(101 days)
The Epstein Barr Virus Viral Capsid Antigen (EBV-VCA) IgG ELISA Test is for the qualitative detection of IgG antibodies to EBV-VCA in serum as an aid in the clinical laboratory diagnosis of EBV infection in patients with clinical symptoms consistent with infectious mononucleosis (IM). The PANBIO EBV-VCA IgG ELISA should be used in conjunction with other EBV serologies.
The EBV-VCA IgG ELISA Kit is an enzyme-linked immunosorbent assay (ELISA) for the detection of IgG antibodies to EBV-VCA antigen in human serum.
Acceptance Criteria and Device Performance for PANBIO EBV-VCA IgG ELISA Kit
1. Table of Acceptance Criteria and Reported Device Performance:
The document does not explicitly state pre-defined acceptance criteria values for the performance metrics (sensitivity, specificity, and agreement). However, it reports the calculated performance against the defined EBV status. For the purpose of this response, the reported performance values will be considered as effectively meeting the implicit criteria for substantial equivalence to a predicate device.
| Performance Metric | Acceptance Criteria (Implicit) | Reported Device Performance (Study Site 2, USA) | Reported Device Performance (Study Site 3, Australia) |
|---|---|---|---|
| Serological Sensitivity (Acute) | Sufficient to demonstrate equivalence | 69.2% (95% CI: 48.2 – 85.7%) | 92.9% (95% CI: 80.5 – 98.5%) |
| Serological Sensitivity (Past) | Sufficient to demonstrate equivalence | 94.1% (95% CI: 87.6 – 97.8%) | 89.3% (95% CI: 85.6 – 93.1%) |
| Serological Specificity (Negative) | Sufficient to demonstrate equivalence | 96.4% (95% CI: 81.6 – 99.9%) | 91.7% (95% CI: 80.0 – 97.7%) |
| Serological Agreement | Sufficient to demonstrate equivalence | 90.4% (95% CI: 84.6 – 94.5%) | 90.1% (95% CI: 86.4 – 93.0%) |
| Cross-Reactivity (Specificity) | 0% positive results for disease panel | 0/29 (100% true negative) | N/A (Not reported separately for this site) |
2. Sample Sizes Used for the Test Set and Data Provenance:
- Study Site 2 (USA):
- Sample Size: 156 frozen retrospective sera.
- Data Provenance: Maryland, USA. The samples were retrospective, meaning they were collected in the past for other purposes (EBV testing) and then re-analyzed.
- Study Site 3 (Australia):
- Sample Size: 352 prospective sera.
- Data Provenance: Queensland, Australia. The samples were prospective, meaning they were collected specifically for this study.
- Cross-Reactivity Study (Study Site 5):
- Sample Size: 29 specimens.
- Data Provenance: Not explicitly stated for specific geography, but the study was conducted to establish analytical specificity for the EBV-VCA IgG ELISA Test.
3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications of Those Experts:
The document does not specify the number or qualifications of experts used to establish the "EBV status" of the sera in either Study Site 2 or Study Site 3. The ground truth (EBV Status) was determined using "EBV ELISA assays from an alternate manufacturer" and other EBV serologies (VCA IgM, EBNA IgG) to categorize samples as "Seronegative," "Acute Infectious Mononucleosis," or "Past Infection." This implies reliance on established laboratory diagnostic methods rather than individual expert adjudication of raw data.
4. Adjudication Method for the Test Set:
Not applicable in the traditional sense of human expert adjudication. The "EBV Status" (ground truth) was established through the results of other EBV ELISA assays and serological markers, not by human experts adjudicating the PANBIO device's results. The comparison was to an established diagnostic status determined by alternative, presumably validated, methods.
5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size of Human Improvement with AI vs. Without AI Assistance:
This information is not applicable. The device described is an in vitro diagnostic ELISA kit for detecting antibodies in serum, not an AI-powered diagnostic tool requiring human-in-the-loop performance evaluation or MRMC studies.
6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study Was Done:
Yes, the studies presented (Study Site 2 and Study Site 3) evaluate the standalone performance of the PANBIO EBV-VCA IgG ELISA kit. The results (sensitivity, specificity, agreement) are calculated solely based on the device's output compared to the established EBV status of the samples. There is no mention of human interpretation or involvement in the final classification of the device's results.
