Lagerburg Vera, van den Boorn Michelle, Crane Reinier F, Welvaars Koen, Groen Jaap M
Department of Medical Physics, OLVG, Amsterdam, Netherlands.
Department of Medical Physics and Instrumentation, St. Antonius Hospital, Nieuwegein, Netherlands.
Front Digit Health. 2025 Apr 1;7:1461107. doi: 10.3389/fdgth.2025.1461107. eCollection 2025.
The legislation regarding in-house development of medical devices has changed substantially with the introduction of the Medical Device Regulation (MDR) in 2021. Practical guidelines regarding the implementation of a quality management system for in-house developed medical software are scarce. In this article, we describe our experience with fulfilling the requirements of the MDR for an in-house developed prediction model, qualified as medical software.
Our quality management system (QMS) is based on the ISO13485:2016. It is a workflow consisting of elements subdivided in subelements, which consist of procedures, work instructions and/or formats. Within the data science team procedures regarding the process and documentation of software development were already in place. The existing procedures and documentation were compared with the procedures of the QMS and where possible, integrated into the workflow. The gap between the existing procedures regarding software development and the procedures of the QMS was defined. Existing documentation and procedures were used as much as possible. If there was a gap, additional documentation was written.
The majority of the (sub)elements was considered to be applicable for our software development project beforehand. Only in 6 out of 32 cases (19%), the (sub)element was deemed not applicable. For 32% of the applicable elements the documentation of the data scientists team was sufficient and additional information was not needed. For 23% the documentation was incomplete and we decided to add relevant information to fulfil the requirements of the MDR and for 45% the documentation was completely lacking and the standard formats were used.
We showed in this article that it is possible to use a QMS developed with physical medical products in mind for medical software and thus comply with applicable legislation and regulations. This can be done without too much effort when there is already some structured form of software development methodology in place.
随着2021年《医疗器械法规》(MDR)的出台,关于医疗器械内部开发的法规发生了重大变化。关于内部开发医疗软件的质量管理体系实施的实用指南很少。在本文中,我们描述了我们在满足MDR对内部开发的预测模型(被认定为医疗软件)要求方面的经验。
我们的质量管理体系(QMS)基于ISO13485:2016。它是一个由元素组成的工作流程,这些元素又细分为子元素,子元素由程序、工作指令和/或格式组成。数据科学团队内部已经有关于软件开发过程和文档的程序。将现有程序和文档与QMS的程序进行比较,并在可能的情况下整合到工作流程中。定义了现有软件开发程序与QMS程序之间的差距。尽可能多地使用现有文档和程序。如果存在差距,则编写额外的文档。
大多数(子)元素事先被认为适用于我们的软件开发项目。在32个案例中,只有6个(19%)案例中的(子)元素被认为不适用。对于32%的适用元素,数据科学家团队的文档就足够了,不需要额外信息。对于23%的元素,文档不完整,我们决定添加相关信息以满足MDR的要求,对于45%的元素,文档完全缺失,我们使用了标准格式。
我们在本文中表明,有可能将为物理医疗产品开发的QMS用于医疗软件,从而符合适用的法律法规。当已经存在某种结构化的软件开发方法时,可以不费太多力气做到这一点。