What a Medical Review Officer is
A Medical Review Officer (MRO) is a licensed physician with specific training in drug and alcohol testing. The MRO’s role is to review a laboratory result and determine whether there is a legitimate medical explanation for it. The MRO is independent of the laboratory and independent of TrueTest. TrueTest does not employ the MRO and does not participate in the review.
When a result goes to the MRO
A laboratory result that is negative does not go to the MRO. There is nothing to review.
A laboratory result that is positive for a substance that could have a legitimate medical explanation is referred to the MRO for review. The MRO contacts the donor, asks whether there is a medical explanation for the result, and verifies any explanation offered — for example, by confirming a prescription directly with the prescribing physician or the dispensing pharmacy. The MRO does not take the donor’s word for it.
Any party to a case may request MRO review of any result at any time.
What the MRO can decide
Verified positive. The MRO found no legitimate medical explanation. The laboratory result stands as the verified result.
Verified negative (a “downgrade”). The laboratory reported a positive result; the MRO has determined that its presence is medically accounted for. The verified result is downgraded to a negative.
Cancelled. The MRO determined that the test cannot produce a valid result — because of a problem with the specimen or the collection, for example. A cancelled test is not negative and not positive. It is no result.
Why the laboratory result is still reported on a downgrade
The laboratory report is a record of what was found in the specimen. It does not change when the MRO reviews it. TrueTest’s notice states both facts: what the laboratory reported, and what the MRO determined. Leaving out either one would misstate the record.
Why the notice does not say what the explanation was
The basis for the MRO’s determination — which medication, which condition, which prescriber — is medical information. It belongs to the MRO’s review, not to TrueTest’s notice. TrueTest reports that a legitimate medical explanation was verified, because that is what a downgrade means. The MRO’s own report, which is attached to every MRO-complete notice, says whatever the MRO chose to say about it.
What this means when reading a notice
A positive laboratory result and a negative MRO determination for the same substance are not contradictory. The laboratory result is fact. The MRO determination states that there is a medical explanation for that result.
The MRO is not stating that the donor is taking the medication as prescribed. The MRO is stating only that the presence of the substance is accounted for by a valid prescription or other legitimate medical explanation.
Drug and alcohol testing cannot determine time, dose, or frequency of use.