7. The Type of Ground Truth Used:
The ground truth used was expert consensus on serological markers/established diagnostic assays. For the sensitivity and specificity studies (Study Site 2 & 3), the "EBV Status" was determined by a combination of other EBV serological assays (VCA IgG, VCA IgM, EBNA IgG) from an alternate manufacturer. For the cross-reactivity study, the ground truth was "confirmed disease other than Epstein Barr Virus" as characterized prior to analysis.
8. The Sample Size for the Training Set:
The document does not explicitly state a separate "training set" size. For an ELISA kit, development often involves optimization and calibration using various samples, but these are typically not referred to as a "training set" in the same way as machine learning models. The provided studies focus on validation/test sets.
9. How the Ground Truth for the Training Set Was Established:
As there is no explicitly defined "training set" for the purpose of a machine learning model, the method for establishing its ground truth is not provided. The development and calibration of an ELISA kit involve establishing cutoff values and validating reagent performance, which would inherently rely on characterized samples but not a "training set" in the AI sense.
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JUN 1 3 2002
510(k) SUMMARY OF SAFETY AND EFFECTIVENESS
This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.
The assigned 510(k) number is: K020706
Applicant Information:
| Date Prepared: | 07th June, 2002 |
|---|---|
| Name: | PANBIO Limited |
| Address: | 116 Lutwyche RoadWindsor 4030 Australia |
| Contact Person: | Helen Jennings |
|---|---|
| Phone Number. | 61-(0)7-3357-1177 |
| Fax Number. | 61-(0)7-3357-1222 |
Device Information:
| Trade Name: | EBV-VCA IgG ELISA Kit |
|---|---|
| Common Name. | EBV-VCA IgG EIA Test |
| Classification Name; | EBV-VCA IgG Serological Reagent |
Equivalent Device:
DiaSorin Incstar EBV-VCA IgG ELISA
Device Description:
The EBV-VCA IgG ELISA Kit is an enzyme-linked immunosorbent assay (ELISA) for the detection of IgG antibodies to EBV-VCA antigen in human serum.
Intended Use:
The Epstein Barr Virus Viral Capsid Antigen (EBV-VCA) IgG ELISA Test is for the qualitative detection of IgG antibodies to EBV-VCA in serum as an aid in the clinical laboratory diagnosis of EBV infection in patients with clinical symptoms consistent with infectious mononucleosis (IM). The PANBIO EBV-VCA IgG ELISA should be used in conjunction with other EBV serologies.
Principle of Procedure:
Serum containing antibodies to VCA antigen, when present, combine with EBV-VCA gp125 antigen attached to the polystyrene surface of the microwells. This antigen is grown in P3HR1 cell lines, and immunopurified utilising a monoclonal specific for gp125. Residual serum is removed by washing and peroxidase conjugated IgG is added. The microwells are washed and a colourless substrate system, anti-human tetramethylbenzidine/hydrogen peroxide (TMB/H2O2) is added. The substrate is hydrolysed by the enzyme and the chromogen changes to a blue colour. After stopping the reaction with acid, the TMB becomes yellow. Color development is indicative of the presence of EBV-VCA IgG antibodies in the test sample.
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PERFORMANCE CHARACTERISTICS
Study Site 2:
156 frozen retrospective sera of various ages and genders were submitted to a state health lab in Maryland USA for EBV testing. The sera include samples from the following groups: 28 seronegative samples, 26 samples from patients with acute Infectious Mononucleosis, and 102 samples from patients with past exposure to EBV. These sera were tested on the PANBIO EBV-VCA IgG kit and EBV ELISA assays from an alternate manufacturer to determine the EBV status of the sera. The PANBIO EBV VCA IgG results were compared to the EBV status of the sera to determine the sensitivity, specificity, and agreement of the assay relative to the EBV serological status. The data is summarized in the Table 1.
| PANBIO ELISA | ||||
|---|---|---|---|---|
| EBV Status | Positive | Equivocal* | Negative | Total |
| SeronegativeVCA IgG (-)VCA IgM (-)EBNA IgG (-) | 1 | 0 | 27 | 28 |
| AcuteVCA IgM (+)EBNA IgG (-) | 18 | 4 | 4 | 26 |
| Past InfectionVCA IgG (+)VCA IgM (-)EBNA IgG (+) | 96 | 2 | 4 | 102 |
| Total | 115 | 6 | 35 | 156 |
TABLE 1 EBV VCA IgG Serological Sensitivity and Specificity of PANBIO ELISA versus EBV Status
95% Confidence Interval
| Serological Sensitivity (Acute) | = 18/26 | = 69.2 % | 48.2 – 85.7 % |
|---|---|---|---|
| Serological Sensitivity (Past) | = 96/102 | = 94.1% | 87.6 – 97.8% |
| Serological Specificity (Negative) | = 27/28 | = 96.4 % | 81.6 – 99.9 % |
| Serological Agreement | = 141/156 | = 90.4 % | 84.6 – 94.5 % |
- Retesting of equivocal samples was not conducted, as the samples were unavailable.
