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510(k) Data Aggregation
(107 days)
GENETIC TESTING INSTITUTE
The Factor VIII Antibody Screen is a qualitative solid phase enzyme linked immunosorbent assay (ELISA) designed to detect IgG antibodies reactive with recombinant human factor VIII (FVII) in human serum and plasma.
The Factor VIII Antibody Screen is designed as a solid phase enzyme-linked immunosorbent assay (ELISA) with a colorimetric endpoint. This product is intended to be used as an in vitro diagnostic kit by hemostasis and other laboratories to screen patient samples for the presence of IgG antibodies reactive with human Factor VIII.
The Factor VIII Antibody Screen is an Enzyme Linked Immunosorbent Assay with a colorimetric endpoint. The Factor VIII Antibody Screen is designed to detect IgG antibodies reactive with recombinant human Factor VIII in human serum and plasma. The Factor VIII Antibody Screen kit contains all of the reagents necessary to perform the assay.
The Factor VIII Antibody Screen solid phase ELISA microwells provide immobilized recombinant human FVIII as target molecules for the detection of anti-Factor VIII IgG antibodies.
Diluted patient serum or plasma is added to microwells coated with recombinant FVIII molecules allowing antibody, if present, to bind. Unbound material is then washed away. An alkaline phosphatase labeled anti-human immunoglobulin reagent (Anti-IgG) is added to the wells and incubated. The unbound Anti-IgG is washed away and the substrate PNPP (p-nitrophenyl phosphate) is added. After a 30 minute incubation period, the reaction is stopped by a sodium hydroxide solution. The optical density of the color that develops is measured in a spectrophotometer at 405 nm with no reference filter.
Here's an analysis of the provided text to extract the acceptance criteria and study details:
1. Table of Acceptance Criteria and Reported Device Performance
The document doesn't explicitly define a list of "acceptance criteria" with specific thresholds in a standardized table format. Instead, it discusses the performance against a predicate device and a "gold standard" (Bethesda assay), and establishes internal precision and reproducibility standards. Based on the "Conclusions" sections of the performance studies, here's a reconstructed table:
Performance Characteristic | Acceptance Criteria (Implied/Derived from Conclusions) | Reported Device Performance (Factor VIII Antibody Screen) |
---|---|---|
Accuracy (vs. Predicate: FVIII Inhibitor Assay) | "Excellent sensitivity (co-positivity), specificity (co-negativity), and overall agreement" | Co-positivity: 92.7% (95% CI: 85.7 - 96.4%) |
Co-negativity: 97.6% (95% CI: 87.4 - 99.6%) | ||
Overall Agreement: 94.2% | ||
Accuracy (vs. Gold Standard: Bethesda Assay) | "Excellent sensitivity (co-positivity), specificity (co-negativity), and overall agreement" | Co-positivity: 95.8% (95% CI: 89.8 - 98.4%) |
Co-negativity: 89.1% (95% CI: 81.9 - 93.6%) | ||
Overall Agreement: 92.2% | ||
Precision (OD Values) | Imprecision 0.600; ≤ 24% CV for OD 0.600 | |
≤ 24% CV total imprecision for OD values 98% of the normal samples must be negative. This iterative process established the "ground truth" for setting the kit's operational cutoff. |
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(170 days)
GENETIC TESTING INSTITUTE
PF4 IgG™ is a qualitative solid phase enzyme linked immunosorbent assay (ELISA) designed to detect antibodies reactive with Platelet Factor 4 (PF4) when it is complexed to polyanionic compounds such as polyvinyl sulfonate (PVS). These antibodies are found in some patients undergoing heparin therapy.
PF4 IgG™ is designed as a solid phase enzyme-linked immunosorbent assay (ELISA). This product is intended to be used as an in vitro diagnostic kit by hematology, coagulation, or other pathology laboratories to assist in screening patient samples for the presence of heparin-associated antibodies commonly found in patients with heparin-induced thrombocytopenia or thrombosis.
PF4 IgG™ is a qualitative screening assay for the detection of heparin associated IgG antibodies in human serum. The presence of heparin associated antibodies are commonly found in patients with Heparin Induced Thrombocytopenia (HIT).
