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510(k) Data Aggregation

    K Number
    K210902
    Manufacturer
    Date Cleared
    2022-07-27

    (488 days)

    Product Code
    Regulation Number
    866.5100
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K141375, K061165/A003

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    EliA Ro52 is intended for the in vitro semi-quantitative measurement of IgG antibodies directed to Ro52 in human serum as an aid in the diagnosis of Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and idiopathic inflammatory myopathies (IIM) in conjunction with other laboratory and clinical findings. EliA Ro52 uses the EliA IgG method.

    EliA Ro60 is intended for the in vitro semi-quantitative measurement of IgG antibodies directed to Ro60 in human serum as an aid in the diagnosis of Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE) in conjunction with other laboratory and clinical findings. EliA Ro60 uses the EliA IgG method.

    Device Description

    The EliA Ro52 and EliA Ro60 Immunoassays are semi-quantitative solid-phase fluoroenzyme immunoassays, for the determination of autoantibodies against SS-A/Ro 52 kDa and 60 kDa proteins. The EliA Ro52 and EliA Ro60 test System is a fully integrated and automated system composed of assay-specific reagents, EliA method-specific reagents, and general reagents.

    AI/ML Overview

    The provided document describes the EliA Ro52 and EliA Ro60 Immunoassays, which are intended for the semi-quantitative measurement of IgG antibodies directed to Ro52 and Ro60 in human serum, respectively. These devices aid in the diagnosis of specific autoimmune diseases. The document includes detailed analytical and clinical performance data to support the substantial equivalence claim.

    Here's an analysis of the acceptance criteria and the study that proves the device meets them:

    1. Table of Acceptance Criteria and Reported Device Performance

    The document does not explicitly state formal "acceptance criteria" in a tabulated format. Instead, it presents various analytical and clinical performance metrics, implying that these metrics, when compared to the predicate device and established clinical utility, are deemed acceptable for the device's intended use. Based on the provided performance data, the implicit acceptance criteria would likely be related to aspects like precision, linearity, detection limits, specificity (interference), and clinical sensitivity/specificity.

    Below is a table summarizing key performance indicators reported in the document:

