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510(k) Data Aggregation

    K Number
    K243846
    Device Name
    Access anti-HAV
    Date Cleared
    2025-09-09

    (267 days)

    Product Code
    Regulation Number
    866.3310
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Access anti-HAV assay is a paramagnetic particle, chemiluminescent immunoassay for the in vitro qualitative detection of total antibodies (anti-HAV IgG and IgM) to hepatitis A virus (HAV) in human pediatric (2 through 21 years) and adult serum and serum separator tubes or plasma [lithium heparin, lithium heparin separator tubes, sodium citrate, acid-citrate-dextrose (ACD), and citrate phosphate-dextrose (CPD)] using the Dxl 9000 Access Immunoassay Analyzer.

    The Access anti-HAV assay is indicated as an aid in the diagnosis of current or past HAV infection in persons with risk factors and/or signs or symptoms of hepatitis A, when used in conjunction with other serological and clinical information. The assay may also be used in the identification of HAV susceptible individuals and to determine the presence of an antibody response to HAV in vaccine recipients.

    This assay is not intended for use for screening donors of blood or blood products or human cells, tissues, or cellular or tissue-based products (HCT/Ps).

    Device Description

    The Access anti-HAV assay requires Access anti-HAV (reagent packs), Access anti-HAV Calibrator (C1), and Access anti-HAV QC (QC1-QC2). The Access anti-HAV assay is a two-step competitive immunoassay. During incubation, the anti-HAV antibodies present in the patient sample bind to the coated antigen. After incubation in a reaction vessel, materials bound to the solid phase are held in a magnetic field while unbound materials are washed away. A monoclonal anti-HAV antibody alkaline phosphatase conjugate is added to the reaction vessel and the conjugate competes with the bound patient antibodies to affix the HAV antigen coated on the particles. After a second incubation and wash step, the chemiluminescent substrate is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is compared to the cutoff value defined during calibration. The Qualitative assessment is automatically determined from a stored calibration.

    Quality control (QC) materials simulate the characteristics of patient samples and are essential for monitoring the system performance of the Access anti-HAV immunoassay. In addition, they are an integral part of good laboratory practices. When performing assays with Access reagents for anti-HAV, include quality control materials to validate the integrity of the assay. The assayed values should fall within the acceptable range if the test system is working properly.

    The Access anti-HAV reagents are provided in liquid ready-to-use format designed for optimal performance on the Beckman Coulter DxI 9000 Access Immunoassay Analyzer only. Each reagent kit contains two reagent packs. The Access anti-HAV Calibrator kit contains one vial, and the Access anti-HAV QC kit contains three vials, each of anti-HAV positive control and anti-HAV negative control. Other items needed to run the assay include Lumi-Phos PRO (chemiluminescent substrate) and UniCel DxI Wash Buffer II.

    AI/ML Overview

    N/A

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    K Number
    K243483
    Device Name
    Access hsTnI
    Date Cleared
    2025-08-01

    (266 days)

    Product Code
    Regulation Number
    862.1215
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    Access hsTnI is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of cardiac troponin I (cTnI) levels in human serum and plasma using the Unicel DxI Immunoassay Systems to aid in the diagnosis of myocardial infarction (MI).

    Device Description

    The Access hsTnI is a two–site immunoenzymatic ("sandwich") assay. Monoclonal anti–cTnI antibody conjugated to alkaline phosphatase is added to a reaction vessel along with a surfactant–containing buffer and sample. After a short incubation, paramagnetic particles coated with monoclonal anti–cTnI antibody are added. The human cTnI binds to the anti–cTnI antibody on the solid phase, while the anti–cTnI antibody–alkaline phosphatase conjugate reacts with different antigenic sites on the cTnI molecules. After incubation, materials bound to the solid phase are held in a magnetic field while unbound materials are washed away. Then, the chemiluminescent substrate is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is directly proportional to the concentration of analyte in the sample. Analyte concentration is automatically determined from a stored calibration.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and study information for the Access hsTnI device, based on the provided FDA 510(k) clearance letter:

    Acceptance Criteria and Reported Device Performance

    Acceptance Criteria CategoryAcceptance CriteriaReported Device Performance (Access hsTnI Candidate on UniCel DxI 800)
    Method ComparisonSlope of Passing-Bablok linear regression model: 1.00 ± 0.10Met acceptance criteria (exact slope not provided, but stated that the study "met the acceptance criteria of slope 1.00 ± 0.10"). Bias data supported that reference intervals have not changed appreciably from the commercialized product.
    ImprecisionWithin-laboratory (total) CV: ≤ 10% for concentrations ≥ 11.5 pg/mLWithin-laboratory (total) SD: ≤ 1.15 pg/mL for concentrations < 11.5 pg/mLWithin-laboratory (total) % CV ranged from 3% to 4% for Access hsTnI concentrations ≥ 11.5 pg/mL. The within-laboratory (total) SD was 0.48 pg/mL for Access hsTnI concentration < 11.5 pg/mL.
    LinearityFor each sample concentration range, the higher order (2nd or 3rd) term of the polynomial fit should be non-significant (p > 0.05). If significant, the fit of the polynomial regression demonstrating significance should have ≤ 10% bias across the analytical measuring range.The analysis of the data found that across the UniCel DxI 800 instruments, and for each sample concentration range, the higher order (2nd or 3rd) term of the polynomial fit is non-significant (p > 0.05), and if significant, the fit of the polynomial regression demonstrating significance had ≤ 10% bias across the analytical measuring range.
    LoB/LoDNot explicitly stated as an "acceptance criteria" but limits are reported for the predicate.LoB estimate of the Access hsTnI is 1.5 (serum and plasma).LoD estimate of the Access hsTnI is 1.8 (serum and plasma).
    LoQNot explicitly stated as an "acceptance criteria" but limits are reported for the predicate.The LoQ for Access hsTnI at ≤20% within-lab CV was determined to be 1.3 pg/mL (serum) and 1.2 pg/mL (plasma).
    CarryoverNot explicitly stated as an "acceptance criteria" for numeric limits, but the sponsor performed studies and included a limitation in labeling acknowledging observed carryover.When a sample with cTnI > 150,000 pg/mL (ng/L) was tested, intra-assay carryover was observed if an Access hsTnI was tested after a high cTnI sample. Estimated carryover was 3-5 pg/mL (ng/L) from a high sample at 270,000 pg/mL (ng/L) and 5-8 pg/mL (ng/L) from a high sample at 500,000 pg/mL (ng/L). Limitation statements related to carryover are to be added.
    Analytical Measuring Range2.3 pg/mL to 27,027 pg/mL (Predicate)Similar (Candidate)

    Study Details

    The provided document describes a study primarily focused on demonstrating the substantial equivalence of the Access hsTnI assay when run on the UniCel DxI 800 Immunoassay System compared to its predicate device (Access hsTnI on the Access 2 Immunoassay System). This is achieved through performance testing of various analytical aspects.

    1. Sample Size Used for the Test Set and Data Provenance:

      • Method Comparison: 239 samples (119 Lithium Heparin Plasma and 120 Serum).
      • Data Provenance: Not specified (e.g., country of origin). The document indicates it's a retrospective comparison between the "IVD Access hsTnI (Current Assay Protocol File (APF))" and the "proposed Access hsTnI (Proposed APF)" on the UniCel DxI 800 instruments, implying existing samples or previously collected data.
    2. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts:

      • Not Applicable. This device is an in-vitro diagnostic (IVD) immunoassay for quantitative determination of cTnI levels. The "ground truth" for the test set in this context refers to the measured cTnI values, which are inherently quantitative and determined by the predicate device's method and the proposed device's method, not by expert consensus or interpretation of images/clinical findings.
    3. Adjudication Method for the Test Set:

      • Not Applicable. As noted above, this is a quantitative analytical method comparison, not a diagnostic interpretation or clinical outcome study that would require adjudication.
    4. 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 is an in-vitro diagnostic device, not an AI-based image interpretation or diagnostic aid system involving human readers.
    5. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done:

      • Yes, implicitly. The studies described (Method Comparison, Imprecision, Linearity, LoB/LoD, LoQ, Carryover) evaluate the performance of the analytical instrument and assay without human intervention in the measurement process. The device itself is an automated immunoassay system that produces quantitative results.
    6. The Type of Ground Truth Used:

