Which computable biomedical knowledge objects will be regulated? Results of a UK workshop discussing the regulation of knowledge libraries and software as a medical device

Author:

Wyatt Jeremy C.1ORCID,Scott Philip2ORCID,Ordish Johan3,South Matthew4ORCID,Thomas Mark4,Jones Caroline5,Lacey‐Bryant Sue6,

Affiliation:

1. School of Primary Care, Population Sciences and Medical Education University of Southampton Southampton UK

2. Institute of Management and Health University of Wales Trinity Saint David Lampeter Wales UK

3. Software as a Medical Device Division Medicines and Healthcare Regulatory Agency London UK

4. Department of Medicine University of Birmingham Birmingham UK

5. Hillary Rodham Clinton School of Law Swansea University Swansea Wales UK

6. Chief Knowledge Officer NHS England London UK

Abstract

AbstractIntroductionTo understand when knowledge objects in a computable biomedical knowledge library are likely to be subject to regulation as a medical device in the United Kingdom.MethodsA briefing paper was circulated to a multi‐disciplinary group of 25 including regulators, lawyers and others with insights into device regulation. A 1‐day workshop was convened to discuss questions relating to our aim. A discussion paper was drafted by lead authors and circulated to other authors for their comments and contributions.ResultsThis article reports on those deliberations and describes how UK device regulators are likely to treat the different kinds of knowledge objects that may be stored in computable biomedical knowledge libraries. While our focus is the likely approach of UK regulators, our analogies and analysis will also be relevant to the approaches taken by regulators elsewhere. We include a table examining the implications for each of the four knowledge levels described by Boxwala in 2011 and propose an additional level.ConclusionsIf a knowledge object is described as directly executable for a medical purpose to provide decision support, it will generally be in scope of UK regulation as “software as a medical device.” However, if the knowledge object consists of an algorithm, a ruleset, pseudocode or some other representation that is not directly executable and whose developers make no claim that it can be used for a medical purpose, it is not likely to be subject to regulation. We expect similar reasoning to be applied by regulators in other countries.

Publisher

Wiley

Subject

Health Information Management,Public Health, Environmental and Occupational Health,Health Informatics

Reference37 articles.

1. MHRA.Advice on the regulation of software and apps as medical devices.https://www.gov.uk/government/publications/medical-devices-software-applications-apps. Accessed August 10 2023.

2. Drugs and Devices

3. MHRA.Statement on the future regulation of medical devices following Brexit.https://www.gov.uk/government/publications/implementation‐of‐the‐future‐regulation‐of‐medical‐devices‐and‐extension‐of‐standstill‐period/implementation‐of‐the‐future‐regulations. Accessed August 10 2023.

4. NICE.Evidence standards framework for digital health technologies.https://www.nice.org.uk/about/what‐we‐do/our‐programmes/evidence‐standards‐framework‐for‐digital‐health‐technologies. Accessed August 10 2023.

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