In vitro diagnostic tests: Ensuring test accuracy and patient safety when used as companion diagnostics

Abstract

Risks associated with drugs and treatments are a key concern in clinical investigations of therapeutics. There is a keen attention to side effects and adverse events included in critical safety documentation presented in regulatory submissions for new drugs. Likewise, Companion Diagnostic (CDx) technology is subject to rigorous regulated research and testing because of the risk associated with a false test result that could affect clinical decisions and treatment. The rigor of testing imposed by the regulatory path to clearance or approval is intended to ensure an assay is reliable when performance criteria are defined by a fixed set of these variables so that there is the least risk of false test results. The clinical validation of these assays is especially important when the test result is used to manage therapeutic decisions for patients. The same patients that expect a clinician to use reliable diagnostics to recommend treatment may also be recruited to participate in CDx clinical investigations. This educational review of CDx product development, regulations, and clinical investigations involving human subjects is important to: (1) Clinicians who rely on the test results to manage patient care; (2) Patients who trust these test results are informing the clinician, and (3) Hospital administrators who oversee human subjects safety and data intergrity for clinical investigations in the personalized medicine space.