(84 days)
The Platelia™ Aspergillus EIA is an immunoenzymatic sandwich microplate assay for the detection of Aspergillus galactomannan antigen in adult and pediatric serum samples.
The Platelia™ Aspergillus EIA is a test which, when used in conjunction with other diagnostic procedures such as microbiological culture, histological examination of biopsy samples and radiographic evidence, can be used as an aid in the diagnosis of Invasive Aspergillosis.
The Platelia™ Aspergillus EIA is a one-stage immunoenzymatic sandwich microplate assay which detects galactomannan in human serum. The assay uses rat EBA-2 monoclonal antibodies, which are directed against Aspergillus galactomannan, and have been characterized in previous studies 19,16. The monoclonal antibodies are used to coat the wells of the microplate and bind the antigen, and to detect the antigen bound to the sensitized microplate (conjugate reagent: peroxidase-linked monoclonal antibodies).
Serum samples are heat-treated in the presence of EDTA in order to dissociate immune complexes and to precipitate serum proteins that could possibly interfere with the test . The treated serum samples and conjugate are added to the wells coated with monoclonal antibodies, and incubated. A monoclonal antibody - galactomannan - monoclonal antibody / peroxidase complex is formed in the presence of galactomannan antigen. The strips are washed to remove any unbound material. Next, the substrate solution is added, which will react with the complexes bound to the well to form a blue color reaction. The enzyme reaction is stopped by the addition of acid, which changes the blue color to yellow. The absorbance (optical density) of specimens and controls is determined with a spectrophotometer set at 450 and 620/630 nm wavelength.
Here's a summary of the acceptance criteria and study details for the Bio-Rad Platelia™ Aspergillus EIA, extracted from the provided 510(k) summary:
Acceptance Criteria and Device Performance:
| Performance Metric | Acceptance Criteria (Implied) | Reported Device Performance (Pediatric) | Reported Device Performance (Adult) |
|---|---|---|---|
| Sensitivity (Patients) | Sufficiently high to aid in diagnosis of Invasive Aspergillosis. | Combined Proven & Probable IA: | Combined Proven & Probable IA: |
| 52.9% (9/17) [95% CI: 31.0-73.8%] | 79.3% (23/29) [95% CI: 61.6-90.2%] | ||
| Proven IA: 44.4% (4/9) | Proven IA: 81.8% (9/11) | ||
| Probable IA: 62.5% (5/8) | Probable IA: 77.8% (14/18) | ||
| Specificity (Patients) | Sufficiently high to minimize false positives, when used in conjunction with other diagnostic procedures. | 87.0% (94/108) [95% CI: 79.4-92.1%] | 88.8% (127/143) [95% CI: 82.6-93.0%] |
| Specificity (Samples) | Sufficiently high to minimize false positives at the sample level. | 98.5% (1600/1625) [95% CI: 97.7-99.0%] | 98.5% (1243/1262) [95% CI: 97.7-99.0%] |
| Positive Predictive Value (PPV) - Study Prevalence | (No explicit numerical criteria stated, expected to be clinically useful) | 39.1% [95% CI: 22.2-59.2%] | 59.0% [95% CI: 43.4-72.9%] |
| Negative Predictive Value (NPV) - Study Prevalence | (No explicit numerical criteria stated, expected to be clinically useful) | 92.2% [95% CI: 85.3-96.0%] | 95.5% [95% CI: 90.5-97.9%] |
| Positive Predictive Value (PPV) - 5% Prevalence | (No explicit numerical criteria stated, expected to be clinically useful) | 17.6% [95% CI: 6.5-39.8%] | 27.2% [95% CI: 13.7-46.7%] |
| Negative Predictive Value (NPV) - 5% Prevalence | (No explicit numerical criteria stated, expected to be clinically useful) | 97.2% [95% CI: 92.1-99.1%] | 98.8% [95% CI: 95.4-99.7%] |
| Reproducibility (Inter-assay & Intra-assay %CV) | (No explicit numerical criteria stated, expected to be acceptable for lab diagnostics) | Generally below 20-30% for most panels | (Assumed similar, studies were prior) |
| Cross-Reactivity | No (or minimal) positive results with common interfering conditions. | 0 positives across 15 interfering conditions (10 samples/condition) | (Assumed similar, studies were prior) |
Note: The document implies acceptance criteria by presenting performance data within clinical contexts and stating that the device is "substantially equivalent" to a predicate device, which inherently means it meets similar performance standards.
Study Details:
-
Sample Sizes and Data Provenance (Test Set):
- Pediatric (new study for this submission):
- Total Patients: 129 immunocompromised pediatric patients.
- Total Samples: 1954 serum samples.
- Invasive Aspergillosis (IA) Patients: 17 (9 Proven, 8 Probable).
- Control/Non-IA Patients: 108 (from whom 1625 samples were tested).
- Data Provenance: United States (three testing centers).
- Retrospective/Prospective: Not explicitly stated, but the collection of patients diagnosed with IA and controls suggests it could be a mix or primarily retrospective given the diagnostic criteria often established over time.