    Table 1: Key Performance Metrics for EliA Ro52 and EliA Ro60

    Performance MetricEliA Ro52 Reported PerformanceEliA Ro60 Reported PerformanceImplied Acceptance Criterion (General, not prescriptive)
    Precision (Total Imprecision)On Phadia 250: %CV 4.1% - 6.9% On Phadia 2500/5000: %CV 4.2% - 6.4%On Phadia 250: %CV 4.4% - 9.1% On Phadia 2500/5000: %CV 4.5% - 7.1%Total imprecision (Total %CV) should be within acceptable limits for diagnostic assays, demonstrating consistency and reliability across runs, instruments, and days.
    Linearity (R² value)Phadia 250: 0.9899 - 0.9994 (single), 0.9928 (combined) Phadia 2500E: 0.9875 - 0.9980 (single)Phadia 250: 0.9961 - 0.9996 (single), 0.9979 (combined) Phadia 2500E: 0.9949 - 0.9992 (single)The assay should demonstrate linearity across its entire measuring range, indicated by a high R² value (close to 1) for regression analysis of serially diluted samples.
    Detection Limit (LoD)0.3 EliA U/mLDfU states 0.4 EliA U/mL (harmonized)The Limit of Detection (LoD) should be sufficiently low to detect clinically relevant concentrations of the analyte.
    Analytical SpecificityNo interference observed from listed endogenous/exogenous substances.No interference observed from listed endogenous/exogenous substances.The assay should not be significantly affected by common interfering substances (e.g., bilirubin, hemoglobin, rheumatoid factor, common medications) at clinically relevant concentrations.
    Method Comparison (vs. Predicate)EliA Ro52 vs. QUANTA Flash Ro52: PPA 80.8% - 92.3%, NPA 90.7% - 98.4%, TPA 91.2% - 93.4%EliA Ro60 vs. QUANTA Flash Ro60: PPA 93.9% - 97.0%, NPA 81.6% - 92.1%, TPA 91.3% - 93.3%Agreement with the legally marketed predicate device (expressed as Positive Percent Agreement (PPA), Negative Percent Agreement (NPA), and Total Percent Agreement (TPA)) should be high, demonstrating comparable performance.
    Clinical Sensitivity (EliA Ro52)SLE: 47.5% - 50.8% SS: 50.0% - 55.0% IIM: 36.2% - 37.2% SSc: 20.9% - 26.4%N/A (Ro52 specific)Clinical sensitivity for the specified autoimmune diseases (Sjögren's syndrome, systemic lupus erythematosus, systemic sclerosis, idiopathic inflammatory myopathies) should be clinically acceptable and comparable to established diagnostic benchmarks for similar assays. Specific numerical cut-offs are implied by the data presented.
    Clinical Specificity (EliA Ro52)SLE control: 95.6% - 96.9% SS control: 95.6% - 96.9% IIM control: 95.6% - 96.9% SSc control: 95.6% - 96.9%N/A (Ro52 specific)Clinical specificity against control groups (other autoimmune diseases, infectious diseases) should be high to minimize false positives.
    Clinical Sensitivity (EliA Ro60)N/A (Ro60 specific)SLE: 48.3% - 50.8% SS: 68.3% - 71.7%Clinical sensitivity for the specified autoimmune diseases (Sjögren's syndrome, systemic lupus erythematosus) should be clinically acceptable and comparable to established diagnostic benchmarks for similar assays. Specific numerical cut-offs are implied by the data presented.
    Clinical Specificity (EliA Ro60)N/A (Ro60 specific)SLE control: 98.4% - 98.6% SS control: 98.4% - 98.6%Clinical specificity against control groups (other autoimmune diseases, infectious diseases) should be high to minimize false positives.

    The acceptance of these performance metrics is implicitly based on comparison with the predicate devices (QUANTA Flash Ro52 and QUANTA Flash Ro60) and the established clinical utility in diagnosing the mentioned autoimmune diseases. The FDA's substantial equivalence determination (K210902) confirms that the submitted data supports the claim that the new devices perform comparably to the predicate devices.

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

    The document describes several test sets for different performance characteristics:

    • Precision/Reproducibility:
      • Phadia 250: 5 samples, each with 252 replicate determinations (across 3 instruments, 7 days, 21 runs).
      • Within-lab Imprecision: Samples in 80 replicates on 1 instrument over 20 days (40 runs).
      • Phadia 2500 and Phadia 5000 series (E-module): 5 samples, each with 84 replicates (across 3 instruments, 7 days, 21 runs).
    • Linearity/Assay Reportable Range: 3 patient serum samples serially diluted in at least 9 dilution steps, tested in quadruplicates.
    • Detection Limit: 4 blank and 4 low-level samples, tested in 5-fold determination, across 2 different reagent sets (totaling 120 combined observations for blank and low-level per instrument type).
    • Analytical Specificity (Interference): 3 serum samples (negative, equivocal, high positive), spiked with interfering substances, tested in triplicates.
    • Method Comparison with Predicate Device:
      • EliA Ro52: 208 patient serum samples (only 181 used in agreement calculations due to samples outside measuring range).
      • EliA Ro60: 208 patient serum samples (only 104 used in agreement calculations due to samples outside measuring range).
    • Clinical Sensitivity and Specificity:
      • EliA Ro52: 755 clinically and ethnically defined serum samples. These include:
        • Diagnostic group: SLE (n=120), Sjögren's syndrome (n=60), IIM (n=94), SSc (n=91) - total 365.
        • Disease control group: 390 samples (various autoimmune and infectious diseases).
      • EliA Ro60: 713 clinically and ethnically defined serum samples. These include:
        • Diagnostic group: SLE (n=120), Sjögren's syndrome (n=60) - total 180.
        • Disease control group: 533 samples (various autoimmune and infectious diseases, excluding SSc).