Note: "Serological" sensitivity and specificity refers to the Comparison of the PANBIO assay results to that of other assays normally used to diagnose EBV associated IM. There was not an attempt to correlate the assay's results with disease presence or absence. No judgement can be made on the comparison's accuracy to predict disease. Since the above studies were performed on a pre-selected, retrospective, populations for the assay's positive and negative predictive value may be done or inferred.
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Study Site 3:
352 prospective sera of various ages and genders were tested at a private pathology laboratory in Queensland Australia for EBV testing. The sera include samples from the following groups: 48 seronegative samples, 42 samples from patients with acute Infectious Mononucleosis, and 262 samples from patients with past exposure to EBV. These sera were tested on the PANBIO EBV-VCA IgG kit and EBV ELISA assays from an alternate manufacturer to determine the EBV status of the sera. The PANBIO EBV-VCA IgG results were compared to the EBV status of the sera to determine the sensitivity, specificity, and agreement of the assay relative to the EBV serological status. The data is summarized in Table 2.
| PANBIO ELISA | ||||
|---|---|---|---|---|
| EBV Status | Positive | Equivocal* | Negative | Total |
| SeronegativeVCA IgG (-)VCA IgM (-)EBNA IgG (-) | 4 | 0 | 44 | 48 |
| AcuteVCA IgM (+)EBNA IgG (-) | 39 | 0 | 3 | 42 |
| Past InfectionVCA IgG (+)VCA IgM (-)EBNA IgG (+) | 234 | 1 | 27 | 262 |
| Total | 277 | 1 | 74 | 352 |
| Serological Sensitivity (Acute) | = 39/42 | = 92.9% | 95% Confidence Interval80.5 - 98-5% | |
| Serological Sensitivity (Past) | = 234/262 | = 89.3% | 85.6-93.1% | |
| Serological Specificity (Negative) | = 44/48 | = 91.7% | 80.0 - 97.7% | |
| Serological Agreement | = 317/352 | = 90.1% | 86.4-93.0% |
| TABLE 2 |
|---|
| EBV VCA IgG Serological Sensitivity and Specificity of |
| PANBIO ELISA versus EBV Status |
*This equivocal sample was not tested on an alternative method due to insufficient sample. Collection of a further sample was not possible.
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REPRODUCIBILITY
The reproducibility of the PANBIO EBV-VCA IgG ELISA kit was determined by testing 8 sera 3 times each on three different days at three Australian study sites. Two sites were private pathology laboratories and the third site was PANBIO. Within-run, between day, between site and total precision were estimated by analysis of variance (ANOVA Type II) and are presented in table 3 below.
| Sample | n | *Mean | Within | Between Day | Between Site | Total | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| *S.D | CV | *S.D | CV | *S.D | CV | *S.D | CV | |||
| Positive | 27 | 2.71 | 0.24 | 9.0% | 0.12 | 4.5% | 0.12 | 4.5% | 0.28 | 10.4% |
| Cut-off | 27 | 1.00 | 0.06 | 5.7% | 0.00 | 0.0% | 0.00 | 0.0% | 0.05 | 4.7% |
| Negative | 27 | 0.19 | 0.02 | 8.5% | 0.00 | 2.6% | 0.00 | 0.0% | 0.02 | 8.7% |
| #1 | 27 | 2.08 | 0.21 | 10.2% | 0.07 | 3.6% | 0.11 | 5.4% | 0.24 | 11.5% |
| #2 | 27 | 3.29 | 0.24 | 7.3% | 0.00 | 0.0% | 0.16 | 5.0% | 0.27 | 8.3% |
| #3 | 27 | 1.47 | 0.12 | 8.5% | 0.07 | 5.0% | 0.07 | 4.6% | 0.15 | 10.2% |
| #4 | 27 | 1.24 | 0.08 | 6.8% | 0.01 | 1.0% | 0.05 | 4.0% | 0.09 | 7.6% |
| #5 | 27 | 0.89 | 0.08 | 9.5% | 0.05 | 6.1% | 0.04 | 4.4% | 0.10 | 11.3% |
| #6 | 27 | 1.13 | 0.08 | 7.0% | 0.00 | 0.0% | 0.04 | 3.7% | 0.08 | 7.5% |
| #7 | 27 | 2.24 | 0.27 | 11.9% | 0.07 | 3.0% | 0.19 | 8.6% | 0.32 | 14.1% |
| #8 | 27 | 3.74 | 0.27 | 7.2% | 0.01 | 0.4% | 0.18 | 4.9% | 0.31 | 8.3% |
TABLE 3 - REPRODUCIBILITY DATA PANBIO EBV-VCA IgG Study Site 1, 2 & 3 Precision Measures (Using Cut-Off Ratio)
All values are calculated from Ratios (Cut-Off using O.D) SD = Standard Deviation; CV = Coefficient of Variation
Note: Standard Deviation results have been rounded to two decimal places for tabulation purposes