The PF4 IgGTM assay is an Enzyme Linked Immunosorbent Assay (ELISA). The PF4 IgG™ ELISA is intended to detect IgG antibodies in human serum that react with Platelet Factor 4 (PF4) when it is complexed to heparin or other polyanionic compounds. The PF4 IgG™ kit contains all of the reagents necessary to perform the assay.
In the PF4 IgG™ assay, a complex of PF4/PVS, which has been immobilized in the microwells serve as a target for the binding of antibodies associated with Type II HIT.
In the PF4 IgG™ assay, patient serum is first diluted (1:4), with the specimen diluent provided in the kit. The diluted sample is then added to microwells to which Platet Factor 4 (PF4) complexed to polyvinyl sulfonate (PVS) has been immobilized. The sample is then incubated for 30 minutes at 37°C. If an antibody which recognizes a site on PF4/PVS complex is present in the patient sample, binding will occur. Following this incubation, a wash step then removes any unbound antibodies. A goat anti-human IgG - alkaline phosphatase conjugate is then added to the wells. The conjugate is incubated for 30 minutes at 37°C. Following this incubation, a wash step then removes any unbound conjugate. The alkaline phosphate substrate, p-nitrophenyl phosphate (pNPP) is then added to the microwells. After a 30 minute incubation at room temperature (22 -- 25°C), the reaction is stopped by addition of the stopping solution (3 M sodium hydroxide). The optical density of the color that develops is measured in a spectrophotometer at 405 or 410 nm using a reference wavelength of 490 nm.
1. Table of Acceptance Criteria and Reported Device Performance
Metric | Acceptance Criteria (PF4 IgG™ vs. SRA) | Reported PF4 IgG™ Performance (vs. SRA) | Acceptance Criteria (PF4 IgG™ vs. PF4 ENHANCED®) | Reported PF4 IgG™ Performance (vs. PF4 ENHANCED®) |
---|---|---|---|---|
Sensitivity (Co-Positivity) | Not explicitly stated (but compared) | 100% (95% CI: 84.5 - 100.0%) | Not explicitly stated (but compared) | 74% (95% CI: 61.0 - 83.4%) |
Specificity (Co-Negativity) | Not explicitly stated (but compared) | 90% (95% CI: 85.1 - 93.3%) | Not explicitly stated (but compared) | 100% (95% CI: 97.8 - 100.0%) |
% Agreement | Not explicitly stated (but compared) | 91% | Not explicitly stated (but compared) | 93% |
Assay Imprecision (O.D.) | ≤10% CV total imprecision | ≤10% CV total imprecision | Not applicable | Not applicable |
Reportable Results | 100% agreement | 100% agreement | Not applicable | Not applicable |
Note: The document does not explicitly state pre-defined acceptance criteria values for sensitivity, specificity, and agreement. Instead, it presents the results of the comparison studies and concludes that the device "performs comparable to the predicate device." The conclusion for assay imprecision and reportable results states that the assay "showed acceptable assay imprecision" and "100% agreement."
2. Sample size used for the test set and the data provenance
- Test Set Sample Size: 229 serum samples.
- Data Provenance: The samples were obtained from the BloodCenter of Wisconsin (BCW) and were from patients receiving heparin treatment. The data is retrospective as the samples had been previously tested by BCW for PF4/heparin antibodies using the SRA. The country of origin is the USA.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
The document does not specify the number of experts or their qualifications for establishing the ground truth using the Serotonin Release Assay (SRA). It refers to the SRA as an "in house assay" at BCW.
4. Adjudication method for the test set
The document does not describe an adjudication method for conflicting results. The SRA results from BCW were used as the primary comparator (gold standard). For the PF4 IgG™ and PF4 ENHANCED® assays, samples were tested in duplicate, and the mean of the O.D. values was obtained. Results were considered positive if the mean O.D. value was ≥0.400.
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
A Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. This study describes an in vitro diagnostic (IVD) ELISA test, not an AI-assisted diagnostic tool that would involve human readers for interpretation of results.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
This study describes a standalone assay's performance, which is an analogous concept to an algorithm-only performance for an IVD test. The PF4 IgG™ assay itself is the "algorithm only" in this context, providing a quantitative optical density value that is then interpreted as positive or negative based on a cutoff. No human-in-the-loop performance data is provided beyond implicitly trained lab technicians performing the assay.
