Interpretation of drug concentrations in an alternative matrix: the case of meprobamate in bile
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- Fanton, L., Bevalot, F., Gustin, M.P. et al. Int J Legal Med (2009) 123: 97. doi:10.1007/s00414-008-0259-x
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Investigating toxicological causes of death may require alternative matrices when the usual ones are lacking. Whereas forensic toxicology uses bile almost only for xenobiotic screening, a diagnostic test interpreting postmortem bile concentrations of meprobamate is reported. Based on 128 sets of autopsy data, its intrinsic qualities were good, with 0.95 sensitivity and 0.93 specificity. In a French forensic population, the positive and negative predictive factors were 0.90 and 0.97, respectively. It is a useful means of revealing overdoses where blood samples are not available or of confirming blood tests when postmortem redistribution is suspected.