154 - IVD's, LDT's, Companion Diagnostics, Precision Medicine, Clinical Validation, Biomarkers, Test Methods, Detection Limits and CLIA with Devon C. Campbell

Let's Combinate · 18 Sept 2024 · 37m

What this episode covers

Devon Campbell, Founder of Prodct LLC and CPO of myBiometry, explains the regulatory and engineering distinctions between In Vitro Diagnostics (IVDs), Lab Developed Tests (LDTs), and companion diagnostics. He details how IVD development mirrors medical device design control but adds critical layers of risk management regarding false positives and negatives, particularly for home-use devices like COVID tests. Campbell emphasizes that clinical validation requires proving statistical validity across diverse populations to establish Limit of Detection (LOD) and sensitivity, noting that clinical studies are often the most time-consuming and expensive part of the process for startups.

Other shows on the same ground, closest first.

  • Global Medical Device Podcast · 44m

    #361: Speaking the Language of IVD

    Christie Hughes, a principal consultant and IVD expert at Qserve Group, explains the distinct regulatory, design, and risk management requirements for in vitro diagnostics (IVDs) compared to general medical devices. She details how IVDs are classified by complexity, the critical importance of user needs for diverse operators ranging from lab technicians to laypeople, and the specific hazards of false positives and negatives. Hughes also highlights the current industry upheaval caused by the FDA's proposed rule on Laboratory Developed Tests (LDTs) and the ongoing transition to the European IVDR, noting the significant compliance burden for labs and manufacturers alike.

  • Global Medical Device Podcast · 36m

    #348: Considerations for IVD

    Carmen Brown, regulatory and quality affairs manager at Proxima Clinical Research, explains the specific regulatory pathways for In Vitro Diagnostics (IVDs) under the FDA's CDRH. She details how IVD risk classification (Class 1, 2, or 3) depends on the consequences of false results, using examples like glucose monitors versus cancer diagnostics. Brown highlights common pitfalls in performance evaluation, particularly for multi-band diagnostics, arguing that likelihood ratios are superior to sensitivity and specificity for determining clinical utility. She also warns against the strategy of starting with Laboratory Developed Tests (LDTs) before pursuing full IVD approval, citing enforcement actions against companies like 23andMe as cautionary tales.

  • Global Medical Device Podcast · 34m

    Similarities & Differences between In Vitro Diagnostic (IVD) Devices & Medical Devices

    Milton Yarberry, Director of Medical Programs at Integrated Computer Solutions (ICS), joins host John Spear to discuss the regulatory and engineering distinctions between In Vitro Diagnostic (IVD) devices and traditional medical devices. They clarify that while IVDs are a subset of medical devices subject to similar quality systems (21 CFR Part 820, ISO 13485), their risk classification is based on the assay's impact rather than direct patient harm. The conversation highlights how IVD manufacturers often struggle with design controls because their background is in clinical science rather than commercial engineering, leading to a focus on analytical fidelity over user interface. They also address the evolving regulatory landscape, including CLIA Waiver requirements, the status of Lab Developed Tests (LDTs), and the impact of the EU MDR/IVDR and FDA Emergency Use Authorizations (EUA).

  • Global Medical Device Podcast · 37m

    Part 1: The Theranos Loophole & Lab Developed Tests

    Mike Drues, president of Vascular Sciences, explains the regulatory distinction between Lab Developed Tests (LDTs) and In Vitro Diagnostics (IVDs), noting that LDTs are currently exempt from FDA pre-market review under the guise of the 'practice of medicine.' He argues that this loophole, highlighted by the Theranos case, allows companies to bypass rigorous safety and efficacy testing, creating a double standard where hospitals face no oversight for modifying commercial devices while manufacturers do. Drues emphasizes that the VALID Act, which would bring LDTs under FDA jurisdiction, has been stalled in Congress despite bipartisan support, leaving a significant regulatory gap that risks patient safety.

  • Global Medical Device Podcast · 41m

    Quality Management for IVD Devices vs Medical Devices

    Joanne LeBrun of MDC Associates explains that while In Vitro Diagnostic (IVD) devices share quality management system (QMS) requirements with medical devices, they differ in performance proof, with IVDs often relying on leftover specimens rather than clinical studies. She highlights that the EU IVDR has significantly expanded regulation by changing device classification, while the pandemic has accelerated startup growth through contract manufacturing and molecular science advancements. LeBrun advises startups to avoid starting with a blank QMS, emphasizing the importance of robust internal audits, real-time documentation, and managing FDA inspections to prevent costly field failures and recalls.

The summary, chapters and topics are generated from the episode’s audio by this directory, not written by Let's Combinate. The episode itself belongs to its publisher.