7. The type of ground truth used
The primary ground truth for the comparison of methods study was the Serotonin Release Assay (SRA). The document states that the SRA is "considered to be the gold standard for testing for antibodies that can cause HIT."
8. The sample size for the training set
The document does not explicitly describe a "training set" in the context of machine learning or algorithm development. However, for determining the normal range and assay cutoff, 120 serum samples from normal healthy individuals were used. This set of samples was used to statistically establish the assay's cutoff, which plays a role similar to calibrating or "training" a threshold.
9. How the ground truth for the training set was established
For the "training set" (120 normal healthy individuals used for normal range and cutoff determination):
- The ground truth was established by defining these individuals as "normal healthy" and their serum samples were tested with the PF4 IgG™ and PF4 ENHANCED® assays.
- The normal range was determined non-parametrically using these samples, and the cutoff for the assays (≥0.400) was set based on the upper end of these calculated normal ranges.
- Calculations for the normal range were performed by GTI's Manager of Clinical and Scientific Affairs (Melissa Pressman, Ph.D.), using the Med Calc software program. This implies statistical analysis of the optical density values from these known normal samples.
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(30 days)
GENETIC TESTING INSTITUTE
GTI PF4 ENHANCED® is designed as a solid phase enzyme-linked immunosorbent assay (ELISA). The product is intended to be used as an in vitro diagnostics kit by hematology, (ELIG/Y). The produce is the pathology laboratories to assist in screening patient samples for the presence of heparin-associated antibodies commonly found in patients with heparin induced thrombocytopenia or thrombosis.
PF4 ENHANCED® Solid Phase ELISA microwells provide immobilized PF4:PVS complexes as a target for the detection of antibodies associated with Type II HIT which are found in some patients undergoing heparin therapy. The presence of these antibodies has been shown to be associated with heparin induced thrombocytopenia Type II (Type II HIT).
Patient serum is added to microwells coated with platelet factor 4 (PF4) complexed to polyvinyl sulfonate (PVS). If an antibody recognizing a site on PF4:PVS is present, binding will occur. Unbound antibodies are then washed away. An alkaline phosphatase labeled anti-human globulin reagent (Anti-IgG/A/M) is added to the wells and incubated. The unbound Anti-IgG/A/M is washed away and the substrate PNPP (p-nitrophenyl phosphate) is added. After a 30-minute incubation period, the reaction is stopped by addition of a sodium hydroxide solution. The optical density of the color that develops is measured in a spectrophotometer.
The document describes a 510(k) premarket notification for a device called "PF4 ENHANCED® Solid Phase ELISA" and its substantial equivalence to a predicate device, the "GTI-PF4 ELISA". The focus of the provided text is on demonstrating that the new device performs as well as the predicate device, especially considering changes to certain materials.
Here's an analysis of the acceptance criteria and the study that proves the device meets them, based on the provided text:
1. Table of Acceptance Criteria and the Reported Device Performance
The document does not explicitly state numerical "acceptance criteria" in a typical table format with specific thresholds (e.g., sensitivity > 90%). Instead, the acceptance criteria are implicitly defined by the goal of demonstrating substantial equivalence to the predicate device, the GTI-PF4 ELISA. The performance data was used to show that the PF4 ENHANCED® device performs "as well as" the predicate.
The reported device performance is a qualitative statement of equivalence rather than specific quantitative metrics against pre-defined thresholds.
