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      • Round 1
        • Item 0: Background & Action Plan
        • Item 1: CER Update Frequency
        • Item 2: Device Description & Claims
        • Item 3: Clinical Data
        • Item 4: Usability
        • Item 5: PMS Plan
        • Item 6: PMCF Plan
        • Item 7: Risk
        • MDCG 2020-13 & CER Template (reference)
          • MDCG 2020-13 (CEAR) sections
          • CER Template sections
            • 00 Front matter, introduction, writing tips
            • 1. Administrative particulars
            • 2. Executive summary
            • 3. Scope of the clinical evaluation
            • 4. Clinical evaluation plan — Summary
            • 5. Common specifications and harmonised standards
            • 6. Clinical background, current knowledge, state of the art
            • 7. Equivalence
            • 8. Clinical evidence review
            • 9. Clinical evidence analysis — GSPRs
            • 10. Clinical evidence analysis — Benefit-risk profile
            • 15. Vendor services annex (non-normative)
            • 11–14. Conclusions, Author CVs, References, Excluded sources
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  • Round 1
  • MDCG 2020-13 & CER Template (reference)
  • CER Template sections
  • 10. Clinical evidence analysis — Benefit-risk profile

10. Clinical evidence analysis — Benefit-risk profile

Source: CER Template.pdf pages 23-24 (document: Mantra Systems Free CER Template, Edition 2)

A further objective of the CER is to examine whether available clinical evidence demonstrates a favourable benefit-risk profile for the subject device. In this section, an analysis of identified and appraised clinical evidence must be performed to address this question.

Benefit-risk should be expressed as a quantitative ratio. Methodology will vary between devices, as risk profiles and risk analysis techniques will likewise be variable. Our CER experts can assist with all aspects of conducting quantitative benefit-risk analysis.

10.1 Risk management system​

Provide a summary of the risk management processes within the organisation or refer the reader to relevant technical documents.

10.2 Known risks and acceptability analysis​

Write a summary of known risks and how their acceptability has been determined. Identify any significant residual risks.

10.3 Clinical evidence review - impact on risk analysis​

Did the clinical evidence review conducted for the clinical evaluation reveal any new risks that have not previously been discovered, or otherwise impact known risks? Outline a review of risks observed in relation to the subject device and similar devices. Conduct a quantitative analysis to determine an overall (weighted) risk score.

10.4 Clinical benefits​

Summarise the demonstrated benefits to patients (positive impacts) flowing from use of the device, as supported by evidence appraised in the CER. Quantify benefits using a benefit evaluation scheme that, preferentially, mirrors that used for risk evaluation. Develop a table that outlines observed frequency of identified benefits, weights benefit levels and determines an overall benefit score.

10.5 Benefit-risk analysis​

Employing the analysis methods described previously, outline whether, on an overall assessment, any residual risks (individually and collectively) are acceptable and outweighed by demonstrated clinical benefit.

Calculate a quantitative benefit-risk ratio using:

Benefit-risk ratio=Overall benefit scoreOverall risk score\text{Benefit-risk ratio} = \frac{\text{Overall benefit score}}{\text{Overall risk score}}Benefit-risk ratio=Overall risk scoreOverall benefit score​

A value greater than 1 denotes an acceptable benefit-risk ratio.

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9. Clinical evidence analysis — GSPRs
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15. Vendor services annex (non-normative)
  • 10.1 Risk management system
  • 10.2 Known risks and acceptability analysis
  • 10.3 Clinical evidence review - impact on risk analysis
  • 10.4 Clinical benefits
  • 10.5 Benefit-risk analysis
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