- Adult (previously conducted study for K023857):
- Total Patients: 172 bone marrow transplant (BMT) and leukemic patients.
- Total Samples: 1724 serum samples.
- Invasive Aspergillosis (IA) Patients: 29 (11 Proven, 18 Probable).
- Control/Non-IA Patients: 143 (from whom 1262 samples were tested).
- Data Provenance: North America (three testing centers).
- Retrospective/Prospective: Not explicitly stated, likely retrospective as it refers to a "previously conducted" study with diagnosed patients.
- Pediatric (new study for this submission):
-
Number of Experts and Qualifications (Ground Truth for Test Set):
- The ground truth for Invasive Aspergillosis (IA) was established based on EORTC/NIAID definitions. These definitions are rigorous and rely on a combination of:
- Proven IA: Positive microbiological culture from a sterile site AND histopathological demonstration of fungal forms.
- Probable IA: At least one microbiological criterion AND one major or two minor clinical criteria.
- The document does not specify the number or qualifications of individual experts who applied these definitions to each patient/sample. It relies on the widely accepted, expert-consensus-derived EORTC/NIAID criteria.
- The ground truth for Invasive Aspergillosis (IA) was established based on EORTC/NIAID definitions. These definitions are rigorous and rely on a combination of:
-
Adjudication Method (Test Set):
- The document does not explicitly state an adjudication method (e.g., 2+1, 3+1) for establishing the ground truth of IA. The reliance on EORTC/NIAID definitions suggests a standardized, objective application of these criteria, which may involve review by treating clinicians or infectious disease specialists as part of the diagnostic process.
-
Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:
- No, an MRMC comparative effectiveness study was not done. This device is an in-vitro diagnostic (IVD) assay designed to detect a biomarker (galactomannan antigen). Its performance is evaluated biochemically (sensitivity, specificity, reproducibility) rather than by human readers interpreting outputs, so a study comparing human reader performance with and without AI assistance is not applicable.
-
Standalone Performance Study (Algorithm Only):
- Yes, this is a standalone performance study of the diagnostic assay. The "Performance Evaluation Studies" sections detail the assay's sensitivity and specificity based on its direct measurements of galactomannan antigen in serum, independent of human interpretation or a human-in-the-loop scenario.
- The reproducibility and cross-reactivity studies also evaluate the algorithm's intrinsic performance.
-
Type of Ground Truth Used:
- The ground truth used was "Proven or Probable Invasive Aspergillosis" as defined by EORTC/NIAID definitions. This is a robust clinical standard for diagnosing IA, incorporating:
- Pathology: Histological examination of biopsy samples.
- Microbiological culture: Positive culture from sterile sites.
- Clinical evidence/outcomes data: Major/minor clinical criteria defined by the EORTC/NIAID.
- The ground truth used was "Proven or Probable Invasive Aspergillosis" as defined by EORTC/NIAID definitions. This is a robust clinical standard for diagnosing IA, incorporating:
-
Sample Size for the Training Set:
- The document does not explicitly describe a separate "training set" in the context of an algorithm that learns from data.
- This is an enzymatic immunoassay (EIA) kit, a traditional IVD device. The development and calibration of such a kit typically involve internal studies and optimization (analogous to "training" in AI), but these details are not provided as a distinct "training set" and "validation set" in the way they would be for a software algorithm. The performance evaluation discussed in the 510(k) is essentially the validation of the finalized assay itself.
-
How Ground Truth for the Training Set Was Established:
- As there isn't a traditional "training set" for an AI algorithm in this context, the question of its ground truth establishment is not directly applicable.
- For the initial development and optimization of the Platelia™ Aspergillus EIA (which would be analogous to "training"), the ground truth for positive and negative controls would have been established through well-characterized samples (e.g., purified galactomannan antigens, sera from confirmed IA patients, sera from healthy controls) using established reference methods and standards. However, these specific details for the "training" phase are not presented in this 510(k) summary.
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510(k) SUMMARY
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: K060641
| DATE: | February 28, 2006 |
|---|---|
| APPLICANT: | Bio-Rad3, Boulevard Raymond Poincaré92430 Marnes-la-Coquette, France |
| OFFICIAL CORRESPONDENT: | Dr. Sylvie Confida |
| TELEPHONE:FAX: | 33-1-47-95-613833-1-47-95-6242 |
| PRODUCT TRADE NAME: | Bio-Rad Laboratories Platelia™ Aspergillus EIA |
| COMMON NAME: | Aspergillus Antigen EIA |
| CLASSIFICATION NAME: | Antigen, Galactomannan, Aspergillus spp. |
| PREDICATE DEVICE: | Platelia™ Aspergillus EIA |
DEVICE DESCRIPTION
The Platelia™ Aspergillus EIA is a one-stage immunoenzymatic sandwich microplate assay which detects galactomannan in human serum. The assay uses rat EBA-2 monoclonal antibodies, which are directed against Aspergillus galactomannan, and have been characterized in previous studies 19,16. The monoclonal antibodies are used to coat the wells of the microplate and bind the antigen, and to detect the antigen bound to the sensitized microplate (conjugate reagent: peroxidase-linked monoclonal antibodies).