Acceptance Criteria (Implicit) | Reported Device Performance (Summary) |
---|---|
Equivalence in assay results after material change (wash buffer) | Data showed the effect of the material change on assay results using known patient samples, demonstrating equivalence to the predicate. (Details of specific results are not provided in the summary.) |
Equivalence in kit stability (real-time) after material change (wash buffer) | Data showed the effect of the material change on kit stability (real-time stability), demonstrating equivalence. (Details not provided.) |
Equivalence in component stability (accelerated and real-time) after stabilizer added | Data showed the effect of the material change on component stability (accelerated and real-time stability studies on the alkaline phosphatase conjugated anti-IgG/A/M), demonstrating equivalence. (Details not provided.) |
Equivalence in kit stability (real-time) after stabilizer added | Data showed the effect of the material change on kit stability (real-time), demonstrating equivalence. (Details not provided.) |
Equivalence in assay results after stabilizer added | Data showed the effect of the material change on assay results using known patient samples, demonstrating equivalence to the predicate. (Details not provided.) |
Equivalence in assay reproducibility (within run, lot to lot, total) | Data showed the effect of the material change on assay reproducibility (within run precision, lot to lot reproducibility, and total reproducibility), demonstrating equivalence. (Details not provided.) |
Equivalence in assay specificity (cross reactivity) | Data showed the effect of the material change on assay specificity (cross reactivity of other antibodies), demonstrating equivalence. (Details not provided.) |
Overall Conclusion | The data show that PF4 Enhanced is equivalent to PF4 ELISA. |
Based on comparison with the legally marketed PF4 ELISA, the data demonstrate that PF4 Enhanced ELISA performs as well as the predicate device and does not present new issues of safety and effectiveness. |
2. Sample size used for the test set and the data provenance
The document explicitly states that the studies used "known patient samples." However, it does not provide the specific sample size for the test set or the data provenance (e.g., country of origin, retrospective or prospective nature of the samples). The summary refers to "Section 8: Performance Data Section" for details, which is not included in the provided text.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
The document does not provide information on the number of experts used or their qualifications to establish ground truth for the test set. Given that it's an ELISA for detecting antibodies, the "ground truth" would likely be derived from a combination of clinical diagnosis of Type II HIT and potentially other laboratory tests, rather than expert interpretation of an image or signal that requires adjudication. The document states "known patient samples," implying the status of these samples (e.g., positive or negative for the target antibodies/HIT) was already established.
4. Adjudication method for the test set
The document does not specify an adjudication method. This type of assay (ELISA) typically produces quantitative results (Optical Density) that are then interpreted against cut-offs to yield a qualitative (Positive/Negative) result. Adjudication by multiple readers is less common for such objective assays unless there are borderline results or discrepancies in initial interpretations, which isn't mentioned here.
5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance
No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This device is an in-vitro diagnostic (IVD) ELISA kit, which is a laboratory assay. It does not involve human readers interpreting images or data directly to make a diagnosis in a way that would be "assisted by AI." Therefore, the concept of "human readers improve with AI vs without AI assistance" is not applicable to this device.
6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done
The device itself is a "standalone" assay in the sense that it produces an objective result (Optical Density) which leads to a qualitative determination (Positive/Negative). It is an "algorithm only" in the context of the assay's biochemical steps and optical density measurement leading to a result. However, this is not an "AI algorithm" in the common sense of the term. The performance data described are for the assay itself.
7. The type of ground truth used
The ground truth for the "known patient samples" would be based on clinical diagnosis of Type II HIT and potentially confirmatory laboratory tests, which establish whether the patient samples are truly positive or negative for the antibodies associated with Type II HIT. The document refers to "known patient samples," implying this established truth. It's not pathology (as in tissue biopsy) or purely outcomes data from a large cohort, but rather a pre-established clinical and laboratory status.
8. The sample size for the training set
The document does not mention a training set in the context of machine learning or AI. This is an ELISA kit validation, not an AI model development. The "known patient samples" mentioned would be considered the test set for validating the new device against the predicate.
9. How the ground truth for the training set was established
As there is no mention of a training set in the context of AI, there's no information on how its ground truth was established. The "known patient samples" for the performance studies would have their ground truth established as described in point 7.
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(104 days)
GENETIC TESTING INSTITUTE
GTI-FVIII Inhibitor Assay is designed as a solid phase Enzyme-Linked Immunosorbent Assay (ELISA). The product is intended to be used as an in vitro diagnostic kit by hemostasis and other laboratories providing factor VIII inhibitor assay to assist in screening samples for the presence of alloantibodies to epitopes on FVIII molecule.
FVIII Inhibitor Assay is an ELISA platform which is designed to detect IgG antibodies to human recombinant FVIII in human plasma samples. Recombinant human FVIII molecules are passively immobilized in microtiter wells. Patient plasma is tested against wells containing immobilized recombinant FVIII and compared to the reaction obtained from the negative control sera included in the kit. The results are obtained in optical density (OD) values. The patient samples having OD values greater than the cutoff value are regarded as being positive.
