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3 General requirements for the performance
evaluation
3.1
Responsibilities and resources
The
manufacturer takes the responsibility for the
initiation and/or the
conduct of a
performance evaluation study. He shall define the
responsibility and the interrelation of
all personnel who manage
and conduct
the performance evaluation of IVD MDs,
particularly for
personnel who need the
organisational freedom and authority to
a) assess the validity of test results
and data already available;
b) specify
performance claims which shall be further examined
or
confirmed;
c) specify and
document the evaluation plan and the test
procedures;
d) prepare the evaluation
report.
The manufacturer shall appoint
a co-ordinator with overall
responsibility of the performance
evaluation
study. The co-ordinator
shall himself assure that adequate resources
are available. The investigator
shall ensure that the evaluation plan
is followed at his location and
that
the study is appropriately
reviewed
from an ethical point of view.
3.2
Documentation
The documentation of the
performance evaluation study shall contain
the files relating to clauses 3 to
7 of this standard and shall be part of
the technical documentation of
the IVD
MD.
3.3 Final assessment and review
The co-ordinator shall assess and
document which performance
claims are
met, state whether claims
are not met
and give recommendations for corrective actions,
where
necessary.
The
responsible management of the manufacturer shall
make sure
that the results of the
performance
evaluation study and the
recommendations for corrective actions are
carefully considered and properly
documented before issuing a declaration
of conformity.
4 Organisation of a
performance evaluation study
4.1
Preconditions
Before starting a
performance evaluation study it shall be ensured
by
the co-ordinator that
a)
the performance claims of the IVD MD which are the
subject of the
study are specified;
b) the IVD MD has been manufactured
under controlled production
processes
and conditions;
c) the IVD MD to be
evaluated meets the quality control release
specifications;
d) a
sufficient number of samples of the IVD MD can be
provided
during the entire period of
the
performance evaluation study;
e) all legal requirements for
performance evaluation studies are met;
f) the investigator(s) is (are)
adequately skilled and trained to conduct
the study and the necessary
resources are available.
4.2
Evaluation plan
The evaluation plan
shall state the purpose on scientific, technical
or
medical grounds, the scope of
the evaluation, the structure and
organization of the study and the
number of devices concerned.
Defining the objective of the study,
the co-ordinator shall have
assessed
which performance claims
are already
verified by data or scientific literature.
The evaluation plan shall
be designed to minimise the requirements
for invasive sampling. In the case
of IVD MDs for self-testing it shall be
ensured that the evaluation plan
is
appropriate and acceptable to
users and
the information provided shall be clear and easily
understood.
The evaluation
plan shall specify
a) that the
investigator(s) is (are) adequately skilled and
trained to
use the IVD MD;
b) the list of laboratories or other
institutions taking part in the
performance evaluation study; for
selftesting,
the location and number of
lay persons involved;
c) the time-
table;
d) the necessary minimum number
of probands from whom
specimens are
collected by invasive
procedures in
order to adequately assess the performance of the
IVD
MD;
e) instructions for
use including a description of the conditions of
use;
f) the performance claims (e.g.
analytical sensitivity, diagnostic
sensitivity, analytical specificity,
diagnostic specificity, accuracy,
repeatability, reproducibility) to be
validated;
g) the format of
performance study records.
4.3 Sites
and resources
In general, the
performance study procedure(s) shall be carried
out
under conditions reflecting the
relevant intended conditions of use.
The co-ordinator shall take the
responsibility for the proper conduct of
the performance evaluation
study at all sites. All investigators
shall be named.
The co-ordinator shall
ensure adequate competence and skill at all
sites involved and that the
necessary resources are available.
Where lay persons are involved in a
performance evaluation study of
an IVD
MD for self-testing, the
location of
the study and the number of persons shall be
given. The
co-ordinator shall specify
the
criteria for the selection of a
representative panel.
Especially for
studies involving lay persons it shall be ensured
that
these persons do not receive
additional information on the use of
the IVD MD apart from that which
is
provided with the IVD MD
when it is
placed on the market because the comprehension of
the
manufacturer's instructions for use
is one of the important aspects of the
study. lt shall also be ensured
that
the untrained person(s) do
not receive
any additional information or help, e. g. from a
tutor, other
than the training
specified and
provided by the
manufacturer in the instructions for use.