Serum samples are heat-treated in the presence of EDTA in order to dissociate immune complexes and to precipitate serum proteins that could possibly interfere with the test . The treated serum samples and conjugate are added to the wells coated with monoclonal antibodies, and incubated. A monoclonal antibody - galactomannan - monoclonal antibody / peroxidase complex is formed in the presence of galactomannan antigen. The strips are washed to remove any unbound material. Next, the substrate solution is added, which will react with the complexes bound to the well to form a blue color reaction. The enzyme reaction is stopped by the addition of acid, which changes the blue color to yellow. The absorbance (optical density) of specimens and controls is determined with a spectrophotometer set at 450 and 620/630 nm wavelength.
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INTENDED USE
The Platelia™ Aspergillus EIA is an immunoenzymatic sandwich microplate assay for the detection of Aspergillus galactomannan antigen in adult and pediatric serum samples.
INDICATIONS FOR USE
The Platelia™ Aspergillus EIA is a test which, when used in conjunction with other diagnostic procedures such as microbiological culture, histological examination of biopsy samples and radiographic evidence, can be used as an aid in the diagnosis of Invasive Aspergillosis.
TECHNOLOGICAL CHARACTERISTICS
The following tables summarize similarities and differences between the Platelia™ Aspergillus EIA (Catalog #62793) and Platelia™ Aspergillus EIA (K023857):
| Table 1(a) Similarities between intended use | ||||
|---|---|---|---|---|
| -- | ----------------------------------------------- | -- | -- | -- |
| Similarities inFunction and Use | Platelia™ Aspergillus EIA,Catalog 62793 | Platelia™ Aspergillus EIA(K023857) |
|---|---|---|
| Intended Use | Galactomannan antigendetection in serum. | Galactomannan antigendetection in serum. |
| Matrix | Serum | Serum |
Table 1(b) Differences between intended use
| Differences inFunction and Use | Platelia™ Aspergillus EIA,Catalog 62793 | Platelia™ Aspergillus EIA(K023857) |
|---|---|---|
| Intended Use | Detection of galactomannan antigen in adult and pediatric serum samples. | Detection of Aspergillus galactomannan antigen in serum samples. |
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| Table 2 Similarities between reagents and materials | |||||
|---|---|---|---|---|---|
| -- | ----------------------------------------------------- | -- | -- | -- | -- |
| Similarities inComponents /Materials | Platelia™ Aspergillus EIA,Catalog 62793 | Platelia™ Aspergillus EIA(K023857) |
|---|---|---|
| Microplate | 96 well microplate -antibody coated microwells | 96 well microplate - antibodycoated microwells |
| Reagents | Conjugate, Wash Buffer,Substrate, TMB Chromogen,Sample Diluent, PositiveControl, Stop Solution. | Conjugate, Wash Buffer,Substrate, TMB Chromogen.Sample Diluent, PositiveControl, Stop Solution. |
Table 3(a) Similarities between assay procedures.
| Similarities inAssay Procedures | Platelia™ Aspergillus EIA,Catalog 62793 | Platelia™ Aspergillus EIA(K023857) |
|---|---|---|
| Incubationtemperature of themicroplate afteraddition of theconjugate and thetreated sera. | Incubation temperature: 37°C | Incubation temperature: 37°C |
| Incubation time ofthe microplate afteraddition of theconjugate and thetreated sera. | Incubation time: 90 ± 5minutes | Incubation time: 90 ± 5minutes |
Table 3(b) Differences between assay procedures.
| Differences inAssay Procedures | Platelia™ Aspergillus EIA,Catalog 62793 | Platelia™ Aspergillus EIA(K023857) |
|---|---|---|
| Method of treatmentof the sera | Use of either heat block orboiling water bath fortreatment of the sera. | Use of boiling water bath fortreatment of the sera. |
| Time andtemperature oftreatment | Heat block : 120℃ for 6 minBoiling water bath: 100℃for 3 min | Boiling water bath: 100℃ for 3min |
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| Table 4 Differences between Available Kit Configurations | ||
|---|---|---|
| ---------------------------------------------------------- | -- | -- |
| Differences inComponents /Materials | Platelia™ Aspergillus EIA,Catalog 62793 | Platelia™ Aspergillus EIA(K023857) |
|---|---|---|
| AvailableConfiguration ofTest Kits | Catalog # 62793 96 Test Kit | Catalog # 62793 96 Test Kitand Catalog # 62794 480 TestKit |
Table 5 Differences between Limitations of the Procedure
| Differences inLimitations of theProcedure | Platelia™ Aspergillus EIA,Catalog 62793 | Platelia™ Aspergillus EIA(K023857) |
|---|---|---|
| Limitation | Warning regarding positivetest results in patients beingtreated with Zosyn® andsemi-synthetic ß-lactams. | Warning regarding positive testresults in patients being treatedwith Zosyn®. |
Table 6 Differences between Reference Publications
| Differences inReferencePublications | Platelia™ Aspergillus EIA,Catalog 62793 | Platelia™ Aspergillus EIA(K023857) |
|---|---|---|
| Publications | Publications by Ascioglu etal, Marr et al, Mattei et aland Upton et al added. | - |
PERFORMANCE SUMMARY
I. EXPECTED VALUES
The expected prevalence of Invasive Aspergillosis varies with the patient population; rates from 5-20% have been reported 4,7
The following results have been obtained from clinical studies conducted on pediatric (age ≤ 21 years) patients in the United States and on adult patients (age >22 years) in North America.
