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制定医疗器械的客观性能标准。

Creation of objective performance criteria among medical devices.

作者信息

Gressler Laura Elisabeth, Marinac-Dabic Danica, dosReis Susan, Goodney Philip, Mullins C Daniel, Shaya Fadia

机构信息

Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, Maryland, USA.

出版信息

BMJ Surg Interv Health Technol. 2022 Aug 1;4(1):e000106. doi: 10.1136/bmjsit-2021-000106. eCollection 2022.

Abstract

OBJECTIVES

Objective performance criteria (OPC) may serve as a tool to expedite the approval process and continue active surveillance of class III medical devices. Thus far, published guidance on the creation of OPC has been clinical area-specific. This study aimed to capture reflections from key stakeholders on the creation of OPC that may serve as a precursor for a formalized conceptual framework within the USA.

DESIGN

Reflections from key stakeholders and guidance from an advisory committee were captured to gain an understanding of the elements that are crucial to the generation of OPC.

SETTING

A non-probability sampling method using the purposive sampling strategy was employed to identify relevant stakeholders for engagement in semi-structured, open-ended, concept elicitation discussions.

PARTICIPANTS

Stakeholders involved in the generation of OPC.

MAIN OUTCOME MEASURES

Elements and themes regarding the priorities of, experiences with, roles within and perceived challenges associated with OPC creation captured through a phenomenological approach.

RESULTS

A total of 27 participants were engaged to represent the following contributors: representatives of registries, health systems, health technology assessment bodies, clinicians, device application reviewers, payers, patients, patient representatives, patient caregivers, device manufacturers, data coordinators, data analysts and data informaticians. Consensus was achieved on the five core elements: (1) identification of medical devices, (2) engagement of key stakeholders, (3) selection of data source, (4) performance of appropriate statistical analyses and (5) reporting of findings. The engagement of key stakeholders (38%) was cited most frequently as the most important core element. Access to meaningful and high-quality data sources (47%) was the most frequently mentioned challenge.

CONCLUSIONS

The reflections from the participants identified five elements to be considered when generating an OPC within class III medical devices and may provide the needed foundation for the development of official guidance on OPC generation.

摘要

目的

客观性能标准(OPC)可作为加快III类医疗器械审批流程并持续进行主动监测的工具。迄今为止,已发布的关于制定OPC的指南是针对特定临床领域的。本研究旨在收集关键利益相关者对OPC制定的看法,这些看法可能成为美国正式概念框架的前身。

设计

收集关键利益相关者的看法以及咨询委员会的指导意见,以了解对生成OPC至关重要的要素。

设置

采用非概率抽样方法,运用目的抽样策略来确定参与半结构化、开放式概念引出讨论的相关利益者。

参与者

参与OPC生成的利益相关者。

主要观察指标

通过现象学方法获取的关于OPC创建的优先事项、经验、角色以及感知挑战的要素和主题。

结果

共有27名参与者代表了以下贡献者:注册机构、卫生系统、卫生技术评估机构、临床医生、器械应用评审员、支付方、患者、患者代表、患者护理人员、器械制造商、数据协调员、数据分析员和数据信息专家。就五个核心要素达成了共识:(1)医疗器械的识别;(2)关键利益相关者的参与;(3)数据源的选择;(4)进行适当的统计分析;(5)结果报告。关键利益相关者的参与(38%)被最频繁地提及为最重要的核心要素。获取有意义且高质量的数据源(47%)是最常提到的挑战。

结论

参与者的看法确定了在生成III类医疗器械的OPC时要考虑的五个要素,并可能为制定关于OPC生成的官方指南提供所需的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d1/9345051/2eb5d8c8bcd6/bmjsit-2021-000106f01.jpg

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