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POTENTIAL CROSS-REACTIVITY
Study Site 5:
A panel of 29 specimens from patients with confirmed diseases other than Epstein Barr Virus was tested to establish the analytical specificity of the EBV-VCA IgG ELISA Test. The specimens were from patients with diseases that have the potential for cross-reactivity. Each of the specimens included in the study was characterized with respect to disease diagnosis prior to analysis with the EBV-VCA IgG ELISA Test. No crossreactivity was observed for any of the 29 specimens tested from the disease panel. Refer to Table 4 for a summary of the results.
TABLE 4
| Disease Type | Total Specimens | Positive Result |
|---|---|---|
| Cytomegalovirus | 7 | (0/7) |
| Varicella zoster | 9 | (0/9) |
| Herpes Simplex virus 1 | 6 | (0/6) |
| Herpes Simplex virus 2 | 1 | (0/1) |
| Anti-Nuclear Antigen | 3 | (0/3) |
| Rheumatoid Factor | 3 | (0/3) |
| Total | 29 | (0/29) |
PANBIO EBV-VCA IgG CROSS-REACTIVITY SPECIMEN PANEL
Results indicate that no specimens (0/29) were positive when analysed with the EBV-VCA IgG ELISA Kit. Refer to 'Study Document -- Site 5' for raw data and section 2.3.4.1 for the summary table.
The true negative result of 100% for the above disease panel is consistent with good analytical specificity for the EBV-VCA IgG ELISA Test.
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Image /page/5/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of the department's name arranged in a circular fashion around a symbol. The symbol is a stylized representation of three human profiles facing to the right, stacked on top of each other.
Food and Drug Administration 2098 Gaither Road Rockville MD 20850
JUN 1 3 2002
Ms. Helen Jennings Quality and Regulatory Affairs Manager PANBIO Limited 116 Lutwyche Road Windsor. Brisbane Queensland, 4030 Australia
Re: K020706
Trade/Device Name: Epstein Barr Virus VCA IgG ELISA Test Regulation Number: 21 CFR 866.3235 Regulation Name: Epstein - Barr virus Serological Reagents Regulatory Class: Class I Product Code: GNP Dated: May 9, 2002 Received: May 15, 2002
Dear Ms. Jennings:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
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Page 2 -
This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and v additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4588. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsma/dsmamain.html".
Sincerely yours,
Steven Butman
Steven I. Gutman, M.D., M.B.A. Director Division of Clinical Laboratory Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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Page 1 of of 1
510(k) Number (if known): K020706
Device Name:
Indications For Use:
The Epstein Barr Virus Viral Capsid Antigen (EBV-VCA) IgG ELISA Test is for the qualitative detection of IgG antibodies to EBV-VCA in serum as an aid in the clinical laboratory diagnosis of EBV infection in patients with clinical symptoms consistent with infectious mononucleosis (IM). The PANBIO EBV-VCA IgG ELISA should be used in conjunction with other EBV serologies
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Woody Deibres
Unical Laboratory Devices
PRESCRIPTION USE X
(Optional Format 3-10-98)
§ 866.3235 Epstein-Barr virus serological reagents.
(a)
Identification. Epstein-Barr virus serological reagents are devices that consist of antigens and antisera used in serological tests to identify antibodies to Epstein-Barr virus in serum. The identification aids in the diagnosis of Epstein-Barr virus infections and provides epidemiological information on diseases caused by these viruses. Epstein-Barr viruses are thought to cause infectious mononucleosis and have been associated with Burkitt's lymphoma (a tumor of the jaw in African children and young adults) and postnasal carcinoma (cancer).(b)
Classification. Class I (general controls).