A .- Pediatrics
A clinical study was conducted on a total of 1954 serum samples from 129 immunocompromised pediatric (Age ≤ 21 years) patients, at high risk for Invasive Aspergillosis (IA) and patients diagnosed with Proven and Probable Invasive Aspergillosis, at three testing centers in the United States to determine the performance characteristics of the Platelia™ Aspergillus EIA. The distribution of index for these populations is shown in the following charts:
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Pediatric Patients diagnosed without Invasive Aspergillosis (control population)
A total of 1625* pediatric serum samples obtained from 108 immunocompromised pediatric patients at three testing centers in the United States were tested to determine the performance characteristics of the Platelia™ Aspergillus EIA. The distribution of index values for samples is shown in the following chart:
Image /page/4/Figure/2 description: The image is a bar graph titled "Distribution of the Serum Index Value from the Pediatric Control Population (N=1625)". The x-axis is labeled "Index" and shows values ranging from 0-0.1 to >1.5. The y-axis is labeled "Number of Sera" and ranges from 0 to 900. The bar graph shows that the highest number of sera is in the 0.1-0.2 range, with a value of 805.
Image /page/4/Figure/3 description: The image shows the text "Figure 1" in a simple, sans-serif font. The word "Figure" is capitalized, and the number "1" follows it. The text is black against a white background.
*Note: 80 samples, from 4 control patients with positive galactomannan antigen results coinciding with piperacillin / tazobactam (Zosyn®) therapy were excluded.
Pediatric Patients with Invasive Aspergillosis
The scatter plot depicts galactomannan assay results for the 249 serum samples from 17 patients in this study diagnosed with proven or probable Invasive Aspergillosis as defined by EORTC/NIAID definitions.
Not every serum sample from each patient is expected to be positive. The expected prevalence of Invasive Aspergillosis varies with the patient population; rates from 5-20% have been reported3 6. The prevalence rate of this study was 13.6%.
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Image /page/5/Figure/0 description: The image shows the text "Figure 2" in a simple, sans-serif font. The word "Figure" is capitalized, and the number "2" follows it. The text is black against a white background.
Image /page/5/Figure/1 description: This image shows a scatter plot titled "Pediatric Proven/Probable Aspergillosis: Distribution of Index/Pediatric Patient (N=17)". The x-axis is labeled "Patient Number" and ranges from 0 to 18. The y-axis is labeled "Index" and ranges from 0.0 to >2.0, with a horizontal line at 0.5.
B. Adults
Note: Reproducibility Studies were previously presented in prior 510(k) submission (K023857) for this assay, no new reproducibility studies have been performed.
A clinical study was previously conducted on a total of 1724 serum samples from 172 bone marrow transplant (BMT) and leukemic patients diagnosed with and without Invasive Aspergillosis, at three testing centers in North America to determine the performance characteristics of the Platelia™ Aspergillus EIA. The distribution of index values for these populations is represented in the following charts.
Adult Patients diagnosed without Invasive Aspergillosis (control population)
A total of 1262 serum samples obtained from 143 bone marrow transplant (BMT) and leukemic patients at three testing centers in North America were previously tested with the Platelia™ Aspergillus EIA test. The distribution of index values is shown in the following chart.
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Image /page/6/Figure/0 description: The image shows the text "Figure 3" in a simple, sans-serif font. The word "Figure" is capitalized, and the number "3" is placed directly after it. The text is black against a white background.
Image /page/6/Figure/1 description: The image is a bar graph titled "Distribution of the Serum Index Value from the Adult Control Population (N=1262)". The x-axis is labeled "Index" and shows index ranges from 0-0.1 to >1.5. The y-axis is labeled "Number of Sera" and ranges from 0 to 800. The bar graph shows that the majority of the adult control population has a serum index value between 0.1 and 0.2, with 662 people falling into this range.
Adult Patients diagnosed with Invasive Aspergillosis
Note: Reproducibility Studies were previously presented in prior 510(k) submission (K023857) for this assay, no new reproducibility studies have been performed.