1. A table of acceptance criteria and the reported device performance
Acceptance Criteria (Implied) | Reported Device Performance (GTI-FVIII Inhibitor Assay) |
---|---|
Detects FVIII antibodies with high concordance to Bethesda assay | Concordance: 89.6% |
Detects FVIII antibodies with high sensitivity compared to Bethesda assay | Sensitivity: 98.9% |
Detects FVIII antibodies with high negative predictive value compared to Bethesda assay | Negative Predictive Value: 98.8% |
Lot-to-lot consistency | Comparable between three different lots |
Tech-to-tech consistency | Good correlation of results obtained by three different individuals |
Stability over dating period | Stable over a 27-month period |
2. Sample size used for the test set and the data provenance
The sample size for the test set is not explicitly stated in the provided text.
The data provenance is retrospective, comparing the GTI-FVIII Inhibitor Assay to the Bethesda assay in previously collected samples. The country of origin is not specified, but the study was conducted in "two independent clinical laboratories."
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
This information is not provided. The Bethesda assay is used as the reference standard (ground truth), but the number and qualifications of experts involved in performing or interpreting the Bethesda assay results are not detailed.
4. Adjudication method for the test set
Not explicitly stated. Given that the comparison is against the Bethesda assay, it's implied that the Bethesda assay results served as the reference without a separate adjudication process for the test set itself beyond what is inherent in the Bethesda assay's methodology.
5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance
No, an MRMC comparative effectiveness study was not done. The study compares the performance of a device (ELISA kit) to a predicate assay, not the performance of human readers with or without AI assistance.
6. If a standalone (i.e. algorithm only, without human-in-the-loop performance) was done
Yes, a standalone study was done. The reported performance (concordance, sensitivity, negative predictive value) is for the GTI-FVIII Inhibitor Assay device itself, without human interpretation as part of the primary outcome measure. The device provides "optical density (OD) values" which are then compared to a cutoff value to determine positive or negative results. While human technical staff operate the ELISA, the interpretation of the results as positive or negative is algorithm-driven based on the OD values.
7. The type of ground truth used
The type of ground truth used is a reference assay/methodology, specifically the Bethesda assay.
8. The sample size for the training set
The text does not mention a separate training set. The study describes the comparison of the GTI-FVIII Inhibitor Assay to the Bethesda assay, implying a validation or test set, but no distinct training set for developing the device is detailed in this summary.
9. How the ground truth for the training set was established
Not applicable, as a separate training set and its ground truth establishment are not discussed in the provided summary. The device's underlying principles (ELISA platform detecting IgG antibodies to FVIII) suggest it was developed based on established immunological assays, but the specifics of its internal development and training (if any, in a machine learning sense) are not provided.
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(165 days)
GENETIC TESTING INSTITUTE
INDICATIONS FOR USE OF GTI-PF4 ELISA FOR THE DETECTION OF ANTIBODIES DIRECTED AGAINST PLATELET FACTOR 4 (PF4):POLYVINYL SULFONATE (PVS) COMPLEX
GTI-PF4 ELISA is designed as a solid phase enzyme-linked immunosorbent assay (ELISA). The product is intended to be used as an in vitro diagnostic kit by hematology, coagulation or other pathology laboratories to assist in screening patient samples for the presence of heparin-associated antibodies commonly found in patients with heparin-induced thrombocytopenia or thrombosis.
GTI-PF4 ELISA is designed as a solid phase enzyme-linked immunosorbent assay (ELISA).
This is an FDA 510(k) clearance letter and an Indications for Use statement, not a scientific study report. Therefore, it does not contain the detailed information needed to describe acceptance criteria and a study proving a device meets those criteria in the format requested.
The document states:
- Device Name: GTI-PF4 ELISA
- Intended Use: "as an in vitro diagnostic kit by hematology, coagulation or other pathology laboratories to assist in screening patient samples for the presence of heparin-associated antibodies commonly found in patients with heparin-induced thrombocytopenia or thrombosis."
- Regulatory Class: II
To answer your request, a comprehensive study report or a 510(k) summary would be required. The provided text only informs that the device has received 510(k) clearance based on substantial equivalence to a predicate device, but it does not detail the specific performance studies, acceptance criteria, or ground truth methodologies used by the manufacturer to demonstrate that equivalence.
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