    Data Provenance:
    The document states that the clinical samples used for sensitivity and specificity determination were from "clinically and ethnically defined serum samples, including those of US origin." This indicates a mix of retrospective (clinically defined, likely banked samples) and potentially prospective (if US origin implies some form of fresh collection for the study) data. It is not explicitly stated whether it was purely retrospective or involved prospective collections, but the description "clinically and ethnically defined serum samples" strongly suggests retrospective use of samples with established diagnoses.

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

    The document does not provide information on the number of experts used to establish the ground truth for the test sets (e.g., for diagnoses of SLE, SS, IIM, SSc). It only states that samples were "clinically and ethnically defined." This typically implies that patient diagnoses were established through standard clinical practice by medical professionals, but the specifics of these experts' qualifications or the consensus process are not detailed in this submission summary.

    4. Adjudication Method for the Test Set

    The document does not specify an adjudication method for establishing the ground truth for the test set. It refers to diagnoses as "clinically defined," which generally suggests diagnosis was made by treating physicians following clinical guidelines, but no adjudication process like 2+1 or 3+1 by independent experts is mentioned for the study.

    5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

    No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. This document describes an in vitro diagnostic (IVD) device, specifically an immunoassay for measuring antibody levels. MRMC studies are typically performed for imaging devices or other diagnostic tools where human interpretation is involved and needs to be compared with and/or augmented by AI. This device is an automated laboratory test, and its performance is evaluated directly through analytical measurements and comparison to a predicate device, as well as clinical sensitivity and specificity against established clinical diagnoses.

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

    Yes, this is a standalone device. The EliA Ro52 and EliA Ro60 Immunoassays are "automated semi-quantitative solid phase fluoroenzymeimmunoassays" run on "Phadia 250 instrument and the Phadia 5000 instrument series (E-modules)." The results are automatically converted to EliA U/mL. The performance characteristics described (precision, linearity, detection limit, analytical specificity, clinical sensitivity, specificity) are all based on the output of the automated instrument and reagents, independent of human interpretation during the actual test process itself. The interpretation of results (negative, equivocal, positive) is based on defined cut-off values.

    7. The Type of Ground Truth Used (Expert Consensus, Pathology, Outcomes Data, etc.)

    For the clinical sensitivity and specificity studies, the ground truth was clinical diagnosis. The samples were "clinically and ethnically defined serum samples" with established diagnoses of various autoimmune diseases (SLE, SS, IIM, SSc) and control conditions. This implies that the diagnosis was based on the standard clinical criteria and medical records established by healthcare professionals, rather than a separate expert consensus panel or specific pathology results for the study.

    8. The Sample Size for the Training Set

    The document does not describe a "training set" in the context of machine learning or AI models, as this is an immunoassay and not an AI/ML-based device.

    However, if "training set" is generally interpreted as samples used for assay development, optimization, or establishing parameters like cut-offs, the relevant information is:

    • Cut-off definition: A cohort of 69 healthy blood donors, 19 SLE patients, and 9 Sjögren's syndrome (SS) patients for EliA Ro52, and 70 healthy blood donors, 22 SLE patients, and 6 Sjögren's syndrome patients for EliA Ro60, were used to define the cut-off values. This can be considered the 'development' or 'calibration' set for determining the interpretive thresholds.

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

    As noted above, this device does not utilize a machine learning "training set" in the conventional sense. For the samples used to establish the cut-off values (which could be considered analogous to determining a 'decision boundary' in an ML context), the ground truth was established based on the clinical diagnoses of the patient samples (healthy blood donors, SLE patients, Sjögren's syndrome patients). The document states that the initial cut-off for EliA Ro52, set using SLE and SS patients, was later verified with additional IIM and SSc patient sera. This indicates clinical diagnosis as the gold standard.