This scatter plot depicts galactomannan assay results for the 462 serum samples from 29 patients in this study diagnosed with proven or probable Invasive Aspergillosis as defined by EORTC/NIAID definitions. Not every serum sample from each patient is expected to be positive. The expected prevalence of Invasive Aspergillosis varies with the patient population; rates from 5-20% have been reported 4.7. The prevalence rates for this previous study was 16.9%.
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Image /page/7/Figure/0 description: The image shows the text "Figure 4". The text is written in a simple, sans-serif font and is black. The background is white.
Image /page/7/Figure/1 description: This image is a scatter plot titled "Adult Proven/ Probable Aspergillosis: Distribution of Index/ Adult Patient (N=29)". The x-axis is labeled "Patient Number" and ranges from 0 to 30. The y-axis is labeled "Index" and ranges from 0.0 to greater than or equal to 2.0, with a horizontal line at 0.5.
The following graphs represent examples of a patient without clinical signs or symptoms of Invasive Aspergillosis (negative for Aspergillus) and a patient with proven or probable Invasive Aspergillosis (positive for Aspergillus) respectively.
Negative patient
Image /page/7/Figure/4 description: The image is a graph titled "CONTROL PATIENT" with "Days" on the x-axis and "Index" on the y-axis. The y-axis ranges from 0 to 1.6, and there is a horizontal line at the index of 0.5. The graph shows a fluctuating line that generally stays below the index of 0.2, with a few peaks around days 22, 32, and 52.
Platelia™ Aspergillus EIA (K060641) 510(k) Summary
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Positive patient
Image /page/8/Figure/1 description: The image is a graph titled "PROVEN INVASIVE ASPERGILLOSIS PATIENT". The x-axis is labeled "Days" and ranges from 0 to 60. The y-axis is labeled "Index" and ranges from 0 to 1.6. The graph shows a line plot with data points indicating the index value over time, with a horizontal line at the 0.5 index value.
II. REPRODUCIBILITY STUDIES
Note: Reproducibility Studies were previously presented in prior 510(k) submission (K023857) for this assay, no new reproducibility studies have been performed.
Inter-assay and Intra-assay variability for the Platelia™ Aspergillus EIA were determined in a study using a panel of 6 pooled patient serum samples (one negative, one low positive, two positive, and two high positive) obtained at 3 clinical trial sites in North America. Each of the 6 panel members was tested in triplicate (x3) on 3 different days, on one lot, at two sites (total number of replicates at each site = 9). Each of the 6 panel members was tested in duplicate (x2) on 3 different days, on 1 lot, at a third site (total number of replicates at the third site = 6). One (1) operator performed all precision testing at each site. The data were analyzed according to the National Committee for Clinical Laboratory Standards (NCCLS).
The mean optical density (OD) and mean index value, standard deviation (SD), percent coefficient of variation (%CV), within run precision (intraassay) and within site (interassay) precision for each panel member at each site are illustrated below in the following tables.
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| Site | Panel Member | Neg | Low Pos | Pos #1 | Pos #2 | High Pos#1 | High Pos #2 | Neg Control | CO Control | Pos Control | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OD | Index | OD | Index | OD | Index | OD | Index | OD | Index | OD | Index | OD | Index | OD | Index | OD | Index | ||
| Site 1 | N | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 3 | 3 | 6 | 6 | 3 | 3 |
| Mean | 0.052 | 0.09 | 0.445 | 0.74 | 0.702 | 1.17 | 0.931 | 1.563 | 1.227 | 2.06 | 2.887 | 4.83 | 0.046 | 0.08 | 0.606 | 1.00 | 2.216 | 3.67 | |
| Within Run(Intra-assay) SD | 0.002 | 0.00 | 0.022 | 0.03 | 0.059 | 0.09 | 0.044 | 0.08 | 0.051 | 0.09 | 0.089 | 0.17 | N/A | N/A | 0.02 | 0.03 | N/A | N/A | |
