Medical devices; immunology and microbiology devices; classification of dengue virus serological reagents. Final order

The Food and Drug Administration (FDA) is classifying dengue virus serological reagents into class II (special controls). The special controls that will apply to the device are identified in this order, and the codified language for the dengue serological reagents classification will include the identification of the special controls that will apply to this device. The Agency is classifying the device into class II (special controls) because special controls, in addition to general controls, will provide a reasonable assurance of safety and effectiveness of the device.

Medical devices; ovarian adnexal mass assessment score test system; labeling; black box restrictions. Final rule

The Food and Drug Administration (FDA) is amending the regulation classifying ovarian adnexal mass assessment score test systems to restrict these devices so that a prescribed warning statement that addresses a risk identified in the special controls guidance document must be in a black box and must appear in all labeling, advertising, and promotional material. The black box warning mitigates the risk to health associated with off-label use as a screening test, stand-alone diagnostic test, or as a test to determine whether or not to proceed with surgery.

Medical devices; immunology and microbiology devices; classification of Plasmodium species antigen detection assays. Final rule

The Food and Drug Administration (FDA) is classifying Plasmodium species antigen detection assays into class II (special controls). The special control that will apply to the device is the guidance document entitled "Class II Special Controls Guidance Document: Plasmodium Species Antigen Detection Assays." The agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of the guidance document that will serve as the special control for this device.

Medical devices; immunology and microbiology devices; classification of ribonucleic acid preanalytical systems. Final rule

The Food and Drug Administration (FDA) is classifying ribonucleic acid (RNA) preanalytical systems into class II (special controls). The special control that will apply to the device is the guidance document entitled "Class II Special Controls Guidance Document: RNA Preanalytical Systems (RNA Collection, Stabilization, and Purification Systems for RT-PCR Used in Molecular Diagnostic Testing)." The agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of a guidance document that will serve as the special control for the device.

[Interpreteation of immunochromatographic tests with HRP-2 antigen in children under 5 years in an area of high risk of malaria transmission in Papua New Guinea]

The immunochromatographic tests with HRP-2 antigen (histidine-rich protein) Vision Biotech Pf Rapid Malaria Test was performed in 291 children under 5 years presenting fever or history of fever (malaria presumptive cases) admitted to Children Out-Patient Department of the Modilon Hospital in Madang, in a high malaria risk area of Papua New Guinea. The results of the tests were compared to the results of the parasitic examination of the peripheral blood with light microscopy (thick and thin smears). The HRP-2 test showed very high sensitivity (95.4%) and specificity (94.1%) for Plasmodiumfalciparum parasitaemia and none or very low sensitivity and specificity for other malaria species. The HRP-2 test detected both asexual and sexual stages of the Plasmodium falciparum parasites. The test did not show significant changes in detection of different levels of parasitaemia. These findings enable to conclude that the HRP-2 immunochromatographic assay can be very helpful to diagnose Plasmodium falciparum malaria when microscopy examination is not available, but as qualitative tests can be difficult for interpretation especially in high malaria risk areas. Therefore it can require re-examination of blood with microscopy to confirm species and development stages of Plasmodium spp. and to assess parasite load.

Medical devices; immunology and microbiology devices; classification of the endotoxin assay. Final rule

The Food and Drug Administration (FDA) is classifying the endotoxin assay into class II (special controls). The agency is taking this action in response to a petition submitted under the Federal Food, Drug, and Cosmetic Act (the act) as amended by the Medical Device Amendments of 1976 (the amendments), the Safe Medical Devices Act of 1990 (SMDA), the Food and Drug Administration Modernization Act of 1997 (FDAMA), and the Medical Device User Fee and Modernization Act of 2002 (MDUFMA). The agency is classifying this device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of a guidance document that will serve as the special control for the device.

[Apropos of the evaluation and validation of in vitro tests for measurement of specific IgE]

The performances of the reagents for IN VITRO TESTS in Allergy, are very variable, in spite of the existence of registration procedures as well as those of national quality control. Most of the discrepancies have their origin in the choice of technologies used by the manufacturers (reaction support, raw materials, calibration, vigour of the process of execution). It follows from this that the characteristics must be understood and the limitations appreciated of the tests that are used, as well as their interpretation. Of such information that is accessible in the records of the National Control of Quality of the Medicines Agency, as well as in the studies that are done with the aim of evaluating analytical and/or clinical performance of available tests (this work is a review of the performances of most of the tests sold in France today). It stands out that the best borders on very mediocre and that it is indispensable, like the planned nomenclature of the medical biological consultations, to take into consideration the technique used to obtain a result for interpretation of the latter.