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    K Number
    K202540
    Device Name
    EliA Rib-P
    Manufacturer
    Date Cleared
    2021-09-13

    (376 days)

    Product Code
    Regulation Number
    866.5100
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K141375, K061165/A003

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    EliA Rib-P is intended for the in vitro semi-quantitative measurement of IgG antibodies directed to Rib-P in human serum as an aid in the diagnosis of systemic lupus erythematosus (SLE) in conjunction with other laboratory and clinical findings. EliA Rib-P uses the EliA IgG method.

    Device Description

    EliA Rib-P is a semi-quantitative solid-phase fluoroenzymeimmunoassay, for the determination of autoantibodies against Rib-P. The EliA Rib-P test System is fully integrated and automated system which comprises of assay-specific reagents, EliA method-specific reagents, and general reagents.

    Assav-Specific Reagents include:

    • EliA Rib-P Wells: coated with human recombinant ribosomal P-proteins P0, P1 . and P2 - 2 carriers (12 wells each), ready to use;
    • . EliA ANA 3 Positive Control 250 or 2500/5000: Human monoclonal antibodies in Tris buffer containing IgG antibodies to Ro52, Rib-P and RNA Pol III – 6 single use vials, 0.3 mL each, ready to use;
    • . EliA IgG/IgM/IgA Negative Control 250 or 2500/5000: Human blood preparation from healthy donors in PBS containing BSA, detergent and 0.095% sodium azide - 6 single-use vials, 0.3 mL each, ready to use;

    EliA Method-Specific Reagents include:

    • EliA Sample Diluent: PBS containing BSA, detergent and 0.095% sodium azide . - 6 bottles, 48 mL each, ready to use; or 6 bottles, 400 mL each, ready to use;
    • I EliA IqG Conjuqate 50 or 200: ß-Galactosidase labeled anti-lgG (mouse monoclonal antibodies) in PBS containing BSA and 0.06% sodium azide - 6 wedge shaped bottles, 5 mL each, ready to use; or 6 wedge shaped bottles, 19 mL each, ready to use:
    • . EliA IgG Calibrator Strips: Human IqG (0, 4, 10, 20, 100, 600 uq/L) in PBS containing BSA, detergent and 0.095% sodium azide - 5 strips, 6 single-use vials per strip, 0.3 mL each, ready to use;
    • EliA IgG Curve Control Strips: Human IgG (20 ug/L) in PBS containing BSA, . detergent and 0.095% sodium azide - 5 strips, 6 single-use vials per strip, 0.3 mL each, ready to use:
    • EliA IgG Calibrator Well: coated with mouse monoclonal antibodies 4 carriers . (12 wells each), ready to use;

    General Reagents include:

    • Development Solution: 0.01% 4-Methylumbelliferyl-β-D-galactoside, 110, 6x >170, or 6x >1165 determinations;
    • I Stop Solution: 4% Sodium Carbonate - 6 bottles (65 mL, 119 mL, or 2800 mL each), sufficient for 6x >292, 6x >560, or 6x >13100 determinations;
    • 트 Washing Solution Additive: detergent, preservative
    AI/ML Overview

    The provided document is a 510(k) Summary for the EliA Rib-P device, an in vitro semi-quantitative immunoassay for detecting IgG antibodies directed to Rib-P as an aid in diagnosing Systemic Lupus Erythematosus (SLE). This document does not describe a study involving an AI-enabled device or human-in-the-loop performance. Instead, it focuses on the analytical and clinical performance of a standalone laboratory diagnostic device and its substantial equivalence to a predicate device.

    However, I can extract and structure the information related to acceptance criteria and the performance study of this specific diagnostic device in the format requested, even without AI-specific parameters.


    Acceptance Criteria and Device Performance Study for EliA Rib-P

    The EliA Rib-P device is an automated semi-quantitative solid phase fluoroenzymeimmunoassay for the measurement of IgG antibodies directed to Rib-P in human serum. This summary outlines the performance characteristics tested to demonstrate its substantial equivalence to a legally marketed predicate device, the Quanta Lite Ribosome P ELISA.