      • The "ground truth" in this context refers to the quantitative measurements of cTnI levels themselves. For the method comparison, the predicate device (Access hsTnI on the Access 2 Immunoassay System, or the "Current Assay Protocol File (APF)" on the DxI 800) essentially serves as the reference for comparison against the "Proposed APF" on the UniCel DxI 800. Therefore, it's a comparison against an established, legally marketed reference measurement method.
    7. The Sample Size for the Training Set:

      • Not specified. This documentation primarily focuses on the validation of the device's analytical performance. While there would have been internal development and optimization (which could be considered "training"), the document does not distinguish a formal "training set" (as might be seen with AI/ML models) from "internal validation" data. The tested datasets described are for analytical validation.
    8. How the Ground Truth for the Training Set Was Established:

      • Not specified / Not applicable in the traditional sense. As an IVD assay, the "ground truth" for developing such a test is the accurate quantitative measurement of the analyte (cTnI) in biological samples, requiring highly controlled reference methods and materials. The document indicates the device's principle is a "two-site immunoenzymatic ('sandwich') assay," which is a well-established biochemical technique. The development process would involve extensive characterization against reference standards and known concentrations, rather than establishing ground truth through, for example, expert labeling of clinical data.
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    K Number
    K242022
    Device Name
    Access Toxo IgG
    Date Cleared
    2025-03-28

    (260 days)

    Product Code
    Regulation Number
    866.3780
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Access Toxo IgG assay is a paramagnetic-particle, chemiluminescent immunoassay for the qualitative and quantitative determination of IgG antibodies to Toxoplasma gondii in human serum using the Access Immunoassay Systems. The Access Toxo IgG assay aids in the diagnosis of Toxoplasma gondii infection and may be used to assess the immune status of pregnant women.

    This product is not FDA cleared/approved for the screening of blood or plasma donors. Assay performance characteristics have not been established for immunocompromised or immunosuppressed patients, cord blood, neonatal specimens or infants.

    Device Description

    The Access Toxo IgG assay is a paramagnetic-particle, chemiluminescent immunoassay for the qualitative and quantitative detection of Toxoplasma gondii-specific IgG antibody in adult human serum using the Access Immunoassay Systems.

    The Access Toxo IgG assay consists of the reagent pack, calibrators, and quality controls (OCs), packaged separately. Other items needed to run the assay include substrate and wash buffer.

    AI/ML Overview

    This document describes the premarket notification (510(k)) for the Beckman Coulter Access Toxo IgG assay, a chemiluminescent immunoassay for detecting IgG antibodies to Toxoplasma gondii in human serum. This product is intended to aid in the diagnosis of Toxoplasma gondii infection and assess the immune status of pregnant women.

    The submission claims substantial equivalence to a legally marketed predicate device, the Access Toxo IgG assay (K080869). The primary difference highlighted is the instrument used: the new device runs on the DxI 9000 Access Immunoassay Analyzer, while the predicate runs on the Access 2 Immunoassay System.

    Here's an analysis of the provided information, focusing on the study that proves the device meets the acceptance criteria:

    1. Table of Acceptance Criteria and Reported Device Performance

    Strictly speaking, the document does not present "acceptance criteria" in a separate table with yes/no compliance. Instead, it details specific performance metrics and their measured values. The implicit acceptance criterion for most analytical performance studies (like imprecision and method comparison) is that the new device's performance is acceptable for its intended use and comparable to or better than the predicate. For Linearity, LoB, LoD, and LoQ, the acceptance criterion is that the study supports the claimed values.

    Performance CharacteristicAcceptance Criteria (Implicit from Study Design/Claims)Reported Device Performance (Access Toxo IgG on DxI 9000)
    Method Comparison (vs. Access 2 Immunoassay System)High Positive Percent Agreement (PPA) and Negative Percent Agreement (NPA) to demonstrate interchangeability between instruments.PPA: 100.00% (40/40) with 95% CI = 91.24% to 100% (for Reactive samples) NPA: 100.00% (99/99) with 95% CI = 96.26% to 100.00% (for Non-Reactive samples)
    Imprecision (Within-Laboratory)SD < 0.64 IU/mL at concentrations < 3.2 IU/mL; CV < 20.0% at concentrations > 3.2 IU/mL. (These are the design criteria mentioned, implying they are the acceptance threshold.)Sample 1 (2.7 IU/mL): Overall Precision SD 0.38 (13.9% CV) - Meets SD criterion (0.38 < 0.64) Samples 2-6 (8.3 - 361.0 IU/mL): Overall Precision CVs range from 9.6% to 12.1% - Meets CV criterion (all < 20.0%)
    Imprecision (Reproducibility / Between-Instrument)Not explicitly stated as a separate numerical criterion beyond the general imprecision goal, but implicitly to show consistent performance across instruments.Sample 1 (2.5 IU/mL): Reproducibility SD 0.29 (11.9% CV) Samples 2-6 (7.9 - 377.5 IU/mL): Reproducibility CVs range from 8.9% to 13.4%
    LinearityDemonstrated linearity across the claimed measuring interval.Demonstrated linearity across the measuring interval of 3.2 - 450 IU/mL.
    Limit of Blank (LoB)Claimed value supported by study.0.8 IU/mL (claimed)
    Limit of Detection (LoD)Claimed value supported by study.1.5 IU/mL (claimed)
    Limit of Quantitation (LoQ)Claimed value supported by study.3.2 IU/mL (claimed)

    2. Sample Sizes Used for the Test Set and Data Provenance

    • Method Comparison:

      • Test Sample Size: 140 native serum samples.
      • Data Provenance: The document does not explicitly state the country of origin or whether the samples were retrospective or prospective. It refers to "native serum samples," which typically implies real-world patient samples.
    • Imprecision (Within-Laboratory):

      • Test Sample Size: 6 serum samples (analyzed across 240 replicates each).
      • Data Provenance: Not specified for origin or prospective/retrospective.
    • Imprecision (Reproducibility):

      • Test Sample Size: 6 serum samples (analyzed across 225 replicates each).
      • Data Provenance: Performed at an "internal site." Not specified for origin or prospective/retrospective.
    • Linearity, LoB, LoD, LoQ: The type and number of samples used for these studies are not specified, only that "a study" was performed and values were "claimed."

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

    This type of information (experts, qualifications) is primarily relevant for studies involving human interpretation or clinical diagnosis, such as imaging studies where radiologists establish ground truth.

    For this in vitro diagnostic (IVD) device (an immunoassay), the "ground truth" for the test results is established by the measurement itself and comparison to a reference method or validated system (the predicate device). There are no human experts involved in interpreting the raw assay output to establish ground truth for method comparison or analytical performance studies like imprecision. The "truth" is the analytical measurement obtained by the reference method (the predicate device or a highly characterized sample).

    4. Adjudication Method for the Test Set

    Not applicable. As this is an IVD immunoassay, not a human reader study, adjudication methods (like 2+1 or 3+1 for imaging reads) are not relevant here. The comparison is between two analytical instruments/systems.

    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 in vitro diagnostic immunoassay. It does not involve human readers interpreting images assisted by AI, nor is it an AI-driven device in the sense of image analysis. Its function is to quantitatively and qualitatively measure an analyte in a biological sample.

    6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) Was Done

    Yes, the primary studies listed (Method Comparison, Imprecision, Linearity, LoB, LoD, LoQ) are all "standalone" in the sense that they evaluate the analytical performance of the device itself (Access Toxo IgG assay on the DxI 9000 Access Immunoassay Analyzer) without human interpretation affecting the measurement outcome. The device's output is a quantitative (IU/mL) or qualitative (Reactive/Non-Reactive/Equivocal) result.

    7. The Type of Ground Truth Used (expert consensus, pathology, outcomes data, etc.)

    For the method comparison study, the "ground truth" was essentially the results obtained from the predicate device (Access Toxo IgG assay on the Access 2 Immunoassay System). The goal was to show that the new device on the new instrument produced comparable results to the already cleared predicate.

    For the analytical performance studies (Imprecision, Linearity, LoB, LoD, LoQ), the "ground truth" refers to the inherent analytical properties of the assay and instrument, which are determined by testing characterized samples (e.g., known concentrations for linearity, low-concentration samples for LoD/LoB).

    8. The Sample Size for the Training Set

    This document does not provide information about a "training set" in the context of machine learning or AI models. For IVD assays, "training" typically refers to the development and optimization process that precedes validation studies. The analytical performance studies presented here are primarily validation studies.

    9. How the Ground Truth for the Training Set Was Established

    Not applicable, as a "training set" in the context of AI/ML ground truth establishment is not relevant to this type of IVD device submission. Assay development and optimization for IVDs involve extensive R&D, but the concept of "ground truth for training" as seen in AI is not directly applicable to a chemical immunoassay.