| %CV | N/A | N/A | 4.8% | 4.4% | 8.4% | 7.6% | 4.7% | 5.1% | 4.2% | 4.4% | 3.1% | 3.6% | N/A | N/A | 3.7% | 3.4% | N/A | N/A | |
| Total(Inter-assay) SD | 0.036 | 0.04 | 0.051 | 0.08 | 0.070 | 0.14 | 0.044 | 0.25 | 0.058 | 0.29 | 0.169 | 0.58 | N/A | N/A | 0.102 | 0.03 | 0.317 | 0.12 | |
| %CV | N/A | N/A | 11.5% | 10.4% | 10.0% | 11.6% | 4.7% | 15.7% | 4.7% | 14.3% | 5.9% | 11.9% | N/A | N/A | 16.9% | 2.8% | 14.3% | 3.3% | |
| Site 2 | Panel Member | ||||||||||||||||||
| N | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 9 | 3 | 3 | 6 | 6 | 3 | 3 | |
| Mean | 0.040 | 0.10 | 0.280 | 0.70 | 0.364 | 0.89 | 0.602 | 1.49 | 0.801 | 2.01 | 1.361 | 3.43 | 0.074 | 0.18 | 0.415 | 1.00 | 1.197 | 2.97 | |
| Within Run(Intra-assay) SD | 0.006 | 0.01 | 0.041 | 0.09 | 0.023 | 0.07 | 0.045 | 0.11 | 0.046 | 0.10 | 0.047 | 0.11 | N/A | N/A | 0.00 | 0.01 | N/A | N/A | |
| %CV | N/A | N/A | 14.5% | 13.0% | 6.4% | 7.6% | 7.5% | 7.1% | 5.7% | 4.8% | 3.5% | 3.2% | N/A | N/A | 1.1% | 1.1% | N/A | N/A | |
| Total(Inter-assay) SD | 0.006 | 0.03 | 0.058 | 0.19 | 0.083 | 0.18 | 0.057 | 0.28 | 0.042 | 0.53 | 0.079 | 1.00 | N/A | N/A | 0.094 | 0.01 | 0.068 | 0.54 | |
| %CV | N/A | N/A | 20.8% | 27.3% | 22.7% | 19.8% | 9.5% | 18.7% | 5.3% | 26.5% | 5.8% | 29.2% | N/A | N/A | 22.7% | 0.9% | 5.7% | 18.2% | |
| Site 3 | Panel Member | ||||||||||||||||||
| N | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 3 | 3 | 6 | 6 | 3 | 3 | |
| Mean | 0.049 | 0.10 | 0.388 | 0.81 | 0.652 | 1.36 | 0.830 | 1.73 | 1.158 | 2.41 | 2.378 | 4.96 | 0.059 | 0.12 | 0.480 | 1.00 | 1.652 | 3.45 | |
| Within Run(Intra-assay) SD | 0.003 | 0.01 | 0.009 | 0.02 | 0.082 | 0.17 | 0.068 | 0.14 | 0.094 | 0.20 | 0.126 | 0.25 | N/A | N/A | 0.028 | 0.06 | N/A | N/A | |
| %CV | N/A | N/A | 2.4% | 2.4% | 12.5% | 12.2% | 8.2% | 8.2% | 8.1% | 8.2% | 5.3% | 5.1% | N/A | N/A | 5.8% | 5.8% | N/A | N/A | |
| Total(Inter-assay) SD | 0.012 | 0.03 | 0.078 | 0.13 | 0.068 | 0.15 | 0.104 | 0.25 | 0.082 | 0.15 | 0.111 | 0.34 | N/A | N/A | 0.028 | 0.04 | 0.056 | 0.23 | |
| %CV | N/A | N/A | 20.0% | 15.8% | 10.5% | 11.1% | 12.5% | 14.3% | 7.1% | 6.2% | 4.7% | 6.8% | N/A | N/A | 5.8% | 4.1% | 3.4% | 6.6% |
N/A = not opplicable
NCCLS EP5-A, Vol. 19, No. 2. Page 24, Equation (C2)
NCCLS EPS-A, Vol. 19, No 2. Page 25, Equation (C3) and Equation (C4)
III. CROSS-REACTIVITY STUDIES
Note: Cross-Reactivity Studies were previously presented in prior 510(k) submission (K023857) for this assay, no new cross-reactivity studies have been performed.
A study to evaluate the effect of potentially interfering medical conditions unrelated to Invasive Aspergillosis was performed with one lot of the Platelia™ Aspergillus EIA kit. The following serum samples were tested for cross-reactivity with the Platelia™ Aspergillus EIA. A total of 151 sera were tested.
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| Pathology | # Samples Tested | # Positives |
|---|---|---|
| Rheumatoid Factor | 10 | 0 |
| ANA Positive | 10 | 0 |
| IgG Hypergammaglobulinemia | 10 | 0 |
| IgM Hypergammaglobulinemia | 10 | 0 |
| Cancer* | 11 | 0 |
| Non-Viral Cirrhosis (primary biliary;alcohol induced; drug induced) | 10 | 0 |
| Multiple Transfusions | 10 | 0 |
| Multiparous Females | 10 | 0 |
| HAV | 10 | 0 |
| HCV | 10 | 0 |
| Rubella | 10 | 0 |
| CMV | 10 | 0 |
| Syphilis (RPR+) | 10 | 0 |
| Toxoplasmosis | 10 | 0 |
| Mycoplasma | 10 | 0 |
- One each of bladder, breast(2), colon, endometrial, lung, prostate, renal, and squamous(3).
IV. PERFORMANCE EVALUATION STUDIES
Additional clinical testing to evaluate the specificity and sensitivity of the Platelia™ Aspergillus EIA was conducted at 3 clinical sites located in the United States for the pediatric (Age ≤ 21 years ) population. This testing was performed in addition to the testing done for prior submission (K023857) for adult patients. The study was conducted using samples from the following patient populations*:
- patients without signs of Invasive Aspergillosis ●
- patients with probable Invasive Aspergillosis ●
- patients with proven Invasive Aspergillosis .