    1. Table of Acceptance Criteria and the Reported Device Performance

    ParameterAcceptance Criteria (Implied by Study Design)Reported Device Performance (EliA Rib-P)
    Analytical Performance
    Precision/ReproducibilityInter-run, inter-instrument, and lot-to-lot variability to be within acceptable limits (typically low %CV). CLSI EP05-A3 guidelines followed.Phadia 250:
    • Range of Total Imprecision %CV across 5 samples: 4.0% - 13.3%
    • Within-lab Imprecision %CV across 4 samples: 3.5% - 13.8%
      Phadia 2500/5000:
    • Range of Total Imprecision %CV across 5 samples: 5.7% - 18.4% (one sample had high CV, 18.4%) |
      | Linearity/Reportable Range| Coefficient of determination (R²) close to 1.00, and slopes close to 1.00, across the measuring range. CLSI EP6-A guidelines followed. | Phadia 250:
    • R² values: 1.00 for all three dilution ranges.
    • Slopes: 0.95, 1.00, 1.00.
      Phadia 2500E:
    • R² values: 0.99, 1.00, 0.99 for the three dilution ranges.
    • Slopes: 1.03, 1.00, 1.02.
      "Linearity was shown for the entire measuring range." |
      | Detection Limit | LoB, LoD, and LoQ to be established according to CLSI EP17-A2 guidelines (false positives and false negatives 10 EliA U/mL |
      | Comparison Studies | | |
      | Method Comparison (vs. Predicate Device) | High Positive Percent Agreement (PPA), Negative Percent Agreement (NPA), and Total Agreement with the predicate device. CLSI EP09c-ED3 followed. | EliA Rib-P (equivocal considered negative):
    • PPA: 94.7% (95% CI: 82.3% - 99.4%)
    • NPA: 98.6% (95% CI: 96.4% - 99.6%)
    • Total Agreement: 98.1% (95% CI: 96.0% - 99.3%)
      EliA Rib-P (equivocal considered positive):
    • PPA: 100% (95% CI: 90.7% - 100%)
    • NPA: 88.1% (95% CI: 83.7% - 91.6%)
    • Total Agreement: 89.5% (95% CI: 85.6% - 92.6%) |
      | Instrument Comparison | Strong correlation and agreement between different Phadia instrument series. | Regression analysis showed a slope of 0.94 (95% CI: 0.93 - 0.98) and an intercept of -0.76 (95% CI: -1.20 - -0.48) between Phadia 250 and Phadia 2500E. |
      | Clinical Studies | | |
      | Clinical Sensitivity and Specificity | Acceptable sensitivity for SLE and high specificity against other autoimmune and infectious diseases. | EliA Rib-P (equivocal considered positive):
    • Sensitivity (for SLE): 34.9% (95% CI: 27.2% - 43.3%)
    • Specificity (against disease controls): 99.3% (95% CI: 97.9% - 99.9%)
      EliA Rib-P (equivocal considered negative):
    • Sensitivity (for SLE): 28.1% (95% CI: 21.0% - 36.1%)
    • Specificity (against disease controls): 99.8% (95% CI: 98.7% - 100%) |