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    K Number
    K242095
    Date Cleared
    2024-10-11

    (86 days)

    Product Code
    Regulation Number
    866.3780
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Access Toxo IgM II assay is a paramagnetic-particle chemiluminescent immunoassay for the qualitative detection of Toxoplasma gondii-specific IgM antibody in adult human serum and plasma using the Access Immunoassay Systems.

    The Access Toxo IgM II assay is presumptive for the diagnosis of acute, recent, or reactivated Toxoplasma gondii infection in males and pregnant females. It is recommended this assay be performed in conjunction with a Toxoplasma gondii-specific IgG antibody assay.

    Note: This assay has not been cleared/approved by the FDA for the screening of blood or plasma donors in the United States.

    Device Description

    The Access Toxo IgM II assay is a paramagnetic-particle chemiluminescent immunoassay for the qualitative detection of Toxoplasma gondii-specific IgM antibody in human serum and plasma using the Access Immunoassay Systems. The Access Toxo IgM II Calibrators are intended for use with the Access Toxo IgM II assay for the qualitative detection of Toxoplasma gondii-specific IgM antibody in adult human serum and plasma using the Access Immunoassay Systems. The Access Toxo IgM II QC is intended for monitoring system performance of the Access Toxo IgM II assay. The Access assay consists of the reagent pack, calibrators and QCs. Other items needed to run the assay include substrate and wash buffer. The Access assay reagent pack, Access assay callorators, Access QCs, along with the UniCel DxI Wash Buffer II are designed for use with the DxI 9000 Access Immunoassay Analyzer in a clinical laboratory setting.

    AI/ML Overview

    The provided text is a 510(k) premarket notification summary for the Access Toxo IgM II assay, a diagnostic immunoassay, not an AI/ML-driven device. Therefore, many of the requested criteria (e.g., sample size for training set, number of experts for ground truth, MRMC study, AI assistance effect size) are not applicable to this type of medical device submission.

    However, I can extract and present the relevant information regarding the device's acceptance criteria and the study proving it meets these criteria based on the provided text.


    Acceptance Criteria and Device Performance for Access Toxo IgM II Assay

    This document describes the validation of the Access Toxo IgM II assay on the DxI 9000 Access Immunoassay Analyzer, demonstrating its substantial equivalence to the previously cleared Access Toxo IgM II assay on the Access 2 Immunoassay System. The primary performance metrics reported are Positive Percent Agreement (PPA), Negative Percent Agreement (NPA), and Imprecision (CV%).

    1. Table of Acceptance Criteria and Reported Device Performance

    The acceptance criteria are implied by the results presented, which showed 100% agreement for both positive and negative samples, and the imprecision results were well within the design specification.

    Performance MetricAcceptance Criteria (Implied/Design Goal)Reported Device PerformanceStudy Type
    Method Comparison/AccuracyHigh agreement with predicate deviceMethod Comparison
    Positive Percent Agreement (PPA)N/A (demonstrated 100% agreement)100% (95% CI: 91.43% to 100.00%)Method Comparison (Access 2 vs. DxI 9000)
    Negative Percent Agreement (NPA)N/A (demonstrated 100% agreement)100% (95% CI: 96.53% to 100.00%)Method Comparison (Access 2 vs. DxI 9000)
    Imprecision (Within-Laboratory)≤ 20.0% CV (Design Goal)Precision (CLSI EP05-A3)
    Sample 1 (Non-Reactive) Overall CV%≤ 20.0%6.8%Within-Laboratory Precision
    Sample 2 (Reactive, Low) Overall CV%≤ 20.0%5.9%Within-Laboratory Precision
    Sample 3 (Reactive, Mid) Overall CV%≤ 20.0%5.9%Within-Laboratory Precision
    Sample 4 (Reactive, High) Overall CV%≤ 20.0%5.7%Within-Laboratory Precision
    Imprecision (Reproducibility)N/A (Overall CV% for precision)Reproducibility (CLSI EP05-A3)
    Sample 1 (Non-Reactive) Overall CV%N/A (demonstrated acceptable precision)6.8%Reproducibility
    Sample 2 (Reactive, Low) Overall CV%N/A (demonstrated acceptable precision)5.3%Reproducibility
    Sample 3 (Reactive, Mid) Overall CV%N/A (demonstrated acceptable precision)4.1%Reproducibility
    Sample 4 (Reactive, High) Overall CV%N/A (demonstrated acceptable precision)4.6%Reproducibility

    2. Sample Size Used for the Test Set and Data Provenance

    • Method Comparison Study: 152 samples.
      • Data Provenance: Samples were "collected from the intended use population." The study was "performed at an internal site." No specific country of origin or whether the data was retrospective or prospective is mentioned, but "intended use population" generally implies clinical samples.
    • Imprecision Studies (Within-Laboratory & Reproducibility):
      • For each of the 4 samples tested: N = 240 (for within-laboratory precision) and N = 225 (for reproducibility). These represent the number of individual measurements.
      • The study involved testing multiple samples in duplicate (for precision) or in replicates of 5 (for reproducibility) over multiple days, across three reagent/calibrator lots and three analyzers.

    3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications

    N/A. This is a laboratory diagnostic immunoassay, not an image-based AI/ML device where expert consensus for ground truth is typically required. The "ground truth" for the method comparison study was the result from the FDA-cleared predicate device (Access Toxo IgM II on the Access 2 Immunoassay System).

    4. Adjudication Method for the Test Set

    N/A. The comparison was directly between the candidate device (DxI 9000) and the predicate device (Access 2). There was no human adjudication process involved in settling discrepancies between results from different analyzers beyond standard laboratory procedures for confirming unexpected results.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done

    No, an MRMC study was not done. This type of study is relevant for imaging devices or AI-assisted diagnostic tools where human reader performance is a key metric. This submission is for an automated immunoassay.

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

    Yes, the studies evaluate the standalone performance of the device/assay system (Access Toxo IgM II on the DxI 9000) against a reference standard (predicate device or established precision metrics). The system itself performs the measurement and provides a qualitative (Reactive, Equivocal, Non-Reactive) result. There isn't an "algorithm only" in the AI/ML sense, but the device operates autonomously to produce results.

    7. The Type of Ground Truth Used

    • Method Comparison: The results obtained from the FDA-cleared predicate device (Access Toxo IgM II on the Access 2 Immunoassay System) served as the reference for determining agreement.
    • Imprecision: The consistency of the device's own measurements provided the "ground truth" for precision relative to established statistical methods (CLSI EP05-A3).

    8. The Sample Size for the Training Set

    N/A. This is not an AI/ML device that requires a distinct "training set." The device is a chemical immunoassay system. The development of such assays involves extensive R&D, reagent formulation, and analytical validation, but not "training data" in the machine learning sense.

    9. How the Ground Truth for the Training Set was Established

    N/A. As stated above, there is no "training set" or corresponding ground truth establishment in the context of an AI/ML model. The assay's analytical performance relies on validated biochemical reactions and instrument calibration.

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    K Number
    K240469
    Date Cleared
    2024-08-09

    (171 days)

    Product Code
    Regulation Number
    866.5870
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Access TPO Antibody assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of thyroperoxidase antibody (TPOAb) levels in human serum and plasma using the Access Immunoassay Systems.

    The detection of TPOAb is an aid in the diagnosis of thyroid autoimmune disorders.

    Device Description

    The Access TPO Antibody assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of thyroperoxidase antibody (TPO Ab) levels in human serum and plasma using the Access Immunoassay Systems.

    The Access TPO Antibody Calibrators are intended to calibrate the Access TPO Antibody assay for the quantitative determination of TPO Antibody levels in human serum and plasma using the Access Immunoassay Systems.

    The Access TPO Antibody assay is a sequential two-step immunoenzymatic ("sandwich") assay. A sample is added to a reaction vessel with paramagnetic particles coated with thyroperoxidase protein. The serum or plasma TPO Ab binds to the thyroperoxidase. After incubation, materials bound to the solid phase are held in a magnetic field while unbound materials are washed away. Then, the chemiluminescent substrate is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is directly proportional to the concentration of analyte in the sample. Analyte concentration is automatically determined from a stored calibration.

    AI/ML Overview

    The provided document, a 510(k) summary for the Beckman Coulter Access TPO Antibody assay, describes the analytical performance studies conducted to demonstrate substantial equivalence to a predicate device. This is a common regulatory pathway for in vitro diagnostic devices, focusing on demonstrating that the new device is as safe and effective as a legally marketed predicate device.

