Validation of quantitative liquid chromatography—mass spectrometry software for good laboratory practice compliance

The application of the UK Department of Health Good Laboratory Practice (GLP) guidelines to computer systems is discussed including the scope of an inspection of a computer system for compliance. A validation case history of software for quantitative liquid chromatography—mass spectrometry is reviewed including generation of the validation test plan and brief details of the validation tests performed. Tests for system security, sample continuity, accuracy of integration, accuracy of calibration, and integrity of data exported from the system are described..     

FDA regulation of invasive neural recording electrodes: a daunting task for medical innovators

The U.S. Food and Drug Administration (FDA) is charged with assuring the safety and effectiveness of medical devices. Before any medical device can be brought to market, it must comply with all federal regulations regarding FDA processes for clearance or approval. Navigating the FDA regulatory process may seem like a daunting task to the innovator of a novel medical device who has little experience with the FDA regulatory process or device commercialization. This review introduces the basics of the FDA regulatory premarket process, with a focus on issues relating to chronically implanted recording devices in the central or peripheral nervous system. Topics of device classification and regulatory pathways, the use of standards and guidance documents, and optimal time lines for interaction with the FDA are discussed. Additionally, this article summarizes the regulatory research on neural implant safety and reliability conducted by the FDA's Office of Science and Engineering Laboratories (OSEL) in collaboration with Defense Advanced Research Projects Agency (DARPA) Reliable Neural Technology (RE-NET) Program. For a more detailed explanation of the medical device regulatory process, please refer to several excellent reviews of the FDA's regulatory pathways for medical devices [1]-[4].     

Laboratory software validation — from corporate policy to bench top systems

This tutorial presents a practical approach to implementing computer validation across a whole laboratory organization. It discusses the types of policies and practices which need to exist in order to meet both business and regulatory needs in the multi-system, multi-department laboratory workplace. It advocates the use of international standards (IEEE, ISO) and global regulations (GLP, GCP, GMP, CANDA) for validation activities and documentation. Experience has shown the approach to be useful in many companies and in many countries.     

FDA regulation of computerized cytology devices

When talking about computerized cytology devices, a "different" aspect of quality assurance must be addressed. Any medical device intended for in vitro diagnostic use in the United States must be cleared or approved by the Food and Drug Administration (FDA): the May 28, 1976, Medical Device Amendments to the Federal Food, Drug and Cosmetic Act granted authority to the FDA to regulate medical devices. The FDA regulatory process as it relates to computerized cytology devices is discussed. This includes an explanation of the differences between the two types of documents used to clear a medical device: (1) premarket notification [510(k)] and (2) premarket approval (PMA) application. Devices intended for "research use only" are also discussed. A computerized cytology device of current interest, the "automated Pap smear reader," is used as an example to further discuss performance and software considerations.     

New FDA guidelines for anti-infective drugs

The 1977 Guidelines for the Evaluation of Anti-infective Drug Products are no longer useful. The IDSA has established a contract with the FDA to revise and update these documents. Thirteen sub-committees will address specific areas of infectious diseases. A general guideline will also be written that proposes modification of the drug evaluation process. The documents will be reviewed by specialist in infectious diseases and clinical microbiology working in practice, academic medicine, the pharmaceutical industry, and the FDA. A second series of draft documents will be prepared and reviewed again, with final approval provided by the FDA. Current plans call for presentation of these guidelines to FDA Advisory Committees in November 1990. Publication of most or all of these guidelines is the primary objective of the contract. If successful, the process may be used to develop guidelines for the evaluation of other classes of drugs, medical devices, and biologic products.     

A broader view of validation; the balance of compliance and science

Validation is discussed in terms of the business environment and its implementation as a balance between the requirements of science and compliance. “Top down” and “Bottom up” methods are discussed in the light of current regulatory practices of ISO, NAMAS, GLP, and GMP etc. A framework is proposed to allow a common sense approach to validation programmes.     

Guidelines for analytical method development and validation of biotechnological synthesis of drugs. Production of a hydroxyprogesterone as model

In connection with biotechnological synthesis of pharmaceutical drugs, validated methods for quantification of both product and substrate at different time intervals are essential for proper calculation of rate coefficients. In this field, there still exist no guidelines for analytical validation, unlike the situation in the bioanalytical field. Therefore, in this study the detailed guidelines by FDA for bioanalytical method validation were applied to a typical biotechnological process; the enzymatic synthesis of 9alpha-hydroxyprogesterone in E. coli using progesterone as substrate. The process liquid was extracted and analyzed using an HPLC-DAD system. The quality control (QC) samples of the product demonstrated excellent precision (C.V.<1.5%) and accuracy between 99.3 and 107%. The study showed that the recommendations and the validation terms for bioanalytical methods can be used also for biotechnological production, but with some important exceptions. The tolerances (C.V. values) of the validation terms should be much narrower; the internal standard (I.S.) must be present in the process liquid before the start of the process and must be much different in structure from the substrate (so as not to participate in the biotechnological process). In addition, the selectivity must be checked very frequently during the process due to the changes in the blank process liquid with time.     