4.4 Basic design information
The co-ordinator shall provide the
investigator(s) with sufficient
information in order to understand the
function and application of the IVD MD
and, where necessary, the
investigator
shall make himself
familiar with the
IVD MD and its application. The information
provided
shall include a statement that
the device in question conforms with
the requirements of the Directive
98/79/EC apart from those to be
evaluated.
4.5
Experimental design
The experimental
procedures to validate each performance claim
subject to the performance
evaluation study shall be documented in
the evaluation plan.
Special
consideration in performance evaluation studies of
reagents/kits shall be given, where
applicable, to the following:
–
specification of type
(e.g. serum, plasma, urine) and properties (e.g.
concentration range, age
and
sex of the proband population) of specimens
appropriate to the
intended use;
–
probands to be enrolled;
–
suitability, stability and
volume of specimens and specimen
exclusion criteria;
–
blind
procedures, where necessary;
–
reagent stability;
–
inclusion of common
interfering factors, caused by specimen
condition or the
pathological/physiological status of
the specimen donor or treatment;
–
conditions for use which
can be reasonably anticipated; special
attention shall be paid to the
conditions of use by lay persons;
–
selection of an
appropriate reference measurement procedure and
reference material of
higher
order, where available;
–
determination of the status of specimens (for
qualitative tests with a
nominal or
ordinal scale);
–
calibration procedures, including traceability,
where appropriate;
–
appropriate means of control;
–
limitations of the test;
–
criteria for re-
examination and data exclusion;
–
availability of additional
information concerning the specimen or
donor if follow-up of
unexpected results is required;
–
appropriate measures to
reduce risk of infection to the user.
Where the study is intended to validate
the performance claims of an
instrument
special consideration
shall be given
additionally to the following:
–
maintenance and cleaning;
–
carry-over effects;
–
software validation.
NOTE For the investigation of the
technical aspects of instruments, other
standards can be relevant.
4.6 Performance study records
The performance study records shall
–
refer to the experimental
procedures in the evaluation plan;
–
be unequivocally
identifiable;
–
contain or
refer to all results and related relevant data;
–
be part of the technical
documentation of the IVD MD.
The
protection of all confidential data shall be
ensured.
4.7 Observations
and unexpected outcomes
Special
attention shall be paid to observations and
unexpected
outcomes, e. g. drop outs,
outliers,
instability of sample or
reagent signal etc., non-reproducibility,
non-
correlation of results to the
reference or to the diagnostic pattern,
defects or breakdowns,
software errors,
or error signals.
Any deviation from
the defined procedures shall be recorded. In the
case of IVD MDs for self-testing,
the investigator or tutor shall duly
note any difficulty or question a
user
may have and any deviation
from the
mode of application of the IVD MD as described by
the
manufacturer.
Any such
observation shall be properly recorded. The co-
ordinator
shall, together with the
investigator,
trace the cause whenever
possible. The result shall be recorded and
shall be part of the evaluation
report.
Where the validity
of the examinations already performed may be
questionable because of an
identified source of error the tests
shall be repeated after exclusion of
that cause.
Where a misuse
or misinterpretation of the instructions for use
has
been the cause and where an
unexpected risk inherent to the product
design or the mode of
application has
been identified this shall
be clearly
stated.
The proposals of the
investigator(s) and the co-ordinator for any
improvement of the IVD MD and/or its
application shall be recorded.
4.8 Evaluation report
The
co-ordinator shall establish an evaluation report.
It shall contain a
description of the
study, an
analysis of the results
together with a conclusion on the performance
claims investigated.
The
report shall also discuss any unexpected outcomes
which have
occurred. It shall identify
the
cause whenever possible and give
recommendations for corrective
actions
to be taken, where
necessary.
If several studies have been conducted
for one IVD MD, a single
summarizing
report may be
established.
5
Modifications during the performance
evaluation study
Where the
manufacturing process has been changed it shall be
checked whether the performance
claims of the IVD MD still conform to
those which had been set
initially.
Otherwise the validity of the
examinations already performed shall be
questioned and the
evaluation plan
shall be revised
accordingly.
Where design changes are introduced,
the evaluation plan shall be
revised.
6 Re-evaluation
In case of
changes to the design or manufacturing process of
the IVD
MD, the performance evaluation
study shall be repeated as far as
necessary, to ensure that the
intended
use and the performance
claims of the
IVD MD placed on the market are adequately
evaluated.
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