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Performance Evaluation: The critical component in bringing your product to market and keeping it there

Abingdon Health and IVDeology Ltd have decades of  In-Vitro Diagnostic (IVD) regulatory compliance experience where our teams support your entire product journey from ‘cradle-to-grave’ to ensure you are getting your product to market in the quickest timeframe possible, reducing cost and strain, and keeping it compliant through its lifetime.

Abingdon Health also offer full-service contract development and manufacturing for lateral flow assays, bringing your idea to commercial success, with the benefit of an integrated regulatory and quality approach.

In our latest blog, Candice Vendettuoli Head of RAQA at Abingdon Health covers the importance of getting your Performance Evaluation (PE) right to streamline your route to market, and ensuring compliance to keep it there.

What is Performance Evaluation?

The In Vitro Diagnostic Regulation (IVDR) 2017/746, which entered into force in May 2017 and applied in May 2022, has introduced significant changes to the way in vitro diagnostic (IVD) medical devices are regulated in the European Union. One of the key aspects of this regulation are the new requirements for documenting the performance evaluation of IVD medical devices using a prescriptive document structure mandated within the Regulation.

Performance evaluation under IVDR is expected to be a continuous process throughout its entire lifecycle of the device. This process is crucial for ensuring that the device meets upon entry to the market, and continues to meet, the intended clinical benefits and safety as claimed by the manufacturer.

The mandated documents should be written to provide a comprehensive and structured narrative for the reviewer giving a clear and logical explanation of how the device was developed, verified and validated against the intended use/purpose claimed by the manufacturer. These documents are a requirement of the Technial Documentation described in Annex II and forms an essential part of the submission to the Notified Body

The mandated documents, unless they can justify why such studies are not applicable are as follows:

Performance Evaluation Plan

Ideally written during the early development of the device and updated regularly, this document has content prescribed within Annex XIII section 1.1 of the Regulation. Manufacturers are required to establish and regularly update the performance evaluation plan that outlines the device’s characteristics and performance, as well as the process and criteria used to generate the necessary clinical evidence.

Scientific Validity

The concept of scientific validity under the In Vitro Diagnostic Regulation (IVDR) 2017/746 is a cornerstone in the performance evaluation of in vitro diagnostic (IVD) medical devices. It refers to the association of an analyte with a clinical condition or physiological state, which must be substantiated with a medical-scientific rationale evidenced through a systematic literature search

Analytical Performance

Analytical performance refers to a device’s ability to accurately and reproducibly measure an analyte, marker, or molecule, which is a strictly technical performance without the need for correlation with a targeted pathology.  There are analytical performance characteristics mandated within Annex I section 9.1(a) including assessing the accuracy, sensitivity and specificity,

Clinical Performance

Clinical performance is defined as the ability of a device to yield results that are correlated with a particular clinical condition, physiological or pathological process, or target population and intended user. Manufacturers must demonstrate clinical performance through one or more of the following:

  • Clinical performance studies, carried out according to the IVDR requirements on clinical performance studies described in Articles 57-77, Annex XIII section 2 and, if applicable, Annex XIV for studies other than those using leftover samples
  • Scientific peer-reviewed literature on the device under evaluation, or
  • Published routine diagnostic testing.

Performance Evaluation Report

The report (also known as a ‘PER’) provides a summary of the clinical evidence collected through the previous reports. An assessment can then be made against the current state of the art in diagnostics and medicine that a positive benefit-risk ratio of using the device for its intended purpose has been met and then all data has been collected.

This rigorous approach ensures the reliability and effectiveness of in vitro diagnostic devices within the European Union, with the primary aim of protecting public health by requiring high levels of safety and performance of these devices to be evidenced.

For manufacturers, understanding and adhering to the IVDR’s performance evaluation requirements is vital for successful market introduction of their IVDs in the European Market. It involves a comprehensive understanding of the general safety and performance requirements (GSPR), as well as the specific guidelines on performance evaluation stipulated in Article 56 of the IVDR.

Abingdon Health and through its subsidiary IVDeology Ltd , can offer support and guidance to help companies navigate these new and complex EU Performance Evaluation requirements.

We offer a full-service solution for all your regulatory and quality requirements including:

Contact Us today to book some time with one of our industry experts to understand how we can support you bringing your product to market and keeping it there.


 

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EUDAMED: A recap for what it means for you

IVDeology are a UK based regulatory and quality compliance support company, with over 100 years combined of expertise within our team, providing you everything you need for your in-vitro diagnostic device life cycle to support you on your compliance journey. In this most recent blog written by Regulatory specialist TszWai Woo takes a look at what EUDAMED is, and what the changes mean to you.