Anatomically-based skeletal coordinate systems for use with impact biomechanics data intended for anthropomorphic test device development

Post-mortem human subjects (PMHS) are frequently used to characterize biomechanical response and injury tolerance of humans to various types of loading by means of instrumentation installed directly on the skeleton. Data extracted from such tests are often used to develop and validate anthropomorphic test devices (ATDs), which function as human surrogates in tests for injury assessment. Given that the location and orientation of installed instrumentation differs between subjects, nominally similar measurements made on different PMHS must be transformed to standardized, skeletal-based local coordinate systems (LCS) before appropriate data comparisons can be made. Standardized PMHS LCS that correspond to ATD instrumentation locations and orientations have not previously been published. This paper introduces anatomically-defined PMHS LCS for body regions in which kinematic measurements are made using ATDs. These LCS include the head, sternum, single vertebrae, pelvis, femurs (distal and proximal), and tibiae (distal and proximal) based upon skeletal landmarks extracted from whole body CT scans. The proposed LCS provide a means to standardize the reporting of PMHS data, and facilitate both the comparison of PMHS impact data across institutions and the application of PMHS data to the development and validation of ATDs.     

GLP机构档案室的建立和管理与科研档案管理之比较

档案的建立和管理在药物非临床安全性评价和科学研究中都起到非常重要的作用。我们通过查阅文献发现,关于GLP机构档案管理的文献综述极少,涉及到将它与科研档案管理作系统全面的比较的文章是没有的。现从资料档案保存机构的硬件设施、档案管理规范和应注意的问题3个方面详细介绍了资料档案管理的相关规定和经验,并将GLP档案管理规范与科研档案管理规范作比较,我们根据国家档案局发布的《科学技术研究档案管理暂行规定》和7年GLP档案管理经验以及多次国家食品药品监督管理局(SFDA)认证现场检查的经历,总结出两者在功能实现、硬件设施、温湿度要求、档案防护、制定SOP、档案管理人员资质、各方人员职责、归档范围、归档形式、资料档案的接收与审查、归档时间、保管期限、借阅返还规定、资料的书写规范性、进出记录和电子文件的保存这16个方面的异同之处,突出GLP档案管理规范的特点和重点。通过这一深入全面的比较分析,得出GLP档案管理更加明确、具体、细致和可操作。     

Barriers and enablers to introducing comprehensive patient blood management in the hospital

Patient Blood Management (PBM) is a patient-focused multidisciplinary and comprehensive concept that is designed to ensure the optimal, appropriate and safe use of blood and blood products, resulting in better outcome and safety for the recipients. The World Health Organization, in May 2010, adopted a resolution in favour of PBM, on the availability, safety and quality of blood products and their safe and rational use. However, several factors may enhance or hamper this process including health care personnel, available techniques and technologies, devices, standards, guidelines and documentation, quality systems as well as coordination, monitoring and evaluation. The implications in developing countries may have other peculiarities.     

Introduction to the Food and Drug Administration (FDA) regulatory process

FDA oversight of medical devices, including in vitro diagnostic devices (IVDs or laboratory tests), in the United States was a direct result of the passage of the Medical Device Amendments of 1976. This law introduced a series of general controls for medical devices including registration and listing, requirements for production using good manufacturing practices, and requirements for post-market reporting of device failures. This produced for the first time a menu of laboratory tests on the market, a system to ensure these were produced consistently over time, and a mechanism for FDA to identify problems with device use and to work with companies to ensure corrective action. This law also introduced the requirement for premarket review of new versions of old devices and of fundamentally new medical devices.     

Results and harmonization guidelines from two large-scale international Elispot proficiency panels conducted by the Cancer Vaccine Consortium (CVC/SVI)

