(112 days)
The RPS Adeno Detector is a rapid immunochromatography test for visual, qualitative in-vitro detection of adenoviral antigens (hexon protein) directly from human eye fluid. The test is intended for use as an aid in the rapid differential diagnosis of acute adenoviral conjunctivitis. All negative test results should be confirmed by cell culture.
The RPS Adeno Detector utilizes technology based on lateral flow immunochromatography. Adenoviral antigen, hexon protein, when present in the patient sample is captured between two antigen specific antibodies. One antibody is immobilized in the detection zone of the device. The second antibody is labeled with colloidal gold. The detector is a disposable, rapid test requiring 10 minutes for a result. The patient's lower eyelid is gently retracted to expose the inferior fornix. The eye fluid is collected on the sterile sample collector by gently swabbing the inferior fornix with the sampling pad on the test cover to gain a sample of tears for point of care analysis. The sample collector is reassembled to the immunoassay cassette. Sample transfer happens automatically. Analysis of the sample starts when the absorbant pad of the strip is dipped into a provided buffering solution. After 1-10 minutes, red colored lines in the read out area will appear. One line (control line) only indicates a (Adenoviral) negative result, where as two lines (control line and test line) indicate a (Adenoviral) positive result. It is best used within 7 days of developing a red eye consistent with infectious conjunctivitis.
The provided text describes the RPS Adeno Detector, a rapid immunochromatography test for the visual, qualitative in-vitro detection of adenoviral antigens from human eye fluid, intended as an aid in the rapid differential diagnosis of acute adenoviral conjunctivitis.
Here's an analysis of the acceptance criteria and study proving the device meets them:
1. Table of Acceptance Criteria and Reported Device Performance:
The document implicitly defines the acceptance criteria by stating the clinical performance against the "gold standard" of viral cell culture. While explicit targets for sensitivity, specificity, and agreement are not clearly stated as "acceptance criteria," the reported performance metrics are presented as evidence of the device's suitability. For the purpose of this analysis, we will treat the reported performance values as the demonstrated achievement against an unstated but implied satisfactory threshold for market clearance.
| Performance Metric | Acceptance Criteria (Implied) | Reported Device Performance |
|---|---|---|
| Sensitivity | Adequate for diagnostic aid | 88% (95% CI: 74.4%-96%) |
| Specificity | Adequate for diagnostic aid | 91% (95% CI: 84.8%-95.2%) |
| Overall Agreement | Adequate for diagnostic aid | 90% (95% CI: 84.9%-94.2%) |
| Positive Predictive Value | Adequate for diagnostic aid | 76% (95% CI: 61.1%-86.7%) |
| Negative Predictive Value | Adequate for diagnostic aid | 96% (95% CI: 91%-98.7%) |
2. Sample size used for the test set and the data provenance:
- Sample Size for Test Set: 175 samples
- Data Provenance: The document states, "A total of 175 samples were collected and tested from patients who developed a red eye consistent with infectious conjunctivitis within the last 7 days." This indicates the data is prospective and collected from patients presenting with symptoms. The country of origin is not specified in the provided text.
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 test set was established using viral cell culture as the "gold standard." This is a laboratory-based method. The number of experts involved in interpreting the cell culture results and their specific qualifications are not detailed in the provided text. However, cell culture requires trained laboratory personnel.
4. Adjudication method for the test set:
The document compares the RPS Adeno Detector's results directly against viral cell culture results. There is no mention of an adjudication method involving multiple human readers for the device's test results. It appears the device's output (presence/absence of two lines) was directly compared to the cell culture outcome.
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:
No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. The RPS Adeno Detector is a standalone device producing a visual, qualitative result (lines), not an AI-assisted diagnostic tool for human readers. Therefore, there is no discussion of human reader improvement with or without AI assistance.
6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done:
Yes, a standalone study was done. The clinical performance data presented (sensitivity, specificity, etc.) directly reflects the performance of the RPS Adeno Detector device itself, without human interpretation influencing its diagnostic output. The device produces a visual, qualitative result (one line for negative, two lines for positive) that is read directly.
7. The type of ground truth used:
The type of ground truth used was viral cell culture, which is described as the "gold standard" for identifying adenovirus in conjunctival specimens.
8. The sample size for the training set:
The provided text does not mention a separate training set or its sample size. The "Clinical Studies" section describes a single set of 175 samples used for performance evaluation against the gold standard. For devices utilizing lateral flow immunochromatography (like the RPS Adeno Detector), the "training" typically refers to the development and optimization of the assay components and their interactions, rather than a machine learning training set with labeled data for an algorithm.
