminophen)

> > permitted for use by all people in recovery are known to

> upregulate

> > the enzyme system producing EtG, thereby amplifying the urine

> EtG

> > test result by as much as forty fold.

> > * A routine disclaimer stating that in the presence of

> any of

> > the above modifiers (female or enzyme upregulation) that any

> urine

> > EtG100 test result below 5000ng/ml cannot be confidently

> considered

> > proof of alcohol consumption, even in small quantities.

> > * A routine warning that inhalation of ethanol fumes

> impossible

> > to avoid routinely produces overlap of urine EtG results

> occurring

> > with consumed ethanol.

> > * Removal of all references to EtG representing proof of

> consumed

> > ethanol.

> >

> >

> > The status of revision to your companies marketing and materials

> > distributed to assist with the interpretation of urine EtG

> testing is

> > being closely documented and monitored on a daily basis. A list of

> > companies refining their advertising and interpretation

> instructions

> > will be updated daily at the Group, EthylGlucuronide.

> Companies

> > not voluntarily changing and posting their information will be

> > considered formally for every legal remedy available. Compliance

> with

> > the above requests does not remove liability for past statements,

> but

> > prevents further incurred liability.

> >

> >

> > In addition to the above, I also request your company to

> immediately

> > post on your website a copy of the letter you send to all of your

> > clients containing the following:

> >

> > * Notification of the revisions made above.

> > * A specific request for your client to review their

> records,

> > and that if adverse action were taken against a person solely

> > because of a positve urine EtG that it be immediately

> rescinded.

> > * An apology.

> > * A list of the clients you sent the letter.

> >

> >

> > Your website will be monitored on a daily basis. Companies not

> > voluntarily posting the above information will be formally

> considered

> > for every legal remedy available. Compliance with this request

> does not

> > remove liability for past actions, but prevents further incurred

> > liability.

> >

> >

> > Respectfully,

> >

> > J. DiBona, M.D. (or, if there is some way, a list of those

> of us

> > with positive EtGs in the absence of consumption.)

> >

>

[Guest guest]

I may be a day late & a dollar short here but have been away c no computer access. Excellent work, . By all means, add my name (Marsha Dienelt, RN) to the list. I'll Fax the signed auth. Marshanautiques5 <nautiques5@...> wrote: EXCELLENT!!! You may certainly add my name ( RN)....They might recognize it from the WSJ article. I think you are right about adding names...it will give more power behind it....we are a group.>> > OPEN LETTER TO ALL COMPANIES OFFERING URINE ETG TESTING> > Please refer to the File section of the Group, EthylGlucuronide> <../../../> for access to "Statistical Mistakes Made by EtG Testing> Companies."> > I respectfully request the immediate revision of your advertised use of> urine EtG testing to include:> > * Routine reporting of urine EtG values standardized to a urine> creatinine of 100mg/L> * Identification of the sex of the tested subject, and if> female, a disclaimer stating it currently appears women are known> to produce more EtG than men for any given exposure, thus reducing> the predictive value of any of their positive tests at any level.> * A

routine disclaimer stating many medications, including> common over the counter medications (such as acetaminophen)> permitted for use by all people in recovery are known to upregulate> the enzyme system producing EtG, thereby amplifying the urine EtG> test result by as much as forty fold.> * A routine disclaimer stating that in the presence of any of> the above modifiers (female or enzyme upregulation) that any urine> EtG100 test result below 5000ng/ml cannot be confidently considered> proof of alcohol consumption, even in small quantities.> * A routine warning that inhalation of ethanol fumes impossible> to avoid routinely produces overlap of urine EtG results occurring> with consumed ethanol.> * Removal of all references to EtG representing proof of consumed> ethanol.> > > The status of revision to your companies marketing and

materials> distributed to assist with the interpretation of urine EtG testing is> being closely documented and monitored on a daily basis. A list of> companies refining their advertising and interpretation instructions> will be updated daily at the Group, EthylGlucuronide. Companies> not voluntarily changing and posting their information will be> considered formally for every legal remedy available. Compliance with> the above requests does not remove liability for past statements, but> prevents further incurred liability.> > > In addition to the above, I also request your company to immediately> post on your website a copy of the letter you send to all of your> clients containing the following:> > * Notification of the revisions made above.> * A specific request for your client to review their records,> and that if adverse action

were taken against a person solely> because of a positve urine EtG that it be immediately rescinded.> * An apology.> * A list of the clients you sent the letter.> > > Your website will be monitored on a daily basis. Companies not> voluntarily posting the above information will be formally considered> for every legal remedy available. Compliance with this request does not> remove liability for past actions, but prevents further incurred> liability.> > > Respectfully,> > J. DiBona, M.D. (or, if there is some way, a list of those of us> with positive EtGs in the absence of consumption.)>

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