Lack of Support in Medical Device Regulation within Academia

Medical device regulatory challenges in the UK are affecting innovation and its potential benefits

The increase in regulatory challenges on medical technology developed and deployed in the UK is having a negative impact on innovation. In this paper we show how the limited capacity of Approved and Notified Bodies is one more barrier in the innovation pipeline, that could push more teams to consider applying for FDA approval instead of UKCA marking, potentially limiting how much our patients benefit from the world-leading research undertaken in UK universities.

Elastodontic treatment with oral bio-activators in young children

BACKGROUND

Elastodontic therapy can correct bad oral habits and malocclusions in young patients by guiding jaw growth, eliminating functional disorders, and improving tooth position. The aim of this study was to assess the effects of bio-activator therapy on the presence of atypical swallowing with tongue thrust in growing patients.

METHODS

A retrospective study was conducted. Data regarding the early orthodontic treatment of 40 consecutive patients with atypical swallowing and tongue thrust (23 males and 17 females) were assembled from January 2019 to January 2020. All patients (≥7 and ≤15 years of age) were monitored for 1 year in a private practice in Isernia, Italy.

RESULTS

The mean age at commencement of orthodontic treatment was 8.5 years (range=7.1-14.9 years), and the mean total duration of therapy was 1 year (range=11 months-1 year). Final lateral radiographs demonstrated a mean of improvement of 8° for upper and lower incisor proclination (I/SN) and 3.5° for incisor mandibular plane angle (IMPA) in 36 patients, and 5° of I/SN and 2° of IMPA in the remaining 4 children after 1 year of treatment.

CONCLUSIONS

Bad oral habits in younger patients must not be ignored. The duration of treatment can differ depending on the severity of the open bite and the patient's cooperation. This study demonstrates the short-term efficacy of these myofunctional appliances in the treatment of atypical swallowing. In order to quickly eliminate factors which endanger healthy development of dento-skeletal structure, it is important to closely monitor patients during their development phase.

Regulating Environmental Impact of Medical Devices in the United Kingdom—A Scoping Review

Medical devices are highly regulated to ensure safety and efficacy of the products and minimize the risk of harm to users and patients. However, the broader impacts of these devices on the environment have scarcely been questioned until recently. The United Kingdom National Health Service intends to achieve a “net zero” emissions service by 2040 and has identified specific targets to achieve through this process. However, medical device manufacturers do not see sufficient incentives to invest in reducing greenhouse gas emissions unless enforced by legislation. Furthermore, there is little evidence on the legislation required to reduce emissions from medical devices. This study addresses the relationship of medical device regulations and the environmental impact of the devices throughout their lifecycle. A scoping review was conducted on academic literature on the topic, followed by a critical review of the current medical device regulations and associated guidelines in the United Kingdom. The challenges to regulating environmental impact of medical devices were identified under seven themes. These challenges were contextualized with the National Health Service target of achieving zero emissions by 2040. The review indicates that current guidelines support single-use disposal of devices and equipment as the best approach to prevent pathogen transmission and landfilling and incineration are the most used waste management strategies. Manufacturers need to be guided and educated on reducing their emissions while ensuring the development of safe and effective devices.

The Complexity of Medical Device Regulations Has Increased, as Assessed through Data-Driven Techniques

Medical device regulations are dynamic, as they need to cover an ever changing landscape. In Europe this has led to a new set of regulations (both for Medical Devices and In Vitro Diagnostics), which replaced the old rules. This study is interested in how the complexity of these medical regulations changed over time and if additional time-based metrics can be associated with any of the complexity metrics. Complexity is defined in terms of readability of the text and it is computed using established linguistic measures, as well as Halstead complexity scores. It was shown that the regulatory complexity of new EU medical device regulations was higher than their predecessors, especially when Halstead complexity measures were considered. The complexity metrics obtained for the new regulations were subsequently associated with the time it took to consider these regulations. Only very weak Pearson’s correlation coefficients were found between the complexity scores and the obtained response times for the new regulations. This could indicate that there are issues with how complexity is perceived by those that need to apply these regulations. Taking the complexity of regulations into account can greatly help with the development of more user friendly regulations. The results from the data-driven methods that are applied in this research indicate that governments could benefit from focusing on making regulations more accessible and utilitarian. This would improve the stakeholder adherence and facilitate effective implementation. This work also highlighted the need to develop more suitable methods to analyse regulatory text to further inform the wider research community.

Evaluating the Presence of Software-as-a-Medical-Device in the Australian Therapeutic Goods Register

In recent years, medical device regulatory bodies have recognised software-as-a-medical-device (SaMD) as a distinct subgroup of devices. The field of SaMD has been rapidly evolving and encompasses a range of different digital solutions. Many organisations have now started to look into digital healthcare, as a way to solve key global challenges. However, there remains uncertainty regarding how many of these SaMD products are entering the market and to what extent these systems achieve a desired level of general safety once they are in the market. In this study, we utilise data collected from publicly available databases. The data are evaluated for trends and a descriptive analysis is performed of the recall and adverse events associated specifically with SaMD. We find that there is a significant positive trend (p < 0.05) of SaMD registrations, although the number of SaMD registrations remains relative low compared to non-SaMD. This rise in SaMD registrations coincides with increasing levels of recalls and adverse events. More importantly, it becomes apparent that adverse events notification is not yet fit for purpose with regards to SaMD.