9. How the ground truth for the training set was established:
As no specific "training set" in the context of machine learning is indicated, this question is not directly applicable. If "training set" refers to samples used during the development and optimization phases of the immunoassay, the ground truth would have likely been established using viral cell culture or well-characterized adenovirus samples, similar to how the ground truth for the clinical study was established. However, the document does not provide details on this development process.
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NOV 2 2 2 2005
.
510-K SUMMARY OF SAFETY AND EFFECTIVENESS
| Assigned 510-K Number: | K052092 |
|---|---|
| Submitted By: | Rapid Pathogen Screening, Inc.101 Phillips Park DriveSouth Williamsport, PA 17702 |
| Submission Contact: | Robert Sambursky, MD |
| Date Prepared: | September 14, 2005 |
| Device Trade Name: | RPS Adeno Detector |
| Predicate Devices: | SA Scientific, Inc.SAS Adeno TestK990630 |
| Device Classification: | Adenovirus serological reagents are devices thatconsist of antigens and antisera used in serologicaltests to identify antibodies to adenovirus in serum.The identification aids in the diagnosis of diseasecaused by adenoviruses and providesepidemiological information on these diseases.Adenovirus infection may cause pharyngitis, acuterespiratory diseases, gastroenteritis, andconjunctivitis |
| I. Device Category: | Class IRPS Adeno Detector differs from serologic tests byits ability to directly detect the antigen, a conservedepitope on the hexon portion of the adenovirus,which is characteristic and consistent for allserotypes. |
| II. Product Code: | GOD |
| III. Regulation Number: | 866.3020; Adenovirus serological reagents[Antigens, Cf (including control)]. |
| Intended Use: | The RPS Adeno Detector is a rapidimmunochromatography test for visual, qualitativein-vitro detection of adenoviral antigens (hexonprotein) directly from human eye fluid. The test is |
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intended for use as an aid in the rapid differential diagnosis of acute adenoviral conjunctivitis. All negative test results should be confirmed by cell culture.
-
- Indication(s) for use: Local (in tears of the eye) adenovirus detection associated with acute infectious conjunctivitis
- Special condition for use statement(s): 2. For use by health professionals only
- Special instrument Requirements 3. None
Morphologically, adenoviruses are nonenveloped DNA viruses with an icosahedral structure about 80 nm in diameter [4]. Adenovirus has been implicated in diseases affecting the respiratory, ocular and gastrointestinal systems [1], [2], [3].
Adenovirus is a frequent cause of infectious conjunctivitis. Human adenoviruses are classified into 6 subgenera and 51 serotypes [6],[10]. Approximately one third of the human adenovirus serotypes have been associated with common forms of adenoviral related eye infections [11] but the most common causes of acute conjunctivitis are related to serotypes 3, 4, 8, 11, 19 and 37 [12]. The serotypes have the following associations: serotypes 8, 19 and 37 are most responsible for epidemic keratoconjunctivitis [13],[14],[15]; serotypes 3, 4, 5 and 7 tend to cause pharyngeal-conjunctival fever, which usually affects children [13]; serotypes 1-11 and 19 are the primary cause of nonspecific follicular conjunctivitis [13]. However, the other serotypes can also produce clinically indistinguishable episodes of acute follicular conjunctivitis [4], [14], [16].
Cell culture in combination with immunofluorescence remains the "gold standard" for identifying adenovirus in conjunctival specimens [5]. Virus isolation requires a laboratory infrastructure, technical expertise, and may take up
Physiologic Basis of the Test:
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to 2 weeks to complete. In addition, the differential diagnosis of various forms of conjunctivitis (viral, bacterial, allergic) is often difficult because they manifest similar symptoms.
Device Description:
The RPS Adeno Detector utilizes technology based on lateral flow immunochromatography. Adenoviral antigen, hexon protein, when present in the patient sample is captured between two antigen specific antibodies. One antibody is immobilized in the detection zone of the device. The second antibody is labeled with colloidal gold. The detector is a disposable, rapid test requiring 10 minutes for a result.
The patient's lower eyelid is gently retracted to expose the inferior fornix. The eye fluid is collected on the sterile sample collector by gently swabbing the inferior fornix with the sampling pad on the test cover to gain a sample of tears for point of care analysis. The sample collector is reassembled to the immunoassay cassette. Sample transfer happens automatically.
Analysis of the sample starts when the absorbant pad of the strip is dipped into a provided buffering solution. After 1-10 minutes, red colored lines in the read out area will appear. One line (control line) only indicates a (Adenoviral) negative result, where as two lines (control line and test line) indicate a (Adenoviral) positive result.
It is best used within 7 days of developing a red eye consistent with infectious conjunctivitis.