    Here's an analysis of the acceptance criteria and the study that proves the device meets them, based on the provided text:

    Acceptance Criteria and Reported Device Performance

    The document presents acceptance criteria implicitly through the study designs and results, as it's a submission for an IVD kit rather than an AI/ML algorithm. The performance is assessed by comparing the new device (Access TPO Antibody Assay on Dxl 9000 Access Immunoassay System) to its predicate device (Access TPO Antibody Assay on Access 2 Immunoassay System).

    Table of Acceptance Criteria and Reported Device Performance:

    Performance CharacteristicAcceptance Criteria (Implicit from Study Design/Goal)Reported Device Performance (Access TPO Antibody Assay on Dxl 9000)Study Method/Description
    Method Comparison (Agreement with Predicate)A strong correlation and minimal bias between results from the new device and the predicate device, demonstrated by slope and intercept close to 1 and 0 respectively, and a high correlation coefficient.Slope: 1.06 (95% CI: 1.04 - 1.08) Intercept: -0.26 (95% CI: -0.32 - -0.22) Correlation Coefficient (R): -0.978 (Note: The negative sign for R with a positive slope is unusual and might be a typo in the document; typically, a strong positive correlation is indicated by R closer to +1 for agreement studies).CLSI EP09c, 3rd Edition; Passing-Bablok regression.
    Imprecision (Repeatability and Reproducibility)Within-laboratory imprecision meeting predefined thresholds: - < 0.07 IU/mL SD at concentrations < 0.6 IU/mL - < 12.0% CV at concentrations ≥ 0.6 IU/mL and < 450.0 IU/mL - < 15.0% CV at concentrations ≥ 450.0 IU/mLSample 1 (0.35 IU/mL): Within-Laboratory SD: 0.02, %CV: 6.9 (Meets <0.07 SD) Sample 2 (5.5 IU/mL): Within-Laboratory SD: 0.36, %CV: 6.7 (Meets <12.0% CV) Sample 3 (20 IU/mL): Within-Laboratory SD: 1.23, %CV: 6.2 (Meets <12.0% CV) Sample 4 (318 IU/mL): Within-Laboratory SD: 21.35, %CV: 6.7 (Meets <12.0% CV) Sample 5 (747 IU/mL): Within-Laboratory SD: 96.48, %CV: 12.9 (Meets <15.0% CV)CLSI EP05-A3; multiple samples in duplicate for 2 runs/day over ≥20 days.
    LinearityAssay demonstrates linearity across the claimed measuring interval (0.25 - 1,000 IU/mL)."the assay demonstrated linearity across the measuring interval."CLSI EP06-Ed2
    Detection Capability (LoB, LoD, LoQ)Established quantitative limits relevant for clinical use, demonstrating the ability to detect and quantify low concentrations of the analyte.Limit of Blank (LoB): 0.19 IU/mL Limit of Detection (LoD): 0.23 IU/mL Limit of Quantitation (LoQ): 0.25 IU/mLCLSI EP17-A2

    Study Details:

    This submission focuses on an In Vitro Diagnostic (IVD) assay (Access TPO Antibody), not an AI/ML algorithm. Therefore, many of the questions related to AI/ML development (training set, experts for ground truth, MRMC studies) are not directly applicable in the way they would be for an AI-based medical device. However, I will interpret them in the context of an IVD assay where possible, based on standard IVD validation practices.

    1. Sample Size Used for the Test Set and Data Provenance:

      • Method Comparison: N = 219 patient samples.
      • Imprecision: N = 80 replicates (for each of 5 samples).
      • Linearity & Detection Capability: Sample sizes for these studies are not explicitly stated, but are governed by CLSI guidelines (EP06-Ed2 and EP17-A2 respectively), which typically involve analyzing serially diluted samples.
      • Data Provenance: Not explicitly stated (e.g., country of origin). The studies appear to be analytical performance studies conducted on patient samples, but whether they were retrospective or prospective is not specified. Given the nature of an IVD, these are typically conducted prospectively in a lab setting using banked or newly collected samples.
    2. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of those Experts:

      • Not Applicable in the traditional AI/ML sense. For an IVD assay, the "ground truth" for the test set is either:
        • Clinical Diagnosis: For the diagnostic claim ("aid in the diagnosis of thyroid autoimmune disorders"), the ground truth would be established by independent clinical diagnosis (e.g., by endocrinologists) typically using a variety of clinical data and other diagnostic tests. This information is usually part of clinical utility studies, which are not detailed in this analytical performance summary.
        • Reference Method/Predicate Product: For the analytical performance studies like Method Comparison, the "ground truth" or reference is the result obtained from the predicate device (Access TPO Antibody Assay on Access 2 Immunoassay System). The predicate device itself is validated against established (often clinical) criteria.
        • Known Concentrations/Materials: For linearity, imprecision, and detection capability studies, the "ground truth" is established by using characterized materials with known concentrations, or by measuring the variability around the mean of repeated measurements. This doesn't involve medical experts in the adjudication sense.
    3. Adjudication Method for the Test Set:

      • Not Applicable. Adjudication is typically for subjective interpretations (like image reading). For an IVD, the results are quantitative measurements from an instrument. The "adjudication" is essentially the statistical analysis (e.g., Passing-Bablok regression, CV calculations) of these quantitative results against predefined criteria or a reference method.
    4. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done:

      • No. An MRMC study is relevant for interpreting subjective data (like medical images) where human readers are involved. This document describes the analytical performance of an in vitro diagnostic assay that produces quantitative results, not an image interpretation or decision support AI.
    5. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was done:

      • Yes, in the context of an IVD. The entire analytical performance evaluation (Method Comparison, Imprecision, Linearity, Detection Capability) describes the standalone performance of the Access TPO Antibody assay on the Dxl 9000 system. It functions automatically based on its chemiluminescent immunoassay technology to produce a quantitative result. There is no "human-in-the-loop" aspect to the measurement itself, though human lab personnel operate the instrument and interpret the results.
    6. The Type of Ground Truth Used:

      • Known concentrations, reference method results (predicate device), and statistical averages.
        • For Method Comparison, the "ground truth" for comparison is the result obtained from the predicate Access 2 Immunoassay System.
        • For Imprecision, the "ground truth" is the mean concentration of the samples derived from repeated measurements, and the variability around that mean.
        • For Linearity, the ground truth is derived from known dilutions of a high-concentration material.
        • For Detection Capability (LoB, LoD, LoQ), the ground truth involves the statistical analysis of measurements of blank samples and low-concentration samples.
    7. The Sample Size for the Training Set:

      • Not Applicable. This is an IVD assay relying on chemical and immunological reactions, not a machine learning algorithm that requires a "training set" in the AI/ML sense. The device's parameters are determined during its design and optimization phases by Beckman Coulter, based on established immunoassay principles.
    8. How the Ground Truth for the Training Set was Established:

      • Not Applicable. As above, there is no "training set" for this type of device in the AI/ML context. The assay's performance characteristics (e.g., reactivity, linearity, precision) are inherent to its reagent formulation and instrument design, which are optimized by the manufacturer using internal R&D processes guided by scientific principles and regulatory standards.
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    K Number
    K240987
    Device Name
    Access sTfR
    Date Cleared
    2024-07-03

    (84 days)

    Product Code
    Regulation Number
    866.5880
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Access sTfR assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of soluble transferrin receptor (sTR) levels in human serum and plasma (heparin) using the Access Immunoassay Systems. This assay is intended as an aid in the diagnosis of Iron Deficiency Anemia (IDA), and for the differential diagnosis of IDA and Anemia of Chronic Disease (ACD).

    This assay may also be used in conunction with an Access Ferritin measurement to provide a calculated sTR log ferritin index. This index is intended as an aid in the diagnosis of IDA, and for the differential diagnosis of IDA and ACD.

    Device Description

    Access sTfR: The sTfR assay reagent pack consists of two specific reagents: (R1a) paramagnetic particles coated with streptavidin:biotinylated soluble transferrin receptor monoclonal antibody, proteins (mouse, goat, bovine), bovine serum albumin (BSA), 0.1% sodium azide, and 0.17% ProClin 300; and (R1b) Monoclonal mouse anti-human soluble transferrin receptor alkaline phosphatase (bovine) conjugate, BSA, 0.1% sodium azide and 0.17% ProClin 300. Two assay packs containing 50 tests per pack are provided for a total of 100 assay determinations.