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

    • Precision/Reproducibility:
      • Phadia 250: 5 samples, tested in 252 replicates each across 3 lots and 3 instruments over 7 days.
      • Within-Lab Imprecision: 4 samples, tested in 80 replicates each on 1 instrument over 20 days.
      • Phadia 2500/5000 (E-module): 5 samples, tested in 84 replicates each on 3 instruments over 7 days.
      • Provenance: Not explicitly stated, typically laboratory-prepared controls or banked human serum samples.
    • Linearity/Assay Reportable Range: 3 serum samples (diluted). Provenance not explicitly stated.
    • Detection Limit: 4 blank and 4 low-level samples (depleted IgG sera and prepared low-level samples) tested in 5-fold determination across 3 runs on Phadia 250 and Phadia 2500E.
    • Analytical Specificity (Interference): 3 serum samples (one negative, one equivocal, one high positive) spiked with interfering substances. Provenance not explicitly stated.
    • Assay Cut-Off: A cohort of 70 apparently healthy blood donors and 30 samples from SLE patients. Provenance not explicitly stated.
    • Method Comparison with Predicate Device: 323 patient samples. Provenance not explicitly stated, but implies diverse clinical samples covering the measuring range.
    • Instrument Comparison: 47 positive, 10 equivocal, and 28 negative samples. Provenance not explicitly stated.
    • Clinical Sensitivity and Specificity: 560 clinically defined serum samples from various diagnostic groups (146 SLE, 414 disease controls). Provenance not explicitly stated, but these are patient samples with confirmed diagnoses.
    • Expected Values/Reference Range: 638 apparently healthy subjects, equally distributed by age and gender from Caucasian, African American, Hispanic, and Asian populations obtained from a blood bank.

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

    The document does not mention the use of experts to establish ground truth for the analytical performance characteristics. For clinical studies, the "ground truth" for patient samples was based on "clinically defined serum samples with a diagnosis" (e.g., systemic lupus erythematosus, Celiac disease, etc.). This typically implies diagnosis by medical professionals (e.g., rheumatologists, gastroenterologists, etc.) based on established diagnostic criteria, but the number and specific qualifications of these experts are not explicitly stated in this summary.

    4. Adjudication Method (e.g. 2+1, 3+1, none) for the Test Set

    No explicit adjudication method is mentioned. The ground truth for clinical samples appears to be based on pre-existing clinical diagnoses.

    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

    This section is not applicable as the device is a standalone in vitro diagnostic immunoassay, not an AI-enabled device or an assist device for human readers. No MRMC study was conducted.

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

    This device is a standalone algorithm/device in the sense that it performs automated semi-quantitative measurement of antibodies without real-time human interpretation impacting the measurement result. The assay directly measures the amount of antibody via fluorescence. The interpretation of results (negative, equivocal, positive) is based on predefined cut-offs.

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

    • Analytical ground truth: Based on reference materials, spiked samples, and dilution series with known concentrations or characteristics.
    • Clinical ground truth: "Clinically defined serum samples with a diagnosis" (e.g., SLE patients, various disease controls). This implies established clinical diagnoses, likely based on standard diagnostic criteria, which could involve expert clinical assessment, pathology, and other laboratory findings.

    8. The Sample Size for the Training Set

    This document does not specify a separate "training set" in the context of machine learning or AI. For a traditional immunoassay, method development and optimization would involve various experiments and sample sets, but these are not explicitly termed "training sets" here. The "Assay Cut-Off" study used 70 healthy blood donors and 30 SLE patients to define the cut-off, which could be considered a form of "training" for the interpretive criteria.

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

    As noted above, a formal "training set" in the AI sense is not described. For the cut-off determination, the ground truth was established by using "apparently healthy blood donors" and "samples from SLE patients," indicating that these samples had known clinical statuses (healthy or diagnosed with SLE).

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    K Number
    K202067
    Device Name
    EliA SmDP-S
    Manufacturer
    Date Cleared
    2021-07-14

    (352 days)

    Product Code
    Regulation Number
    866.5100
    Reference & Predicate Devices
    Why did this record match?
    Reference Devices :

    K082759, K141375, K151799

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    EliA SmDP-S is intended for the in vitro semi-quantitative measurement of IgG antibodies directed to Sm in human serum and EDTA-plasma as an aid in the diagnosis of systemic lupus erythematosus (SLE) in conjunction with other laboratory and clinical findings. EliA SmDP-S uses the EliA IgG method.

    Device Description

    The EliA SmD -S is a semi-quantitative solid-phase fluoroimmunoassay, for the determination of autoantibodies against Sm. The EliA SmDP-S test System is fully integrated and automated system which comprises of assay-specific reagents, EliA method-specific reagents, and general reagents.