The Cancer Vaccine Consortium of the Sabin Vaccine Institute (CVC/SVI) is conducting an ongoing large-scale immune monitoring harmonization program through its members and affiliated associations. This effort was brought to life as an external validation program by conducting an international Elispot proficiency panel with 36 laboratories in 2005, and was followed by a second panel with 29 participating laboratories in 2006 allowing for application of learnings from the first panel. Critical protocol choices, as well as standardization and validation practices among laboratories were assessed through detailed surveys. Although panel participants had to follow general guidelines in order to allow comparison of results, each laboratory was able to use its own protocols, materials and reagents. The second panel recorded an overall significantly improved performance, as measured by the ability to detect all predefined responses correctly. Protocol choices and laboratory practices, which can have a dramatic effect on the overall assay outcome, were identified and lead to the following recommendations: (A) Establish a laboratory SOP for Elispot testing procedures including (A1) a counting method for apoptotic cells for determining adequate cell dilution for plating, and (A2) overnight rest of cells prior to plating and incubation, (B) Use only pre-tested serum optimized for low background: high signal ratio, (C) Establish a laboratory SOP for plate reading including (C1) human auditing during the reading process and (C2) adequate adjustments for technical artifacts, and (D) Only allow trained personnel, which is certified per laboratory SOPs to conduct assays. Recommendations described under (A) were found to make a statistically significant difference in assay performance, while the remaining recommendations are based on practical experiences confirmed by the panel results, which could not be statistically tested. These results provide initial harmonization guidelines to optimize Elispot assay performance to the immunotherapy community. Further optimization is in process with ongoing panels.     

Characteristics of Pivotal Trials and FDA Review of Innovative Devices

When patients lack sufficient treatment options for serious medical conditions, they rely on the prompt approval and development of new therapeutic alternatives, such as medical devices. Understanding the development of innovative medical devices, including the characteristics of premarket clinical trials and length of Food and Drug Administration (FDA) review, can help identify ways to expedite patient access to novel technologies and inform recent efforts by FDA to more quickly get these products to patients and physicians. We analyzed publicly available information on clinical trials and premarket FDA review for innovative medical devices that fill an unmet medical need. In this first-of-its-kind study focusing on these products, we extracted data on the length of the pivotal trials, primary study endpoint and FDA review; number of patients enrolled in trials; and in what country the device was available first. We identified 27 approved priority review devices from January 2006 through August 2013. The median duration of pivotal clinical trials was 3 years, ranging from 3 months to approximately 7 years. Trials had a median primary outcome measure evaluation time of one year and a median enrollment of 297 patients. The median FDA review time was 1 year and 3 months. Most priority review devices were available abroad before they were approved in the United States. Our study indicates that addressing the length of clinical studies—and contributing factors, such as primary outcome measures and enrollment—could expedite patient access to innovative medical devices. FDA, manufacturers, Congress and other stakeholders should identify the contributing factors to the length of clinical development, and implement appropriate reforms to address those issues.     

GLP机构档案室的建立和管理与科研档案管理之比较

档案的建立和管理在药物非临床安全性评价和科学研究中都起到非常重要的作用。我们通过查阅文献发现,关于GLP机构档案管理的文献综述极少,涉及到将它与科研档案管理作系统全面的比较的文章是没有的。现从资料档案保存机构的硬件设施、档案管理规范和应注意的问题3个方面详细介绍了资料档案管理的相关规定和经验,并将GLP档案管理规范与科研档案管理规范作比较,我们根据国家档案局发布的《科学技术研究档案管理暂行规定》和7年GLP档案管理经验以及多次国家食品药品监督管理局（SFDA）认证现场检查的经历,总结出两者在功能实现、硬件设施、温湿度要求、档案防护、制定SOP、档案管理人员资质、各方人员职责、归档范围、归档形式、资料档案的接收与审查、归档时间、保管期限、借阅返还规定、资料的书写规范性、进出记录和电子文件的保存这16个方面的异同之处,突出GLP档案管理规范的特点和重点。通过这一深入全面的比较分析,得出GLP档案管理更加明确、具体、细致和可操作。     

Progress in proteomics for clinical microbiology: MALDI-TOF MS for microbial species identification and more

Although classical proteomic approaches are still used regularly in routine clinical diagnostic procedures, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) MS has recently moved into diagnostic microbiology laboratories. MALDI-TOF MS is currently replacing phenotypic microbial identification. Many laboratories now use MALDI-TOF MS for its high efficiency, both from a diagnostic and a cost-per-analysis point of view. The US FDA has now cleared two of the commercially available systems for in vitro diagnostics. This will further spark development of MS applications in antimicrobial susceptibility testing and epidemiology. This review summarizes the state of affairs of MALDI-TOF MS in clinical microbiology; however, this is an active field of research subject to rapid evolution. We emphasize assessment of the clinical relevance and studies focusing on data obtained through comparative analyses of different MALDI-TOF MS instrumentation and multicenter validation studies. The future of MALDI-TOF MS, including antimicrobial susceptibility testing and epidemiological typing, is also highlighted.     