    The Access sTfR assay is a sequential two-step immunoenzymatic ("sandwich") assay. A sample is added to a reaction vessel along with paramagnetic particles coated with anti-sTfR antibody. During incubation, the sTfR antigen in the sample binds to the immobilized anti-sTfR antibody on the solid phase. Alkaline phosphatase conjugated anti-sTfR antibody is then added and reacts with a different antigenic site on the sTfR molecule.

    After incubation, materials bound to the solid phase are held in a magnetic field while unbound materials are washed away. Then, the chemiluminescent substrate is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is directly proportional to the concentration of analyte in the sample. Analyte concentration is automatically determined from a stored calibration.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and study information for the Access sTfR device, based on the provided FDA 510(k) summary:

    Acceptance Criteria and Reported Device Performance

    Acceptance Criteria CategorySpecific Acceptance CriteriaReported Device PerformanceMeets Criteria?
    Method ComparisonSlope: 0.99 – 1.01 (95% CI)Slope: 1.00 (95% CI: 0.99 – 1.01)Yes
    Intercept: -0.14 - 0.15 (95% CI)Intercept: -0.016 (95% CI: -0.14 - 0.15)Yes
    Correlation Coefficient (R): Not explicitly stated as acceptance, but comparison shows R = 1.00Correlation Coefficient (R): 1.00Yes (Excellent)
    Imprecision≤ 0.72 nmol/L SD at concentrations ≤ 9 nmol/LSample 1 (9.1 nmol/L): 0.24 nmol/L SDYes
    ≤ 8.0% CV at concentrations > 9 nmol/LSample 2 (17 nmol/L): 2.6% CV < 8%Yes
    Sample 3 (20 nmol/L): 2.4% CV < 8%Yes
    Sample 4 (33 nmol/L): 1.8% CV < 8%Yes
    Sample 5 (67 nmol/L): 2.0% CV < 8%Yes
    Sample 6 (118 nmol/L): 2.2% CV < 8%Yes
    Linearity"The assay demonstrated linearity across the measuring interval.""The assay demonstrated linearity across the measuring interval."Yes (Direct statement)
    Detection CapabilityNot explicitly stated as acceptance criteria, but listed as targets to be determined.LoB: 0.04 nmol/LAchieved targets
    LoD: 0.05 nmol/LAchieved targets
    LoQ: 0.05 nmol/L (≤ 20% within-lab CV)Achieved targets

    Study Details

    1. Sample size used for the test set and the data provenance:

      • Method Comparison: N = 200 patient samples.
      • Imprecision: N = 6 samples (Sample 1-6) tested in duplicate, in 2 runs/day for a minimum of 20 days (total N for each sample is 80 measurements).
      • Linearity & Detection Capability: Sample sizes for these specific studies are not explicitly stated, but the studies were performed on the Dxl 9000 Access Immunoassay Analyzer.
      • Data Provenance: Not specified in the provided document (e.g., country of origin, retrospective or prospective).
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

      • This device is an in vitro diagnostic (IVD) immunoassay for the quantitative determination of soluble transferrin receptor (sTfR) levels. The performance studies (method comparison, imprecision, linearity, detection capability) do not involve human experts establishing a "ground truth" in the way an imaging AI might. Instead, the "ground truth" (or reference standard) for method comparison is the measurement from the predicate device (Access sTfR Assay on Access 2 Immunoassay System). For imprecision, linearity, and detection capability, the ground truth is established by the analytical measurement procedures themselves against defined statistical targets.
    3. Adjudication method for the test set:

      • Not applicable. As noted above, this is an IVD immunoassay, not a system requiring human adjudication of results in the traditional sense. The reference method (predicate device) serves as the comparator for the method comparison study.
    4. 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 is an IVD immunoassay, not an imaging AI or a device that assists human readers.
    5. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

      • Yes, the performance studies (method comparison, imprecision, linearity, detection capability) represent the standalone performance of the Access sTfR assay on the Dxl 9000 Access Immunoassay Analyzer. Its output is a quantitative sTfR value.
    6. The type of ground truth used:

      • Method Comparison: Measurements from the predicate device (Access sTfR Assay on Access 2 Immunoassay System). This serves as the reference for comparison against the new device.
      • Imprecision, Linearity, Detection Capability: Analytical measurements are compared against pre-defined statistical performance targets (e.g., SD, CV, LoB, LoD, LoQ) established according to CLSI guidelines.
    7. The sample size for the training set:

      • Not applicable. This is a conventional immunoassay, not a machine learning/AI device requiring a separate "training set" in that context. The device uses established biochemical reactions and a stored calibration curve.
    8. How the ground truth for the training set was established:

      • Not applicable (see above). The device establishes its "calibration" using internal calibrators and controls to create a stored calibration curve, as is typical for immunoassays. This is distinct from machine learning model training with labeled ground truth data.
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    K Number
    K232164
    Device Name
    Access NT-proBNP
    Date Cleared
    2024-04-12

    (266 days)

    Product Code
    Regulation Number
    862.1117
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Access NT-proBNP assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of N-terminal pro B-type natriuretic peptide levels in human serum and plasma using the automated DxI Access Immunoassay Analyzers to aid in the following:

    1. diagnosis of patients suspected of having acute heart failure in the Emergency Department
    2. assessment of heart failure severity
    3. risk stratification of patients with heart failure
    4. risk stratification of patients with acute coronary syndrome
    Device Description

    The Access NT-proBNP assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of N-terminal pro B-type natriuretic peptide levels in human serum and plasma using the automated Dxl 9000 Access Immunoassay Analyzers to aid in the following: 1) diagnosis of patients suspected of acute heart failure in the Emergency Department, 2) assessment of heart failure severity, 3) risk stratification of patients with heart failure, 4) risk stratification of patients with acute coronary syndrome.

    The Access NT-proBNP is a two-site immunoenzymatic (sandwich) assay. Paramagnetic particles coated with monoclonal anti-NT-proBNP antibody and monoclonal anti-NTproBNP antibody conjugated to alkaline phosphatase are added to a reaction vessel along with a surfactant-containing buffer and serum or plasma sample. The human NTproBNP binds to the anti-NT-proBNP antibody on the solid phase, while the anti-NTproBNP antibody-alkaline phosphatase conjugate reacts with a different antigenic site on the NT-proBNP molecule. After incubation, materials bound to the solid phase are held in a magnetic field while unbound materials are washed away. Then the chemiluminescent substrate is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is directly proportional to the concentration of analyte in the sample. Analyte concentration is automatically determined from a stored calibration.

    Other items required to use the assay include calibrators, Lumi-Phos PRO, and wash buffer. The Access NT-proBNP reagent packs. Access NT-proBNP calibrators, along with the Access wash buffer, and Lumi-Phos PRO are designed for use on the Dxl 9000 Access Immunoassay Analyzers in a clinical laboratory setting.

    AI/ML Overview

    Here's a breakdown of the acceptance criteria and study details for the Beckman Coulter Access NT-proBNP device, based on the provided text:

    Acceptance Criteria and Reported Device Performance

    The acceptance criteria are implied by the clinical and non-clinical studies conducted, with the device performance needing to meet expected ranges and exhibit substantial equivalence to predicate devices. Specific quantitative acceptance criteria are given for imprecision, LoB/LoD/LoQ, and linearity.

