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510(k) Data Aggregation
(137 days)
Nexstim Navigated Brain Therapy (NBT®) System 2 is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode.
The Nexstim NBT® System 2 is a repetitive transcranial magnetic stimulation (rTMS) system that delivers repetitive pulsed magnetic fields of sufficient magnitude to induce neural action potentials in the prefrontal cortex to treat the symptoms of major depressive disorder (MDD) without inducing seizure in patients who have failed one antidepressant medication.
The Nexstim NBT System 2 is used for patient treatment by prescription only and must be operated by a trained medical professional. It can be used in both inpatient and outpatient settings including physician's offices and clinics, psychiatric hospitals, and general medical/surgical hospitals with psychiatric units.
The Nexstim NBT System 2 consists of a group of devices designed to localize the stimulation site in the brain and deliver rTMS stimulation using controlling and interpretive software. Operational control of the Nexstim NBT System 2 is provided by the software.
The Nexstim NBT System 2 combines magnetic resonance imaging-based (MRI-based), three-dimensional (3-D) localization of cortical motor areas of the brain with non-invasive TMS and simultaneous electromyography (EMG) measurement to locate areas of the brain that are capable of evoking muscle responses when stimulated, and to locate the target area for depression therapy.
The Nexstim NBT System 2 software is used to import a patient's MR image slices through standard DICOM communication protocols, and generates an accurate 3-D model of the patient's head which can be "peeled back" to reveal the anatomical structures of the brain.
The provided text describes the Nexstim Navigated Brain Therapy (NBT) System 2, a repetitive transcranial magnetic stimulation (rTMS) system for treating Major Depressive Disorder. However, it does not contain specific acceptance criteria, reported device performance metrics in a table, or details of a study directly proving the device meets acceptance criteria in the format requested for AI/ML devices.
The document is a 510(k) summary, which focuses on demonstrating substantial equivalence to predicate devices rather than providing detailed clinical trial results or performance metrics against pre-defined acceptance criteria typical for novel AI/ML device evaluations.
It primarily details:
- Device Description and Intended Use
- Technology Comparison with predicate devices (showing similar technical characteristics)
- Summary of Performance Testing related to general medical device standards (sterilization, biocompatibility, software verification, electrical safety, EMC, and usability).
There are two studies mentioned under "Performance Testing – Bench Verification," which relate to the device's methods for determining motor threshold (MT) and coil localization, comparing them to manually-determined methods. However, these are not presented as a "study that proves the device meets the acceptance criteria" in the context of clinical effectiveness or diagnostic accuracy, which is often what is implied by "acceptance criteria" and "reported device performance" for AI/ML enabled devices.
Given the information provided, here's what can be extracted and what is missing:
Acceptance Criteria and Study Details (Based on provided text)
1. A table of acceptance criteria and the reported device performance
The document does not explicitly state acceptance criteria or device performance in the context of clinical efficacy or diagnostic accuracy in a table format. Instead, it refers to compliance with various medical device standards and internal specifications. The "Performance Testing - Bench Verification" section mentions two studies that compare specific aspects of the device's function (MT determination and coil localization) to other methods, suggesting "no significant statistical difference" or "substantially equivalent results" as outcomes for these functional aspects, which could be interpreted as meeting an implicit acceptance criterion of equivalence for these specific functions.
| Acceptance Criteria (Implied from Performance Testing) | Reported Device Performance |
|---|---|
| Biocompatibility: Device materials comply with ISO 10993-1. | Determined to be safe to use with patients. |
| Software: Complies with predetermined specifications and relevant FDA guidance (e.g., software development, cybersecurity), IEC 62304. | Software complies with its predetermined specifications, and the Standards and guidance documents. |
| Electrical Safety: Complies with IEC 60601-1, ANSI/AAMI ES 60601-1. | Nexstim NBT System 2 complies with the Standards. |
| Electromagnetic Compatibility (EMC): Complies with IEC 60601-1-2, FCC 47 CFR §15. | Nexstim NBT System 2 complies with the Standards. |
| Usability: Complies with IEC 60601-1-6, IEC 62366. | Nexstim NBT System 2 complies with the applicable Standards. |
| Motor Threshold (MT) Determination: Nexstim's Electromyography-Determined MT Method is comparable to Manually-Determined MT Method. (Study: O'Reardon, 2007; Pridmore, 1998) | Demonstrates no significant statistical difference between methods. |
| Navigated Coil Localization: Nexstim's method is comparable to Manually-Determined Method (moving the coil 5.5 cm anteriorly from the motor cortex). (Study: Ahdab, 2010) | Demonstrates substantially equivalent results between methods. |
2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)
The document lists "Study Comparing Nexstim's Electromyography-Determined Motor Threshold (MT) Method to the Manually-Determined MT Method (O'Reardon, 2007; Pridmore, 1998)" and "Study Comparing Nexstim's Navigated Coil Localization Method to Manually-Determined Method (Ahdab, 2010)".
- Sample Size: Not specified in the provided text for either study.
- Data Provenance: Not specified in the provided text for either study (e.g., country of origin, retrospective or prospective). The studies are referenced by author and year, suggesting they are published literature or internal studies referring to published methods.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
Not specified in the provided text. For the MT and coil localization comparison studies, "manually-determined methods" serve as a reference, implying human expertise, but details are not given.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set
Not specified in the provided text.
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. The Nexstim NBT System 2 is not an AI-assisted diagnostic device where "human readers" would be involved in interpreting data with or without AI. It is a therapeutic device (rTMS system). The listed comparative studies focus on functional aspects of the device (MT determination and coil localization) rather than comparative effectiveness studies in the context of improving human reader performance.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
Not applicable in the typical sense of standalone AI performance. The device is a system operated by a trained medical professional. The functional comparisons (MT determination, coil localization) are aspects of the system's operation that are being compared to manual methods.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)
- For the Motor Threshold (MT) determination, the ground truth appears to be established by a "manually-determined MT method" (implied expert determination, likely involving visual and/or manual assessment of muscle twitch).
- For the Navigated Coil Localization, the ground truth is a "manually-determined method (moving the coil 5.5 cm anteriorly from the motor cortex)," which is a standard anatomical targeting approach.
8. The sample size for the training set
Not applicable/specified. The document does not describe the device as an AI/ML system that undergoes "training." The software development process is mentioned, but without details on a training set for model development.
9. How the ground truth for the training set was established
Not applicable/specified, as there is no mention of an AI/ML "training set."
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