The Medical Devices Regulation (Regulation (EU) 2017/745, ‘MDR’) and the In Vitro Diagnostic Medical Devices Regulation (Regulation (EU) 2017/746, ‘IVDR’) introduced the requirement of EUDAMED, the European database on medical devices. It has been over 3 and 2 years, respectively, since the date of application of the MDR and IVDR, and even after several transition extensions and amendments to both regulations, EUDAMED is still a way off from being fully functional.

With another proposed Regulation (2024/0021 (COD)) due to be published in the Official Journal of the European Union, it is worth having a recap on what EUDAMED is, the current status and what changes the new regulation will introduce.

What is EUDAMED?

EUDAMED is a European database on medical devices that the European Commission was to set up, maintain and manage, as required by the MDR and IVDR. The aim of EUDAMED is to improve transparency and provide information on medical devices on the EU market to the public and healthcare professionals. It also aims to improve medical device traceability, enhance coordination between the EU National Competent Authorities and provide them with easy access to relevant regulatory information.

EUDAMED contains information on medical devices which are organised into the following 6 categories, also known as modules:

  • Actor registration
  • UDI/Devices registration
  • Notified Bodies and Certificates (except for the mechanism for scrutiny and the clinical evaluation consultation procedure (CECP) functionalities)
  • Clinical Investigations and Performance Studies
  • Vigilance and post-market surveillance
  • Market Surveillance

A lot of the information within EUDAMED is to be accessible to the public via a public website.

Current State of Play

To date, only the following 3 modules have been available for voluntary use:

  • Actor registration (since December 2020)
  • UDI/Devices registration (since Oct 2021)
  • Notified Bodies and Certificates (since Oct 2021)

Therefore, manufacturers can submit their organisation and device details on a voluntary basis.

For Actor registration, as well as providing the organisation details, all manufacturers will need to provide a declaration on information security responsibilities and non-EU manufacturers will also need to provide a mandate summary document.

For UDI/Device registration, manufacturer will need to submit device information such as the Basic UDI-DI & UDI-DI, the European Medical Device Nomenclature (EMDN) and notified body (NB) certificate information (if applicable). For devices requiring NB conformity assessment, the NB must confirm the device information in EUDAMED before the device can be publicly available. Therefore, conformity assessment must be completed before prior to registering a device in EUDAMED.

NBs can register certificates and Summaries of Safety and Clinical Performance (SSCP) on voluntary basis. However, there is a caveat: all the parties referenced in the certificates must first be registered, also on a voluntary basis, in EUDAMED.

Additionally, the ‘Vigilance and post-market surveillance’ and ‘Market Surveillance’ modules are due to be made available Q2/2024 and the ‘Clinical Investigations and Performance Studies’ module is not due to be made available before Q3/2026.

EUDAMED was intended to be mandatory for all economic operators to use, after all 6 modules were declared fully functional following an independent audit and a Commission notice was published in the Official Journal of the European Union.

Proposed changes to EUDAMED requirements

Instead of waiting for the completion of the 6th module to make the use of EUDAMED mandatory, 2024/0021 (COD) proposes a gradual roll-out of the mandatory use of each EUDAMED module, once they have been audited and declared functional.

This means that the mandatory use of 3 modules (Actor registration, UDI/Device registration and Notified Bodies & certificates) could therefore start in Q4/2025.

Given the requirements of Article 123 (3) (d) MDR/113 (3) (f) IVDR and Article 123 (3) (e) MDR/113 (3) (a) IVDR, this would mean that mandatory use of all six modules cannot be expected before Q4/2027 and final transitional periods will not end before Q2/2029.

Final Thoughts

Whilst the medical device industry waits with bated breath for the proposed regulation to be published in the Official Journal of the European Union, it is advisable that manufacturers ensure they understand and have all the information they need for the EUDAMED Actor and UDI/Devices registration processes. Hopefully, the proposal will encourage more manufacturers to register on a voluntary basis, as delays in the module development have resulted in low adoption of EUDAMED.

As a UK provider of quality and regulatory services, IVDeology are proud to engage with the IVD industry and keen to support IVD manufacturers with IVD devices market access. For further information on how we can help, please contact [email protected] or you can book straight into our calendar here

Note: This blog contains a summary of the key changes within the proposal, it is important that Manufacturers read and understand the proposal in full, and get independent legal advice if required.