    Acceptance Criteria CategorySpecific Criteria (Implied or Stated)Reported Device Performance
    Imprecision- ≤ 4.0 ng/L SD at concentrations ≤ 50 ng/L - ≤ 8.0% CV at concentrations > 50 ng/LSample 1 (Mean 31 ng/L): SD 1.1 ng/L (3.5% CV). Meets criterion. Sample 2 (Mean 129 ng/L): SD 7.8 ng/L (6.0% CV). Meets criterion. Sample 3 (Mean 266 ng/L): SD 16.7 ng/L (6.3% CV). Meets criterion. Sample 4 (Mean 377 ng/L): SD 26.4 ng/L (7.0% CV). Meets criterion. Sample 5 (Mean 1,777 ng/L): SD 89.5 ng/L (5.0% CV). Meets criterion. Sample 6 (Mean 12,076 ng/L): SD 676.7 ng/L (5.6% CV). Meets criterion. Sample 7 (Mean 26,126 ng/L): SD 1516.1 ng/L (5.8% CV). Meets criterion.
    High Dose Hook EffectNo observed high dose hook effect within a specified high concentration range (e.g., up to 300,000 pg/mL, similar to predicate)No high dose hook effect observed up to 400,000 ng/L. Meets implied criterion (exceeds predicate device's demonstrated hook effect range).
    Limit of Blank (LoB)< 10.0 ng/L (pg/mL)Maximum Observed Result: 1.1 ng/L. Meets criterion.
    Limit of Detection (LoD)≤ 10.0 ng/L (pg/mL)Maximum Observed Result: 4.8 ng/L. Meets criterion.
    Limit of Quantitation (LoQ)≤ 10.0 ng/L (pg/mL) with ≤ 20% within-lab CVMaximum Observed Result: 4.8 ng/L. Meets criterion (implied that CV was ≤20%).
    Linearity- Within ± 10% for values > 50 ng/L - Within ± 5.0 ng/L for values ≤ 50 ng/LDemonstrated acceptable non-linearity across the analytical measuring range (10.0 - 35,000 ng/L) and meets the specified ±10% and ±5.0 ng/L criteria.
    Matrix ComparisonAll indicated sample types (serum, lithium heparin plasma, EDTA plasma) are suitable for use.Study with 68 matched samples showed all sample types are suitable. Meets criterion.
    Interfering SubstancesNo significant interference (defined as > 10% shift in dose) by common substances at specified concentrations.None of the tested compounds caused significant interference (>10% shift). Meets criterion.
    Cross ReactivityNo significant cross-reactivity (>10%) with structurally similar substances.No significant cross-reactivity (>10%) observed. Meets criterion.
    Clinical Performance (AHF Diagnosis)Aid in diagnosis of acute heart failure with comparable diagnostic accuracy to predicate device (Elecsys proBNP II), as evidenced by ROC AUC.AUC for Access NT-proBNP was 0.8536 (95% CI: 0.8362 - 0.8710), comparable to Elecsys proBNP II at 0.8562 (95% CI: 0.8361 - 0.8762). Meets criterion of comparability.
    Clinical Performance (NYHA Correlation)Significant trend relationship between NT-proBNP values and NYHA classification for all subjects, females, and males.JT test of trending resulted in statistically significant p-values (<0.0001 for all subjects, 0.0005 for females, 0.0033 for males), indicating a significant trend relationship. Meets criterion.
    Clinical Performance (Risk Stratification)Demonstrated prognostic utility for risk stratification in patients with heart failure and acute coronary syndrome (supported by peer-reviewed literature).Supported by analysis of peer-reviewed literature and guidelines for the same analyte, confirming correlation between NT-proBNP and cardiovascular events/mortality. Meets criterion.

    Study Details

    1. Sample Size and Data Provenance:

      • Test Set (Clinical Study for AHF Diagnosis): 2,384 patients presenting to the Emergency Department with clinical suspicion of acute heart failure.
        • Provenance: This was a "multicenter prospective study." While specific countries are not mentioned, regulatory submissions to the FDA typically involve studies conducted in the US or other regions following ICH GCP guidelines. The study type is explicitly prospective.
      • Test Set (Reference Interval Study): 675 apparently healthy adults for the overall ULN, broken down into 306 males and 369 females.
        • Provenance: This was a "multicenter prospective reference interval study." Again, specific countries are not mentioned but it was prospective.
      • Test Set (Imprecision): Number of runs (minimum 20 days) and replicates (duplicate) are specified for samples 1-7, with N ranging from 83 to 86 tests per sample.
      • Test Set (LoB, LoD, LoQ): Multiple reagents lots and 3 instruments over 3-5 days.
      • Test Set (Linearity): Native patient samples.
      • Test Set (Matrix Comparison): Sixty-eight (68) matched serum, lithium heparin, and EDTA plasma samples.
      • Test Set (Interfering Substances/Cross Reactivity): Lithium heparin plasma samples (concentrations approx. 125 ng/L and 1,800 ng/L) spiked with various substances. Number of individual samples not specified, but the number of substances tested is large.
    2. Number of Experts and Qualifications for Ground Truth:

      • For the clinical sensitivity study (AHF diagnosis), "Final diagnoses were adjudicated by an independent committee of medical doctors."
      • Number of Experts: Not explicitly stated (e.g., "3 independent physicians"). It mentions "an independent committee," which implies more than one.
      • Qualifications: "Medical doctors." No specific specialties (e.g., cardiologists, emergency physicians) or years of experience are listed in the provided text.
      • For risk stratification, the basis for effectiveness comes from "an objective and systematic analysis of recent peer-reviewed literature and clinical practice guidelines," implying consensus from the broader medical community rather than a specific set of experts for this particular study.
    3. Adjudication Method for the Test Set:

      • For the AHF diagnosis study, the text states: "Final diagnoses were adjudicated by an independent committee of medical doctors who decided on presence of acute heart failure. Adjudicators were blinded to the Access NT-proBNP assay results."
      • The specific method (e.g., 2+1, 3+1) is not explicitly detailed. It simply states "adjudicated by an independent committee," which could imply consensus, majority vote, or a specific tie-breaking rule, but the exact mechanism is not provided.
    4. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

      • No, this device is an in-vitro diagnostic (IVD) assay, not an AI/imaging device. Therefore, an MRMC study and human reader improvement with AI assistance are not applicable. The comparison made is against another IVD assay (Elecsys proBNP II) as a standalone algorithm/test.
    5. Standalone Performance:

      • Yes, the primary performance shown is standalone (algorithm only/test only) performance. The Access NT-proBNP assay is a quantitative determination of NT-proBNP levels. Its performance (e.g., analytical performance, diagnostic accuracy via ROC curves) is measured and reported as the output of the assay itself. The clinical performance section directly presents the assay's ability to diagnose AHF and correlates its results with NYHA classification and risk stratification, without human interpretation of the assay's output as an input to a further AI system.
    6. Type of Ground Truth Used:

      • Clinical Diagnosis (Expert Consensus/Adjudication): For the acute heart failure diagnosis study, the ground truth was established by an "independent committee of medical doctors" adjudicating the final diagnoses. This falls under expert consensus based on clinical information.
      • Clinical Outcomes/Literature Review: For risk stratification, the ground truth is based on the correlation of NT-proBNP with "increased incidence of cardiovascular events, mortality and composite outcomes" as established in existing peer-reviewed literature and clinical practice guidelines.
      • Reference Intervals for Healthy Population: Established by recruiting "apparently healthy adults" based on defined exclusion criteria and screening with additional biomarkers (eGFR, hsTnl) to ensure the health status.
    7. Sample Size for the Training Set:

      • The provided document describes the validation studies (test set) for the Access NT-proBNP device. It does not mention a separate "training set" in the context of an AI/machine learning model. This is an IVD assay, not an AI device trained on data. The development process for such an assay involves R&D, optimization, and internal verification stages, but the term "training set" doesn't directly apply in the same way it would for AI products.
    8. How Ground Truth for the Training Set Was Established:

      • As this is not an AI/machine learning device, the concept of a "training set" with established ground truth as per AI/ML typically doesn't apply. The development of the assay itself would involve internal studies and optimization based on known reference materials and clinical samples, but these are part of the assay's design and analytical verification, not a training phase for a learning algorithm.
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    K Number
    K233480
    Device Name
    Access SHBG
    Date Cleared
    2024-02-08

    (105 days)

    Product Code
    Regulation Number
    862.1680
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Access SHBG assay is a paramagnetic particle, chemiluminescent immunoassay for the quantitative determination of Sex Hormone Binding Globulin levels in human serum and plasma using the Access Immunoassay Systems. The Access SHBG assay is indicated for use in the assessment of androgen disorders.

    Device Description

    The Access SHBG assay is a sequential two-site immunoenzymatic ("sandwich") assay. The Access SHBG assay consists of the reagent pack, calibrators and QCs. Other items needed to run the assay include substrate and wash buffer. The Access SHBG assay reagent pack, Access SHBG assay calibrators, Access SHBG QCs, along with the UniCel Dxl Wash Buffer II are designed for use with the Dxl 9000 Access Immunoassay Analyzer in a clinical laboratory setting.

    AI/ML Overview

    The FDA 510(k) clearance letter and accompanying summary describe the Acceptance Criteria and the study proving the Access SHBG assay meets these criteria.

    Acceptance Criteria and Device Performance

    The provided document focuses on the analytical performance of the Access SHBG assay on the Dxl 9000 Access Immunoassay Analyzer, comparing it to a previously cleared predicate device (Access SHBG on Access 2 instrument). The acceptance criteria are largely derived from CLSI (Clinical and Laboratory Standards Institute) guidelines for various analytical performance characteristics.

