D'Angelo Advantage LLC, Rockwood, MI.
College of American Pathologists, Northfield, IL.
Am J Clin Pathol. 2018 Apr 25;149(6):484-498. doi: 10.1093/ajcp/aqy014.
We introduce regulatory terms, definitions, and the Quality System Regulation as proposed by the US Food and Drug Administration in the 2014 draft guidance entitled Framework for Regulatory Oversight of Laboratory Developed Tests and explore medical device requirements applicable to a laboratory environment to design, develop, and validate laboratory developed tests (LDTs).
We performed nine interviews with laboratory professionals to explore concerns and challenges regarding the draft, translated the results into operational factors, and surveyed professionals to test the factors that would comprise a regulatory quality management system framework.
Nine interviewees and 35 survey respondents shared concerns of risk classification, process validation, patient safety, and general ambiguity regarding the proposed requirements for development of LDTs.
Respondents agree that a regulatory quality management system is needed in laboratories that develop LDTs, but the translation and method for design control to a clinical laboratory do not exist. As a result, laboratories are taking the wait-and-see approach.
我们介绍了由美国食品和药物管理局在 2014 年题为“实验室开发的检测监管框架”草案指南中提出的监管术语、定义和质量体系法规,并探讨了适用于设计、开发和验证实验室开发的检测(LDT)的实验室环境的医疗器械要求。
我们对 9 名实验室专业人员进行了访谈,以探讨他们对该草案的关注和挑战,将结果转化为操作因素,并对专业人员进行了调查,以测试构成监管质量管理体系框架的因素。
9 名受访者和 35 名调查对象对 LDT 开发的拟议要求表示关注,包括风险分类、过程验证、患者安全和普遍的模糊性。
受访者一致认为,开发 LDT 的实验室需要监管质量管理体系,但向临床实验室设计控制的翻译和方法尚不存在。因此,实验室采取观望态度。