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Predicate device Comparison
| Features | RPS Inc.RPS Adeno Detector | Cell Culture | SA Scientific, Inc.SAS Adeno Test |
|---|---|---|---|
| K Number | K052092 | None | K990630 |
| Intended Use | The RPS AdenoDetector allows for therapid, visual,qualitative in vitrodetection ofadenovirus and itsserotypes directlyfrom eye fluid on theconjunctiva. | The gold standard forthe qualitativedeterminationAdenovirus fromconjunctival swabs | A rapid test for thequalitativedetermination of invitro Adenovirusantigen fromconjunctival swabs |
| SpecimenTypes | Eye conjunctivalmucosa swab | Conjunctival swab | Conjunctival swab |
| Matrix | Eye fluid | Eye fluid | Eye fluid |
| Techno-logy | Lateral flowimmunoassay | Growth on hepaticcells; confirmatoryimmunofluorescence | Lateral flowimmunoassay |
| AntigenDetected | Adenovirus | Living Adenovirus | Adenovirus |
| PredicateDevices | SA Scientific, Inc.SAS Adeno Test | None | Meridian, Inc.Adenoclone |
Summary of Performance Data:
Clinical Studies
A total of 175 samples were collected and tested from patients who developed a red eye consistent with infectious conjunctivitis within the last 7 days.
Clinical performance data of the RPS Adeno Detector compared against viral cell culture are summarized in the following scheme:
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| Viral Culture | ||
|---|---|---|
| RPS AdenoDetector | ± | = |
| ± | 37 | |
| = | 5 | 121 |
| Sensitivity: | 88% (37/42), 95% CI (confidence interval) = 74.4%-96% |
|---|---|
| Specificity: | 91% (121/133), 95% CI = 84.8% - 95.2% |
| Overall agreement: | 90% (158/175), 95% CI = 84.9% - 94.2% |
| Positive predictive value: | 76% (37/49), 95% CI = 61.1% - 86.7% |
| Negative predictive value: | 96% (121/126), 95% CI = 91% - 98.7% |
- Out of the 12 culture negative RPS positive samples 3 were found to be PCR positive
Conclusion:
Analytical testing, including analytical sensitivity, specificity, cross-reactivity, and interference were conducted. These studies further demonstrated the suitability of the product for professional use as a point of care device. Such studies also established both the substantial equivalence of the RPS Adeno Detector to viral culture and the fundamental safety and effectiveness of the product and its appropriateness for commercial distribution.
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Image /page/5/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS). The seal features the department's name encircling a stylized caduceus symbol. The text reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement around the symbol.
Food and Drug Administration 2098 Gaither Road Rockville MD 20850
NOV 2 2 2005
Rapid Pathogen Screening, Inc. c/o Robert Sambursky, M.D. 13946 Wood Duck Circle Bradenton, FL 34202
Re: K052092
Trade/Device Name: RPS Adeno Detector Regulation Number: 21 CFR 866.3020 Regulation Name: Adenovirus Serological Reagents Regulatory Class: Class I Product Code: GOD Dated: September 23, 2005 Received: September 29, 2005
Dear Dr. Sambursky:
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 Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. 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 Parts 801 and 809); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820).
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Page 2 --
This letter will allow you to begin marketing your device as described in your Section 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 information about the application of labeling requirements to your device, or questions on the promotion and advertising of your device, please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at (240)276-0484. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act 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/industry/support/index.html
Sincerely yours,
Sales a Hogg
Sally A. Hojvat, M.Sc., Ph.D. Director Division of Microbiology Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health
Enclosure
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Indications for Use
510(k) Number (if known): K 052092
Device Name: RPS Adeno Detector
Indications For Use:
The RPS Adeno Detector is a rapid immunochromatography test for visual, qualitative in-vitro detection of adenoviral antigens (hexon protein) directly from human eye fluid. The test is intended for use as an aid in the rapid differential diagnosis of acute adenoviral conjunctivitis. All negative test results should be confirmed by cell culture.
Prescription Use (Part 21 CFR 801 Subpart D)
AND/OR
Over-The-Counter Use (21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Sally Austin
Division Sign-Off
Division Sign-Off
Office of In Vitro Diagnostic Device Evaluation and Safety
Page 1 of 1
KOS 2092 510(k)_
§ 866.3020 Adenovirus serological reagents.
(a)
Identification. Adenovirus serological reagents are devices that consist of antigens and antisera used in serological tests to identify antibodies to adenovirus in serum. Additionally, some of these reagents consist of adenovirus antisera conjugated with a fluorescent dye and are used to identify adenoviruses directly from clinical specimens. The identification aids in the diagnosis of disease caused by adenoviruses and provides epidemiological information on these diseases. Adenovirus infections may cause pharyngitis (inflammation of the throat), acute respiratory diseases, and certain external diseases of the eye (e.g., conjunctivitis).(b)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 866.9.