    Here is a table summarizing the acceptance criteria and the reported device performance for the analytical studies:

    Performance CharacteristicAcceptance Criteria (from CLSI guidelines or internal design)Reported Device Performance (Access SHBG on Dxl 9000)
    Method Comparison (compared to predicate)R$^2$ $\ge$ 0.95 with a slope equal to 1.00 $\pm$ 0.09R = 1.00, R$^2$ = 0.99, Slope = 1.01 (95% CI: 1.00-1.03), Intercept = -0.019 (95% CI: -0.46 - 0.29)
    Precision (Within-Laboratory Imprecision)$\le$ 0.14 nmol/L SD at concentrations $\le$ 2 nmol/L $\le$ 7.0% CV at concentrations > 2 nmol/LSample 1 (0.82 nmol/L): SD = 0.04, CV = 4.6% Sample 2 (18 nmol/L): SD = 0.5, CV = 2.7% Sample 3 (47 nmol/L): SD = 1.3, CV = 2.7% Sample 4 (90 nmol/L): SD = 2.6, CV = 2.9% Sample 5 (198 nmol/L): SD = 5.1, CV = 2.6%
    LinearityThe assay must demonstrate linearity throughout its analytical measuring interval.Linear throughout the analytical measuring interval of 0.33 nmol/L - 200 nmol/L.
    Limit of Blank (LoB)Not explicitly stated as a number, but derived from the study.0.005 nmol/L (maximum observed)
    Limit of Detection (LoD)Not explicitly stated as a number, but derived from the study.0.01 nmol/L
    Limit of Quantitation (LoQ)Not explicitly stated as a number, but derived from the study.0.06 nmol/L

    Study Details

    The provided document describes analytical verification studies for the Access SHBG assay, not a clinical study involving human readers or AI. Therefore, some of the requested information (e.g., MRMC studies, human reader improvement with AI, ground truth for training AI models, number of experts for AI ground truth) is not applicable or cannot be extracted from this document as it pertains to an immunoassay device, not an AI/ML-based diagnostic system.

    Here's the relevant information that can be extracted:

    2. Sample Size and Data Provenance:

    • Method Comparison: A total of 151 samples were evaluated. The data provenance is implied to be clinical samples (patient samples are mentioned in the CLSI guideline for method comparison), though specific country of origin or whether they were retrospective/prospective is not stated. Given the context of a 510(k) submission for an in-vitro diagnostic, it is highly likely these were de-identified retrospective clinical samples.
    • Precision: Five serum samples with varying SHBG concentrations were used. Each sample was assayed in duplicate with two runs per day, over 20 days, on three Dxl 9000 Access Immunoassay Analyzer systems, three reagent lots, and three calibrator lots. This totals 80 measurements per sample (5 samples * 2 duplicates * 2 runs/day * 20 days / 1 instrument * 1 reagent lot * 1 calibrator lot used for reported results).
    • Linearity: A native low sample and a spiked high sample were used, along with seven mixtures in between.
    • LoB, LoD, and LoQ: Four distinct blank samples were used for LoB. Six to seven samples were used for LoD. 12-13 serum samples were used for LoQ.

    3. Number of Experts and Qualifications for Test Set Ground Truth:

    • This is an immunoassay device, not an image-based AI system. The ground truth for analytical studies like linearity, precision, and limits of detection is established by the assay itself (measurements of known concentrations, serial dilutions, etc.) and validated against established analytical method guidelines (CLSI). No human experts are involved in establishing ground truth for these analytical performance characteristics in the way they would be for image interpretation tasks.

    4. Adjudication Method for Test Set:

    • Not applicable. Adjudication methods (e.g., 2+1, 3+1) are typically used in clinical studies where human readers provide interpretations (e.g., radiology reads) that need to be reconciled to form a ground truth. For analytical performance studies of an immunoassay, the "truth" is based on the chemical and instrument measurements and statistical analysis against predefined acceptance criteria.

    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

    • No, an MRMC comparative effectiveness study was not done. This type of study is relevant for AI systems assisting human readers in diagnostic tasks, such as radiology image interpretation. This document describes the analytical performance of an immunoassay for quantitative determination of SHBG levels, which does not involve human readers interpreting AI output.

    6. Standalone Performance:

    • Yes, the entire document focuses on the "standalone" analytical performance of the Access SHBG assay on the Dxl 9000 Access Immunoassay Analyzer. The performance described (method comparison, precision, linearity, limits) is the direct output of the instrument and reagents, without human interpretation "in the loop" beyond standard laboratory procedures for operating the instrument.

    7. Type of Ground Truth Used:

    • For analytical performance studies, the "ground truth" is established through:
      • Reference measurements/Predicate device: For method comparison, the results from the previously cleared predicate device (Access SHBG on Access 2 instrument) served as the comparative "truth."
      • Known concentrations/mixtures: For linearity, samples with known or precisely diluted concentrations were used.
      • Replicate measurements: For precision, repeated measurements establish the variability.
      • Blank and low-level samples: For LoB, LoD, and LoQ, these are the "truth" against which the assay's detection capabilities are measured.
      • CLSI Guidelines: The studies were designed and evaluated according to CLSI guidelines, which represent a form of accepted scientific and statistical "truth" for validating laboratory assays.

    8. Sample Size for Training Set:

    • This document describes the validation of an immunoassay device, not an AI/ML model. Therefore, there isn't a "training set" in the context of machine learning. The device's underlying chemistry and physics are "trained" during its development and manufacturing process, but not through a data-driven training set in the way an AI algorithm is.

    9. How Ground Truth for Training Set was Established:

    • Not applicable, as there is no AI/ML training set in the context of this immunoassay device.
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    K Number
    K201405
    Date Cleared
    2020-08-30

    (94 days)

    Product Code
    Regulation Number
    866.1645
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    LabPro Data Management System is a Microsoft® Windows based software program and is intended to manage both microbial identification (ID) and antimicrobial agent susceptibility testing (AST) data generated from Beckman Coulter instruments or manually entered microbiology test results, for use by trained laboratory personnel. LabPro AlertEx is a functional subset of the LabPro Data Management System that analyzes Beckman Coulter ID and AST data, or other pre-defined parameters, against a series of established rules/ alerts and notifies the user of unusual, and/or critical conditions, which may warrant further analysis or action.

    LabPro-MBT software is a functional subset of LPDMS intended to electronically transfer and display organism identifications from the Bruker MALDI Biotyper System to the LabPro Data Management System. LabPro-MBT software is a device that is intended to electronically transfer medical device data, without controlling or altering the functions or parameters of any connected medical devices.

    Device Description

    The proposed LabPro Data Management System device is a system intended to be used in laboratory settings by trained personnel to manage both microbial identification (ID) and antimicrobial agent susceptibility testing (AST) data generated from Beckman Coulter instruments, manually entered panels and select third party microbiology instruments.

    The LabPro AlertEx is a functional subset of the LabPro Data Management System and analyzes Beckman Coulter ID and AST data against a series of established rules/alerts and notifies the user of unusual, and/or critical conditions.

    The LabPro MBT is an optional subset of the LabPro Data Management System that provides connectivity to a Bruker MALDI Biotyper (MBT) System. The LabPro MBT subset software allows for transfer and display of organism identifications from the Bruker MALDI Biotyper System to the proposed LabPro Data Management System.

    AI/ML Overview

    Here's an analysis of the provided text regarding the acceptance criteria and study for the LabPro Data Management System:

    The provided text is a 510(k) summary for the LabPro Data Management System. It states that clinical trials are not applicable, and instead, "Performance Bench Testing" was performed. However, the document does not provide specific acceptance criteria or detailed results of this performance bench testing. It only generally states that "All testing passed demonstrating that the proposed LabPro Data Management System device is substantially equivalent to the predicate device."

    Therefore, much of the requested information cannot be definitively extracted from this document. I will provide what can be inferred or is explicitly stated and note where information is missing.

    Acceptance Criteria and Reported Device Performance

    The document does not explicitly state quantitative acceptance criteria or detailed reported device performance in a table format. It focuses on demonstrating substantial equivalence to a predicate device.

