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510(k) Data Aggregation

    K Number
    K103610

    Validate with FDA (Live)

    Date Cleared
    2011-01-06

    (28 days)

    Product Code
    Regulation Number
    866.3328
    Reference & Predicate Devices
    Predicate For
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Clearview® Exact II Influenza A & B Test is an in vitro immunochromatographic assay for the qualitative detection of influenza A and B nucleoprotein antigens in nasal swab specimens collected from symptomatic patients. It is intended to aid in the rapid differential diagnosis of influenza A and B viral infections. It is recommended that negative test results be confirmed by cell culture. Negative results do not preclude influenza virus infection and should not be used as the sole basis for treatment or other management decisions.

    Device Description

    The Clearview Exact II Influenza A & B Test is an immunochromatographic membrane assay that uses highly sensitive monoclonal antibodies to detect influenza type A and B nucleoprotein antigens in respiratory swab specimens. These antibodies and a control protein are immobilized onto a membrane support as three distinct lines and are combined with other reagents/pads to construct a Test Strip. Nasal swab samples are added to a Coated Reaction Tube to which an extraction reagent has been added. A Clearview Exact II Influenza A & B Test Strip is then placed in the Coated Reaction Tube holding the extracted liquid sample. Test results are interpreted at 10 minutes based on the presence or absence of pink-to-purcle colored Sample Lines. The yellow Control Line turns blue in a valid test.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and study information for the Clearview® Exact II Influenza A & B Test, based on the provided 510(k) summary:

    1. Table of Acceptance Criteria and Reported Device Performance

    The acceptance criteria are implied by the reported performance figures, as the device was deemed "substantially equivalent" which indicates these performance metrics were acceptable to the FDA. The document doesn't explicitly state pre-defined acceptance thresholds, but rather presents the results of the clinical study for evaluation.

    Performance MetricAcceptance Criteria (Implied)Reported Device Performance
    Influenza Type A
    SensitivityAdequate for intended use94% (95% CI: 83-98%)
    SpecificityAdequate for intended use96% (95% CI: 93-97%)
    Influenza Type B
    SensitivityAdequate for intended use77% (95% CI: 67-85%)
    SpecificityAdequate for intended use98% (95% CI: 96-99%)
    Invalid Results RateLowLess than 2%
    Analytical Sensitivity (LOD)Detects at specified concentrationsSee detailed table below
    Analytical ReactivityReacts to specified strainsSee detailed table below
    Analytical Specificity (Cross-Reactivity)No cross-reactivity with specified microorganismsAll tested microorganisms were negative
    Interfering SubstancesNo interference with specified substancesNo interference found for most, whole blood interfered with positive samples
    Reproducibility (Type A)
    Moderate Positive DetectionHigh99.2% (119/120)
    Low Positive DetectionHigh94.2% (113/120)
    High Negative DetectionLow9.2% (11/120)
    Reproducibility (Type B)
    Moderate Positive DetectionHigh99.2% (116/120)
    Low Positive DetectionHigh94.2% (113/120)
    High Negative DetectionLow7.5% (9/120)
    Negative Samples100% negative100% negative

    Analytical Sensitivity (LOD) - Reported Device Performance:

    Influenza SubtypeConcentration (TCID50/ml)# Detected per Total Tests% Detected
    Influenza A/HongKong/8/682.37 x 10^464/6697%
    Influenza A/PuertoRico/8/343.16 x 10^537/4288%
    Influenza B/Malaysia/2506/20043.00 x 10^619/2095%
    Influenza B/Lee/404.20 x 10^519/2095%

    Analytical Reactivity Testing - Reported Device Performance:

    Influenza StrainConcentration (TCID50/ml or EIU50/ml)
    Flu A/Port Chalmers/1/73 (H3N2)5.6 x 10^5
    Flu A/WS/33 (H1N1)5.0 x 10^4
    Flu A/Aichi/2/68 (H3N2)3.0 x 10^4
    Flu A/Malaya/302/54 (H1N1)6.0 x 10^5
    Flu A/New Jersey/8/76 (H1N1)2.8 x 10^5
    Flu A/Denver/1/57 (H1N1)8.9 x 10^3
    Flu A/Victoria/3/75 (H3N2)1.8 x 10^4
    Flu A/Solomon Islands/3/2006 (H1N1)1.5 x 10^5
    Flu A/Brisbane/10/07 (H3N2)2.5 x 10^6 EIU50/ml
    Flu A/Puerto Rico/8/34 (H1N1)5.6 x 10^5
    Flu A/Wisconsin/67/2005 (H3N2)1.3 x 10^5
    Flu A/Hong Kong/8/68 (H3N2)7.9 x 10^3
    Flu A/California/04/2009 (H1N1)1.4 x 10^5
    Flu B/Florida/02/20061.4 x 10^4
    Flu B/Florida/04/20067.1 x 10^4
    Flu B/Florida/07/048.5 x 10^4
    Flu B/Malaysia/2506/041.5 x 10^6
    Flu B/Panama/45/901.7 x 10^4
    Flu B/R755.0 x 10^5
    Flu B/Russia/692.2 x 10^6
    Flu B/Taiwan/2/621.0 x 10^5
    Flu B/Mass/3/661.5 x 10^5
    Flu B/Lee/401.8 x 10^5

    2. Sample size used for the test set and the data provenance

    • Sample Size: 478 prospective clinical specimens.
    • Data Provenance: Multi-center, prospective clinical study conducted at seven U.S. trial sites during the 2008-2009 respiratory season. Specimens were nasal swabs collected from symptomatic patients.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

    The ground truth for the clinical study was established using viral culture. This is a laboratory method and does not involve human experts in the typical "expert consensus" sense for image interpretation or diagnosis. Therefore, information about the number and qualifications of experts in this context is not applicable.

    4. Adjudication method (e.g., 2+1, 3+1, none) for the test set

    Not applicable, as the ground truth was "viral culture," which is an objective laboratory method rather than expert interpretation requiring adjudication. However, for the 19 samples where the Clearview test was negative for influenza B but viral culture was positive, an investigational RT-PCR assay was used as a follow-up ("Ten (10) of these samples were negative for influenza B by PCR"). This could be seen as a form of secondary verification for discrepant results.

    5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, if so, what was the effect size of how much human readers improve with AI vs without AI assistance

    Not applicable. This device is an immunochromatographic rapid diagnostic test for direct antigen detection, not an AI-powered diagnostic imaging or interpretation tool that assists human readers.

    6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done

    Yes, the primary clinical performance study evaluated the device in a standalone manner. The results (sensitivity and specificity) represent the performance of the device itself (Clearview® Exact II Influenza A & B Test) compared to the viral culture gold standard, without human interpretation influence (other than reading the test strip, which is part of the device's intended use and not considered "human-in-the-loop AI assistance"). The reproducibility study also assessed the device's inherent performance characteristics.

    7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

    The ground truth for the clinical study was viral culture.

    8. The sample size for the training set

    This information is not provided in the 510(k) summary. Given that this is an immunochromatographic assay using monoclonal antibodies, it's a traditional in vitro diagnostic, not a machine learning or AI-driven device that requires a "training set" in the computational sense. The "training" of such a device involves developing and optimizing the biochemical components and manufacturing processes, rather than training an algorithm on a dataset.

    9. How the ground truth for the training set was established

    Not applicable, as the device is not an AI/ML-based system requiring a training set with established ground truth in the traditional sense. The analytical studies (sensitivity, reactivity, specificity) demonstrate the performance of the developed assay against known viral strains and other microorganisms.

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