Performance Evaluation (IVD)
Overview
For in vitro diagnostic devices under IVDO, clinical evidence takes the form of a performance evaluation rather than a clinical evaluation. The performance evaluation is required by IVDO Annex XIII and must demonstrate that the device achieves its claimed analytical and clinical performance.
Types of Performance Data
Analytical performance — measures the IVD's technical ability to measure or detect an analyte:
- Accuracy (trueness and precision)
- Analytical sensitivity (limit of detection, limit of quantification)
- Analytical specificity (cross-reactivity, interference)
- Linearity / measuring range
- Cut-off determination
Clinical performance — measures the IVD's ability to produce outcomes that correlate with the clinical condition:
- Diagnostic sensitivity (true positive rate)
- Diagnostic specificity (true negative rate)
- Positive/negative predictive values
Performance Studies
For List A IVDs, an NB review of clinical evidence is mandatory via Annex IX Chapter II. For List B IVDs, NB involvement may be required depending on the conformity assessment route chosen (Annex IX Chapter I or Annex X + XI). Ethics committee review is required only when performance studies involve human participants or patient data. Key types:
- Analytical performance studies — laboratory studies validating analytical claims
- Clinical performance studies — studies involving human specimens or participants to validate clinical performance claims
- Scientific validity assessment — establishing the analyte's association with the clinical condition
MDCG 2022-2 Guidance
MDCG 2022-2 (Guidance on general principles of clinical evidence for IVDs) is applicable in Switzerland and provides detailed guidance on the performance evaluation process, performance study design, and how to demonstrate compliance with IVDO Annex XIII.
Official Sources
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Performance Study Design Considerations For List A IVDs, performance studies typically require larger sample sizes and may require multi-centre validation. For List B IVDs, performance data may be derived from literature or smaller validation studies. The choice of study design (prospective vs. retrospective, single-centre vs. multi-centre) should be justified based on the risk classification and intended use of the IVD. Reference to MDCG 2022-2 Section 4 provides detailed guidance on appropriate study designs for each IVD category.