    Acceptance Criteria (Implied)Reported Device Performance (General)
    Maintain parity with currently available operating systems and databases, cybersecurity, programming languages, and hardware platforms.The device has been updated to meet these standards.
    Consolidate AlertEx into the LabPro Data Management System software.Achieved.
    Support additional languages.Achieved.
    Reorganize to improve the presentation of help documentation and Alert rules.Achieved.
    Connectivity of multiple computers into a single network to improve system usability.Achieved.
    Connectivity to multiple WalkAway and autoSCAN-4 instruments to improve usability.Achieved.
    Connectivity to a Bruker MALDI Biotyper.Achieved (via LabPro-MBT software).
    Function as intended to manage microbial identification (ID) and antimicrobial susceptibility test (AST) results.The proposed device performs as intended in all aspects of the predicate device's mapped functionality characteristics, and "all testing passed."
    Provide a safe and secure software product.The safety aspects were "thoroughly tested in accordance with validation practices."
    Functionality and performance demonstrate substantial equivalence to the predicate device.The device "performs as intended in all aspects of the predicate devices' mapped functionality characteristics."

    Study Details:

    1. Sample size used for the test set and the data provenance:

      • Sample Size: Not specified. The document states "Performance Bench Testing was performed" but does not give the number of cases, data points, or a description of the dataset used for this testing.
      • Data Provenance: Not specified.
    2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

      • This information is not provided. Since the testing was "Performance Bench Testing" for a data management system, it's unlikely that traditional "ground truth" derived from human experts in a diagnostic context (e.g., radiologists) would be directly applicable. The "ground truth" for a data management system would likely refer to the correctness and accuracy of its data handling, processing, and display abilities, which would be verified against expected outputs or known correct data.
    3. Adjudication method for the test set:

      • Not specified. This is typically relevant for studies involving human interpretation or subjective assessments. For a data management system's "Performance Bench Testing," adjudication methods like 2+1 or 3+1 are generally not applicable. Verification would likely involve comparing software outputs to expected correct results.
    4. 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 MRMC study was done. The device is a "software only product" for data management, not an AI diagnostic tool that assists human readers. The document explicitly states, "Clinical performance testing is not applicable for the proposed LabPro Data Management System, as it is a software only product."
    5. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done:

      • Yes, "Performance Bench Testing" was done, which would evaluate the algorithm/software's standalone performance in managing and processing data. However, the details of what this testing involved (e.g., specific metrics, test cases) are not provided. The phrase "algorithm only" is perhaps not the most precise for a data management system, as its core function is to handle data correctly and robustly.
    6. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):

      • Not explicitly stated. For a data management system, the "ground truth" would likely involve the correctness of data transfer, storage, processing, and adherence to defined rules/alerts. This would be established by comparing the software's output/behavior against pre-defined, known-correct inputs and expected outputs, as validated by internal testing protocols and specifications.
    7. The sample size for the training set:

      • Not applicable/Not specified. This is not a machine learning or AI algorithm in the context of generating predictive outputs from training data. It is a data management system. Therefore, there is no "training set" in the conventional sense.
    8. How the ground truth for the training set was established:

      • Not applicable, as there is no training set. The "ground truth" for the software's functionality is its adherence to design specifications and correct operation, which would be established during its development and verification/validation processes.
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    K Number
    K172912
    Date Cleared
    2017-12-07

    (73 days)

    Product Code
    Regulation Number
    866.1640
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The MicroScan Dried Gram-Negative MIC/Combo Panel is used to determine quantitative and/or qualitative antimicrobial agent susceptibility of colonies grown on solid media of rapidly growing aerobic and facultative anaerobic gram-negative bacilli. After inoculation, panels are incubated for 16 - 20 hours at 35°C +/ - 1°C in a non-CO2 incubator, and read either visually or with MicroScan instrumentation, according to the Package Insert.

    This particular submission is for the antimicrobial ciprofloxacin (Cp-S) at concentrations of 0.004 to 8 µg/ mL to the test panel.

    The gram-negative organism which may be used for ciprofloxacin susceptibility testing on this panel is:

    Salmonella Typhi

    Device Description

    MicroScan Dried Gram-Neqative MIC/Combo Panels are designed for use in determining quantitative and/or qualitative antimicrobial agent susceptibility of colonies grown on solid media of rapidly growing aerobic and facultative anaerobic gram-negative bacilli.

    The antimicrobial susceptibility tests are miniaturizations of the broth dilution susceptibility test that have been diluted in broth and dehydrated. Various antimicrobial agents are diluted in broth to concentrations bridging the range of clinical interest. Panels are rehydrated with water after inoculation with a standardized suspension of the organism. After incubation in a non-CO2 incubator for 16-20 hours, the minimum inhibitory concentration (MIC) for the test organism is read by determining the lowest antimicrobial concentration showing inhibition of growth.

    AI/ML Overview

    Here's a summary of the acceptance criteria and the study details for the MicroScan Dried Gram-Negative MIC/Combo Panels with Ciprofloxacin-S based on the provided FDA 510(k) summary:

    Device: MicroScan Dried Gram-Negative MIC/Combo Panels with Ciprofloxacin-S (0.004 - 8 µg/mL)
    Intended Use: To determine quantitative and/or qualitative antimicrobial agent susceptibility of colonies grown on solid media of rapidly growing aerobic and facultative anaerobic gram-negative bacilli. Specifically, this submission is for the antimicrobial ciprofloxacin (Cp-S) at concentrations of 0.004 to 8 µg/mL for the organism Salmonella Typhi.


    1. Table of Acceptance Criteria and Reported Device Performance

    The provided document does not explicitly state numerical acceptance criteria for "Essential Agreement" in a formal table format with specific thresholds. However, it indicates that the device demonstrated "acceptable performance" and details the "Essential Agreement" obtained.

    Criterion TypeAcceptance Criteria (Implicit from "acceptable performance")Reported Device Performance (for Ciprofloxacin-S and Salmonella Typhi)
    Essential AgreementAcceptable performance when compared with a CLSI frozen Reference Panel, as defined in "Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test (AST) Systems; Guidance for Industry and FDA", dated August 28, 2009.100% Essential Agreement
    Reproducibility & PrecisionAcceptable reproducibility and precision for ciprofloxacin across different inoculum methods and instruments.Demonstrated acceptable reproducibility and precision.
    Quality ControlAcceptable results for ciprofloxacin in quality control testing.Demonstrated acceptable results.

    2. Sample Size Used for the Test Set and Data Provenance

    • Test Set Organism: The specific organism mentioned for testing in this submission is Salmonella Typhi. The document refers to "stock Challenge strains" for the external evaluation.
    • Sample Size: The document does not specify the exact number of Salmonella Typhi isolates or challenges strains used in the test set. It mentions "external evaluation was conducted with stock Challenge strains."
    • Data Provenance: Not explicitly stated (e.g., country of origin, retrospective/prospective). However, the use of "stock Challenge strains" implies a controlled laboratory setting, which is typical for in vitro diagnostic device evaluations.

    3. Number of Experts and Qualifications for Ground Truth

    • The document does not mention the use of human experts to establish ground truth for the test set.
    • Ground Truth Method: The ground truth for antimicrobial susceptibility testing (in vitro diagnostic devices) is typically established by using a CLSI frozen Reference Panel. This standardized method eliminates the need for human expert consensus on individual results because the reference method itself serves as the gold standard for comparison.

    4. Adjudication Method for the Test Set

    • Not applicable as the ground truth is established by a standardized reference method (CLSI frozen Reference Panel), not by human expert review requiring adjudication.

    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

    • No, an MRMC study was not conducted. This type of study (AI assistance for human readers) is not relevant for an in vitro diagnostic device like an antimicrobial susceptibility test panel, which determines susceptibility directly. The device itself is the primary determinant of the result, not an aid to human interpretation of images or complex data as seen in AI imaging applications.

    6. Standalone (Algorithm Only) Performance

    • Yes, a standalone performance evaluation was done. The entire study described is a standalone evaluation of the device's ability to accurately determine antimicrobial susceptibility concentrations when compared against a recognized reference method (CLSI frozen Reference Panel). The "Essential Agreement" reported is a measure of this standalone performance.

    7. Type of Ground Truth Used

    • CLSI frozen Reference Panel: This is the established "gold standard" reference method for antimicrobial susceptibility testing, providing the ground truth for comparison.

    8. Sample Size for the Training Set

    • The document does not specify a separate training set or its sample size. For in vitro diagnostic devices based on chemical reactions (like MIC panels), there isn't typically a "training set" in the machine learning sense. The device's performance is inherently based on its chemical design and manufacturing, which is validated through performance studies as described.

    9. How the Ground Truth for the Training Set was Established

    • Not applicable, as there is no mention of a traditional "training set" and its ground truth in the context of this device. The development of such panels relies on established microbiological principles and validated manufacturing processes to ensure the correct antimicrobial concentrations are present in each well.
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