Implementation of a configurable laboratory information management system for use in cellular process development and manufacturing

Background aimsRegulatory requirements for the manufacturing of cell products for clinical investigation require a significant level of record-keeping, starting early in process development and continuing through to the execution and requisite follow-up of patients on clinical trials. Central to record-keeping is the management of documentation related to patients, raw materials, processes, assays and facilities.MethodsTo support these requirements, we evaluated several laboratory information management systems (LIMS), including their cost, flexibility, regulatory compliance, ongoing programming requirements and ability to integrate with laboratory equipment. After selecting a system, we performed a pilot study to develop a user-configurable LIMS for our laboratory in support of our pre-clinical and clinical cell-production activities. We report here on the design and utilization of this system to manage accrual with a healthy blood-donor protocol, as well as manufacturing operations for the production of a master cell bank and several patient-specific stem cell products.ResultsThe system was used successfully to manage blood donor eligibility, recruiting, appointments, billing and serology, and to provide annual accrual reports. Quality management reporting features of the system were used to capture, report and investigate process and equipment deviations that occurred during the production of a master cell bank and patient products.ConclusionsOverall the system has served to support the compliance requirements of process development and phase I/II clinical trial activities for our laboratory and can be easily modified to meet the needs of similar laboratories.     

A compliance-independent pressure transducer for biomedical device-tissue interfaces

The measurement of the interface pressure between a biomedical device and part of the human body is useful to improve the performance and safety of such devices during design. Testing of a selection of existing interface pressure transducers has demonstrated that many are dependent on device and tissue compliance. Such a transducer is useful only in an application where it has been calibrated for specific device-tissue compliance combinations. To overcome this limitation, the authors developed an interface pressure transducer whose output signal is not affected by changes in interface compliance. This enables the transducer to quantitatively measure pressure in many applications without the need to calibrate it for varying compliance conditions. Surgical retraction and surgical tourniquets were selected as demonstration applications for the developed transducer, because they represent a wide spectrum of device and tissue characteristics and properties, and are in common use.     

Regulatory initiatives for natural latex allergy: US perspectives

The US Food and Drug Administration (FDA) has regulatory authority over foods, human drugs, cosmetics, medical devices, radiological products, biologics, and veterinary products. Among these products, FDA believes that the use of medical devices, including medical gloves, condoms, catheters, and breathing bags, represents the greatest source of natural latex proteins to exposed individuals. A medical device is defined in the Federal Food Drug and Cosmetic Act (FFDCA) as an instrument, apparatus, implement, machine, etc., that is intended for use in the diagnosis or treatment of disease or is intended to affect the structure or any function of the body of a human or other animal, and that does not achieve any of its principal intended purposes through chemical action in the body. This article provides some brief, general background about FDA's medical device regulatory process and then addresses the issue of natural latex allergy. Finally we discuss the steps the Agency has taken to evaluate the magnitude and nature of the problem, and FDA's efforts to assist manufacturers, health professionals, and others in minimizing exposure and sensitization to natural latex proteins in medical devices.     

Application of good laboratory practice (GLP) to culture collections of microbial and cell cultures

Although the principles and the necessity for good laboratory practice (GLP) guidelines to confirm the credibility, integrity, and quality of non-clinical laboratory studies have been known for more than a decade, culture collection activities are not subject to them. Because of recent advances in biotechnology, culture collections face increased demands not only for quality cultures but also current information. When applied in culture collections, GLP guidelines prove to be an excellent management tool as well as a cost-effective system of providing authentic and reliable microbial and cell cultures and associated data.     

Validation of biomarkers of food intake—critical assessment of candidate biomarkers

Biomarkers of food intake (BFIs) are a promising tool for limiting misclassification in nutrition research where more subjective dietary assessment instruments are used. They may also be used to assess compliance to dietary guidelines or to a dietary intervention. Biomarkers therefore hold promise for direct and objective measurement of food intake. However, the number of comprehensively validated biomarkers of food intake is limited to just a few. Many new candidate biomarkers emerge from metabolic profiling studies and from advances in food chemistry. Furthermore, candidate food intake biomarkers may also be identified based on extensive literature reviews such as described in the guidelines for Biomarker of Food Intake Reviews (BFIRev). To systematically and critically assess the validity of candidate biomarkers of food intake, it is necessary to outline and streamline an optimal and reproducible validation process. A consensus-based procedure was used to provide and evaluate a set of the most important criteria for systematic validation of BFIs. As a result, a validation procedure was developed including eight criteria, plausibility, dose-response, time-response, robustness, reliability, stability, analytical performance, and inter-laboratory reproducibility. The validation has a dual purpose: (1) to estimate the current level of validation of candidate biomarkers of food intake based on an objective and systematic approach and (2) to pinpoint which additional studies are needed to provide full validation of each candidate biomarker of food intake. This position paper on biomarker of food intake validation outlines the second step of the BFIRev procedure but may also be used as such for validation of new candidate biomarkers identified, e.g., in food metabolomic studies.