    AI/ML Overview

    1. Table of Acceptance Criteria and Reported Device Performance

    The acceptance criteria for the EliA SmDP-S device are not explicitly stated as distinct criteria with numerical targets in the provided document. Instead, the document presents performance characteristics that implicitly serve as acceptance criteria by demonstrating that the device is substantially equivalent to a predicate device. Below is a summary of the reported device performance for key analytical and clinical characteristics.

    Performance CharacteristicAcceptance Criteria (Implicit)Reported Device PerformanceComments
    Precision (Phadia 250 Total Imprecision)Acceptable CV% at various concentrationsAt 5.2 EliA U/mL: SD 0.8, %CV 15.4
    At 9.4 EliA U/mL: SD 1.0, %CV 10.7
    At 11.1 EliA U/mL: SD 0.4, %CV 4.1
    At 105.0 EliA U/mL: SD 3.4, %CV 3.2
    At 273.0 EliA U/mL: SD 25.8, %CV 9.4Within general expectations for immunoassays, especially around cut-off values.
    Precision (Phadia 2500/5000 Total Imprecision)Acceptable CV% at various concentrationsAt 4.8 EliA U/mL: SD 0.5, %CV 10.7
    At 8.7 EliA U/mL: SD 0.7, %CV 8.3
    At 9.6 EliA U/mL: SD 0.9, %CV 8.9
    At 102 EliA U/mL: SD 6.2, %CV 6.1
    At 256 EliA U/mL: SD 20.0, %CV 7.6Shows similar performance to Phadia 250.
    Linearity (R2)R2 close to 1.00 across the claimed linear rangePhadia 250: 1.00 for all dilution ranges
    Phadia 2500E: 1.00, 0.99, 1.00 for dilution rangesIndicates excellent linearity. Claimed linear range: 0.8 (LoQ) - 310.8 EliA U/mL.
    Detection Limit (LoQ)Low LoQ to detect low concentrationsHarmonized LoQ: 0.8 EliA U/mLIndicates good sensitivity for detection.
    Analytical Specificity (Interference)No significant interference from common substances and medicationsRatio of blank/spiked sample ranged from 0.92 - 1.09. No interference observed up to specified high concentrations.Demonstrates robustness against common interferents.
    Method Comparison with Predicate (PPA/NPA)High agreement (PPA & NPA) with predicate device (EliA SmDP)EliA SmDP-S equivocal as negative: PPA 91.8% (95% CI: 86.9–95.4), NPA 96.7% (95% CI: 93.9–98.5), Total 94.8% (95% CI: 92.3–96.6)
    EliA SmDP-S equivocal as positive: PPA 92.6% (95% CI: 88.3–95.7), NPA 97.1% (95% CI: 94.2–98.8), Total 95.0% (95% CI: 94.2–98.8)High agreement supports substantial equivalence to predicate.
    Clinical Sensitivity (for SLE diagnosis)Acceptable sensitivity for SLE given its specific natureEquivocal as Positive/Negative: 18.3% (95% CI: 11.4% - 27.1%)This value (18.3%) appears specific to Sm antibodies in SLE, which are not present in all SLE patients. It is not an overall SLE diagnostic sensitivity.
    Clinical Specificity (disease controls)High specificity among various disease controlsEquivocal as Positive: 98.7% (95% CI: 96.1% - 99.7%)
    Equivocal as Negative: 99.6% (95% CI: 97.5% - 100%)High specificity is crucial to reduce false positives in a diagnostic aid.
    Matrix ComparisonHigh correlation between serum and EDTA plasma, and within pre-defined specificationsSerum vs. EDTA plasma: Slope 0.99 (0.96 – 1.02), Intercept 0.13 (-0.12 to 0.38), R2 1.00Confirms EDTA plasma suitability for testing.