- The Invasive Fungal Infection Cooperative Group (IFICG) of the European Organization for Research (EORTC) and the Mycosis Study Group (MSG of the National Institute of Allergy and Infectious Diseases (NIAID) have defined criteria for diagnosis of Invasive Aspergillosis (IA) in patients with hematologic malignancy or hematopoetic stem cell transplant.
Proven Invasive Aspergillosis is defined by positive microbiological culture obtained by sterile procedure from the site affected, and histopathological demonstration of the appropriate morphological forms in a host with symptoms attributed to the fungal infection.
Probable Invasive Aspergillosis is defined as at least one microbiological criterion, and one major or two minor clinical criteria from a site consistent with infection, in a host
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with symptoms attributed to the fungal infection.
Possible Invasive Aspergillosis is defined as at least one microbiological criterion, or one major or two minor clinical criteria from a site consistent with infection, in a host with symptoms attributed to the fungal infection
SENSITIVITY
A. PEDIATRICS
Results from this study have been analyzed in terms of patient sensitivity. Sensitivity testing was conducted using the Platelia™ Aspergillus EIA at three sites on a combined total of 17 immunocompromised pediatric patients diagnosed with Proven or Probable Invasive Aspergillosis.
Table 3
| DIAGNOSIS | NUMBER OFPATIENTS | SENSITIVITY | 95%CONFIDENCEINTERVAL |
|---|---|---|---|
| Proven Aspergillosis | 9 | 44.4% (4/9) | 18.9-73.3% |
| Probable Aspergillosis | 8 | 62.5% (5/8) | 30.6-86.3% |
| Combined Proven andProbable Aspergillosis | 17* | 52.9% (9/17) | 31.0-73.8% |
*Note: 9 of the 17 patients gave negative Aspergillus galactomannan antigen results. All of the 9 patients with negative Aspergillus galactomannan antigen results received therapy with multiple antifungal agents. The concomitant use of mold-active anti-fungal therapy in some patients with Invasive Aspergillosis may result in reduced sensitivity 13
B. ADULTS
Note: Reproducibility Studies were previously presented in prior 510(k) submission (K023857) for this assay, no new reproducibility studies have been performed.
Sensitivity testing was previously conducted using the Platelia™ Aspergillus EIA at three sites on a combined total of 29 Bone Marrow Transplant (BMT) and Leukemia adult patients diagnosed with Proven or Probable Invasive Aspergillosis.
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Table 4
| DIAGNOSIS | NUMBER OFPATIENTS | SENSITIVITY | 95% CONFIDENCEINTERVAL |
|---|---|---|---|
| Proven Aspergillosis | 11 | 81.8% (9/11) | 52.3-94.9% |
| Probable Aspergillosis | 18 | 77.8% (14/18) | 54.8-91.0% |
| Combined Proven andProbable Aspergillosis | 29 | 79.3% (23/29) | 61.6-90.2% |
SPECIFICITY
SPECIFICITY BY PEDIATRIC PATIENTS
Specificity testing was conducted using the Platelia™ Aspergilllus EIA at three sites on a combined total of 108* immunocrompomised pediatric patients without signs of Invasive Aspergillosis (control patients).
Table 5
| SITE | NUMBER OFPATIENTS | SPECIFICITY | 95% CONFIDENCEINTERVAL |
|---|---|---|---|
| 1 | 44 | 86.4 % (38/44) | 73.3-93.6% |
| 2 | 59 | 86.4%(51/59) | 75.5-93.0% |
| 3 | 5 | 100% (5/5) | 56.6-100% |
| Combined Sites | 108 | 87.0%(94/108) | 79.4-92.1% |
*Note: 4 patients with positive galactomannan antigen results coinciding with piperacillin / tazobactam therapy were excluded.
SPECIFICITY BY PEDIATRIC SAMPLES
Specificity testing was conducted using the Platelia™ Aspergilllus EIA at three sites on a combined total of 1625* samples obtained from 108 immunocrompomised pediatric patients without signs of Invasive Aspergillosis (control patients).
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Table 6
| SITE | NUMBER OFSAMPLES | SPECIFICITY | 95% CONFIDENCEINTERVAL |
|---|---|---|---|
| 1 | 794 | 98.9%(785/794) | 97.9-99.4% |
| 2 | 731 | 97.8%(715/731) | 96.5-98.6% |
| 3 | 100 | 100% (100/100) | 96.3-100% |
| Combined Sites | 1625 | 98.5% (1600/1625) | 97.7-99.0% |
*Note: 80 samples from 4 patients with positive galactomannan antigen results coinciding with piperacillin / tazobactam therapy were excluded.
SPECIFICITY BY ADULT PATIENTS
Note: Reproducibility Studies were previously presented in prior 510(k) submission (K023857) for this assay, no new reproducibility studies have been performed.
Specificity testing was previously conducted using the Platelia™ Aspergillus EIA at three sites on a combined total of 143 Bone Marrow Transplant (BMT) and Leukemia adult patients without signs of Invasive Aspergillosis (control patients).
