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The AneuVysion™ (CEP 18, X, Y-alpha satellite, LSI 13 and 21) Multicolor Probe Panel is intended to use CEP 18/X/Y probe to detect alpha satellite sequences in the centromere regions of chromosomes 18, X, and Y, and LSI 13/21 probe to detect the 13q14 region and the 21q22.13 to 21q22.2 region. The AneuVysion™ kit is indicated for use as an adjunct to standard cytogenetic metaphase analysis for identifying and enumerating chromosomes 13, 18, 21, X, and Y via fluorescence in situ hybridization (FISH) in metaphase cells and interphase nuclei obtained from amniotic fluid in subjects with presumed high risk pregnancies. It is not intended to be used as a stand alone assay for test reporting. FISH results are intended to be reported and interpreted only in conjunction with results of standard cytogenetic analysis, performed concurrently, utilizing the same patient specimen. FISH results should not be reported prior to standard cytogenetic results except in instances where reporting of FISH results alone is medically indicated or standard cytogenetic results are not available, e.g., culture failure. Reporting and interpretation of FISH should be consistent with professional standards of practice! This device is intended for use only with amniocyte cells; it is not intended for and has not been validated for use with other test matrices. This FISH assay will not detect the presence of structural chromosome abnormalities frequently associated with birth defects. This FISH assay will be performed in cytogenetics laboratories.

The AneuVysion™ kit is a combination of two DNA probe mixtures; CEP 18/X/Y and LSI 13/21. The CEP 18/X/Y probe is a mixture of directly labeled fluorescent DNA probes specific for the D18Z1, DXZ1 and DYZ3 regions of chromosomes 18, X, and Y respectively. The LSI 13/21 probe contains a mixture of unique DNA sequences that hybridize in the 13q14 region of chromosome 13, and unique DNA sequences complementary to the D21S259, D21S341, and D21S342 loci contained within the 21q22.13 to 21q22.2 region on the long arm of chromosome 21. The LSI 13 probe was created from a set of overlapping clones which contain the entire RB-1 gene as well as regions extending beyond the gene on both sides. The probe extends beyond the 180 kb RB-1 gene for 110-170 kb in the 5' direction and approximately 120 kb in the 3' direction; the entire probe is 410-470 kb. CEP 18/X/Y is an aqua, green, and orange tri-color probe mixture and LSI 13/21 is a green and orange dual-color probe mixture.

Table of Acceptance Criteria and Reported Device Performance

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This assay is designed to provide a method for the detection and quantification of chromosome 8 in both interphase nuclei and metaphase spreads by fluorescence in situ hybridization (FISH).

The CEP 8 SpectrumOrange DNA Probe is a SpectrumOrange fluorescent labeled DNA probe specific for the centromeric region of chromosome 8.

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

Acceptance Criteria and Device Performance for CEP 8 SpectrumOrange DNA Probe Kit

1. Table of Acceptance Criteria and Reported Device Performance

7. Type of Ground Truth Used

• For the clinical methods comparison study, the ground truth was expert consensus / established diagnostic method: Standard Cytogenetic Analysis. This method is referred to as "the standard of care."

8. Sample Size for the Training Set

• The text does not explicitly describe a separate training set in the way modern machine learning models would have one.
• The "pilot study" and "pivotal study" results for hybridization efficiency and reproducibility involve smaller numbers of specimens (35 BM, 60 BM, single normal and single trisomy 8 specimens) that could be considered part of the development and refinement of the assay and its interpretation rules, but not a formal "training set" for an algorithm. The 2.2% cutoff for interphase analysis appears to have been 'validated by the same pivotal clinical study,' suggesting it was developed and then verified within the context of the overall validation.

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

• Since there's no explicitly defined "training set" for an algorithm in the modern sense, the concept of establishing ground truth for it doesn't directly apply here.
• However, the underlying biological understanding and the methodology of interpreting FISH signals (e.g., what constitutes a "tri-signaled nuclei") would be based on established cytogenetic principles and likely refined through internal studies during the probe's development, informed by standard cytogenetic analysis, which is the gold standard for chromosomal abnormalities. The cutoff values (like 2.2%) were likely empirically determined and then validated against the clinical performance.

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