    2. Sample Sizes and Data Provenance

    • Test Set (Method Comparison):
      • Sample Size: A total of 628 patient samples were initially tested in the method comparison study with the predicate device. For statistical analyses, 460 samples were used after excluding 168 values outside the measuring range.
      • Data Provenance: Not explicitly stated, but typically such studies involve samples collected from various clinical sites. It is implied to be clinical patient samples, likely retrospective given they were previously collected for comparison.
    • Test Set (Clinical Sensitivity and Specificity):
      • Sample Size: 328 clinically defined samples: 104 with Systemic Lupus Erythematosus (SLE) and 224 disease controls (Mixed connective tissue disease, Sjögren's syndrome, Scleroderma, Polymyositis/Dermatomyositis, Rheumatoid arthritis, Graves' disease, Hashimoto's disease, Bacterial infections, Viral infections).
      • Data Provenance: Not explicitly stated, but implied to be from clinical settings for diagnosed patients and controls. Likely retrospective.
    • Reference Range/Expected Values:
      • Sample Size: 632 apparently healthy subjects.
      • Data Provenance: Sera obtained from a blood bank, equally distributed by age and gender, from Caucasian, African American, Hispanic and Asian populations.

    3. Number of Experts and their Qualifications for Ground Truth

    • Number of Experts: Not specified.
    • Qualifications of Experts: The ground truth for clinical sensitivity and specificity was based on "clinically defined samples with a diagnosis". This implies that the diagnosis was established by medical professionals (e.g., rheumatologists, infectious disease specialists) based on a comprehensive clinical assessment, which would include other laboratory and clinical findings. The document does not provide details on the number or specific qualifications (e.g., years of experience) of these clinicians or specialists.

    4. Adjudication Method for the Test Set

    The document does not describe an explicit adjudication method (like 2+1 or 3+1 consensus) for establishing the ground truth of the test set samples. The samples were "clinically defined with a diagnosis" or "apparent healthy subjects," implying that their disease status or health status was established through standard clinical practice/diagnostic criteria rather than a specific expert adjudication process for the purpose of this study.

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

    No Multi-Reader Multi-Case (MRMC) comparative effectiveness study was mentioned. The device is an in vitro diagnostic (IVD) immunoassay, which typically does not involve human readers interpreting results in the same way imaging devices do. The performance evaluation focuses on the analytical and clinical accuracy of the assay itself compared to a predicate device and clinical diagnoses, not on human reader improvement with AI assistance.

    6. Standalone (Algorithm Only) Performance

    Yes, a standalone performance study was done. The entire document describes the performance of the EliA SmDP-S device as an in vitro diagnostic assay, which functions independently (algorithm only) to measure IgG antibodies. There is no human-in-the-loop component described for its operation or result generation. The device produces a semi-quantitative measurement (EliA U/mL) that is then interpreted based on defined cut-offs.

    7. Type of Ground Truth Used

    • For Method Comparison: The ground truth was the result obtained from the predicate device (EliA SmDP assay) for common patient samples.
    • For Clinical Sensitivity and Specificity: The ground truth was based on "clinically defined diagnoses" of patients with Systemic Lupus Erythematosus (SLE) and various disease controls. This implies a diagnosis established through standard clinical criteria, which would include medical history, physical examination, other laboratory tests, and imaging findings (i.e., clinical diagnosis/outcomes data).
    • For Reference Range: The ground truth was a group of "apparently healthy subjects."

    8. Sample Size for the Training Set

    The document does not explicitly mention a "training set" in the context of device development or algorithm training. For IVD devices like this, the development process usually involves internal validation and optimization batches, but not typically a formally labeled "training set" in the sense of machine learning. The studies described are primarily for validation and verification of the final device performance.

    9. How Ground Truth for Training Set was Established

    As no explicit "training set" is mentioned, the method for establishing its ground truth is also not detailed. However, for the development and optimization of such assays, ground truth for sample panels would typically be established using confirmed clinical diagnoses, reference methods, or well-characterized reference materials, similar to how the validation samples' ground truth was established using clinical diagnoses and predicate device comparisons.

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