Table 7
| SITE | NUMBER OFPATIENTS | SPECIFICITY | 95% CONFIDENCEINTERVAL |
|---|---|---|---|
| 1 | 28 | 78.6% (22/28) | 60.5-89.8% |
| 2 | 77 | 93.4% (71/77) | 84.0-96.4% |
| 3 | 38 | 89.5% (34/38) | 75.9-95.8% |
| Combined Sites | 143 | 88.8% (127/143) | 82.6-93.0% |
SPECIFICITY BY ADULT SAMPLES
Note: Reproducibility Studies were previously presented in prior 510(k) submission (K023857) for this assay, no new reproducibility studies have been performed.
Specificity testing was previously conducted using the Platelia™ Aspergillus EIA at three sites on a combined total of 1262 samples obtained from 143 Bone Marrow Transplant (BMT) and Leukemia adult patients without signs of Invasive Aspergillosis (control patients).
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Table 8
| SITE | NUMBER OFSAMPLES | SPECIFICITY | 95% CONFIDENCEINTERVAL |
|---|---|---|---|
| 1 | 349 | 98.0% (342/349) | 95.9-99.0% |
| 2 | 560 | 98.6% (552/560) | 97.2-99.3% |
| 3 | 353 | 98.9% (349/353) | 97.1-99.6% |
| Combined Sites | 1262 | 98.5% (1243/1262) | 97.7-99.0% |
PREDICTIVE VALUE
Positive and negative predictive values have been analyzed for the two patient populations. Based on the actual average of 13.6% prevalence rate in pediatrics and 16.9% prevalence rate in adults observed in this study, positive and negative predictive values have been calculated as below:
A. PEDIATRICS
Study Prevalence 13.6%
| PPV: 39.1% | 95% Confidence Interval : 22.2-59.2% |
|---|---|
| NPV: 92.2% | 95% Confidence Interval : 85.3-96.0% |
B. ADULTS
Study Prevalence 16.9%
| PPV: 59.0% | 95% Confidence Interval: | 43.4-72.9% |
|---|---|---|
| NPV: 95.5% | 95% Confidence Interval: | 90.5-97.9% |
The expected prevalence of Invasive Aspergillosis varies with the patient population: rates from 5-20% have been reported 47. For patient populations on the lower end of the published prevalence, the positive and negative prevalence have been re-calculated using a 5% prevalence rate.
A. PEDIATRICS
Calculated Prevalence 5%
| PPV : 17.6% | 95% Confidence Interval : 6.5-39.8% |
|---|---|
| NPV : 97.2% | 95% Confidence Interval : 92.1-99.1% |
B. ADULTS
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Calculated Prevalence 5%
:
.
:
:
.
PPV: 27.2% 95% Confidence interval: 13.7-46.7% NPV: 98.8% 95% Confidence Interval: 95.4-99.7%
Platelia™ Aspergillus EIA (K060641) 510(k) Summary
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:
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DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/16/Picture/1 description: The image is a black and white logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle. The eagle is facing to the right. The logo is simple and clean, and it is easily recognizable.
Public Health Service
Food and Drug Administration 2098 Gaither Road Rockville MD 20850
JUN 2 2006
Ms. Priya Bondre Regulatory Affairs Representative Bio-Rad Laboratories Diagnostics Group 6565 185th Avenue, NE Redmond. WA 98052
Re: K060641
Trade/Device Name: Platelia™ Aspergillus EIA Regulation Number: 21 CFR 866.3040 Regulation Name: Aspergillus Spp. Serological Reagents Regulatory Class: Class I Product Code: NOM Dated: February 28, 2006 Received: March 10, 2006
Dear Ms. Bondre:
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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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.
Sally, a story
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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Bio-Rad Laboratories Platelia™ Aspergillus EIA Premarket 510(k) Notification February 28, 2006
Indications for Use
510(k) Number (if known): Not known at this time
Device Name: Platelia™ Aspergillus EIA
Indications For Use:
The Platelia™ Aspergillus ElA is an immunoenzymatic sandwich microplate assay for the detection of Aspergillus galactomannan antigen in adult and pediatric serum samples.
The Platelia™ Aspergillus ElA is a test which, when used in conjunction with other diagnostic procedures such as microbiological culture, histological examination of biopsy samples and radiographic evidence, can be used as an aid in the diagnosis of invasive aspergillosis.
Prescription Use X (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)
Freddie he Poole
Division Sign off
ivision Sign-Off
Office of In Vitro Diagnostic Device Evaluation and Safety
510(k) Kob 064
§ 866.3040
Aspergillus spp. serological reagents.(a)
Identification. Aspergillus spp. serological reagents are devices that consist of antigens and antisera used in various serological tests to identify antibodies toAspergillus spp. in serum. The identification aids in the diagnosis of aspergillosis caused by fungi belonging to the genusAspergillus. Aspergillosis is a disease marked by inflammatory granulomatous (tumor-like) lessions in the skin, ear, eyeball cavity, nasal sinuses, lungs, and occasionally the bones.(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 § 866.9.