EU MDR Annex XIV • Clinical Evidence Architecture

Connect product claims to clinical evidence.

The era of superficial predicate equivalence is over. Under EU MDR Article 61 and modern FDA Digital Health guidance, every marketing claim, diagnostic indication, and patient safety assertion must be anchored in continuous empirical clinical data. PMX Clinical Intelligence links intended use statements directly to prospective trial cohorts, statistical confidence bounds, and living Clinical Evaluation Reports (CER).

Claim-to-Evidence Visualizer Inspect Study CLN-088 Active Model: CardioSense Pro v3.8.2
Regulatory Clinical Evolution

The Rigorous Shift in Global Clinical Expectations

Why modern medical device companies cannot rely on static literature reviews and disconnected clinical binders.

The Death of MDD Equivalence

Under the old European MDD, manufacturers frequently claimed equivalence to competitor devices without direct access to technical files. Under EU MDR Annex XIV Section 3, you must prove biological, technical, and clinical equivalence concurrently, with full contractually guaranteed data access to the equivalent device's technical dossier.

Mandate: Own Clinical Data Required

Real-World Evidence (RWE)

Both the FDA and Notified Bodies require continuous Post-Market Clinical Follow-up (PMCF) to demonstrate that pre-market safety assumptions remain valid across heterogeneous real-world patient demographics, comorbidities, and extended continuous wear cycles.

Standard: MDCG 2020-7 / 2020-8 Guidance

Living CER Binders

A 600-page static Clinical Evaluation Report in Word freezes in time the day it is printed. When software algorithms evolve (e.g., RespiraAI v4.2 update), a static CER fails to reflect the updated algorithmic sensitivity, creating substantial regulatory non-compliance.

PMX Solution: Continuous Dynamic CER Synthesis
Methodological Lineage

End-to-End Clinical Traceability Architecture

Observe the formal ontological lineage from high-level clinical claims through statistical trials to regulatory filings.

Step 1 Intended Purpose & Indication for Use Continuous ambulatory physiological monitoring in adult post-operative cardiac patients.
DHF Section 1
↓ [derives]
Step 2 Primary Clinical Claim (CLM-01) "Detection of early clinical deterioration and transient arrhythmias with >92% sensitivity."
Clinical Claim
↓ [evaluated in]
Step 3 Clinical Investigation Study (CLN-088) Multi-center prospective clinical protocol (n=240 patients) across 3 tertiary hospital sites.
Protocol CS-088
↓ [measured via]
Step 4 Primary Endpoints & Biostatistical Outcomes Sensitivity: 94.2% (95% CI: 91.8%-96.1%). Thermal Adverse Event Rate: 0.0% (Zero Grade 2+ burns).
Statistically Significant
↓ [compiled into]
Step 5 Regulatory Clinical Evidence Package EU MDR Annex XIV Clinical Evaluation Report (CER Rev 4) • FDA 510(k) Clinical Summary Section 18.
Audit Complete
Empirical Ground Truth

Clinical Investigation Dossier: Study CLN-088

Empirical evidence validating CardioSense Pro v3.8.2 continuous monitoring safety and AI algorithmic precision.

Completed • Audited
Protocol ID: CS-088 Multi-Center Prospective Safety & Efficacy Evaluation

Evaluation of Continuous Ambulatory Telemetry and Thermal Tolerance in Adult Patients

Conducted under ISO 14155:2020 (Good Clinical Practice for Medical Devices)

Study Cohort
n = 240 Patients
Age 18-84 • 54% Male / 46% Female
Primary Endpoint 1: Safety
0.0% Thermal Injury
✓ Zero Grade 2+ skin erythema
Primary Endpoint 2: AI Efficacy
94.2% Sensitivity
95% CI: [91.8%, 96.1%]
Reference Gold Standard
12-Lead Holter
Simultaneous continuous recording
Clinical Trial Registration: NCT-04928114 • Clinical Sites: MGH Boston, Charité Berlin, AIIMS New Delhi • IRB Approval: IRB-2025-091
Interactive Verification Matrix

Interactive Clinical Claim-to-Evidence Explorer

Select a clinical claim below to trace its empirical backing through clinical trials, endpoints, and submission sections.

2 Active Clinical Claims
Claim 1 • Diagnostic Efficacy

"Continuous ambulatory detection of cardiac arrhythmia and respiratory deterioration with >92% sensitivity in adult post-operative patients."

Grounded • Confirmed
1. Validating Investigation
Study CLN-088 (CS-088) across 240 post-operative cardiac patients, comparing RespiraAI v4.2 inference alerts to simultaneous 12-lead continuous Holter ground truth.
2. Statistical Outcome
Observed Sensitivity: 94.2% (95% CI: [91.8%, 96.1%]). Specificity: 98.6% (95% CI: [97.5%, 99.3%]). Statistically exceeds the prespecified performance threshold of 92.0% (p < 0.001).
3. Regulatory Submission
Submitted under FDA 510(k) K240982 Section 18 (Clinical Summary) and EU MDR Annex XIV Clinical Evaluation Report (CER Rev 4). Fully accepted by Notified Body 0123.
Traceability Chain: Intended Use → CLM-01 → CLN-088 → DS-VAL-880 → 510(k) K240982
Inspect Evidence in PMX Workspace

Unify Your Product Design with Clinical Reality

Transform your Clinical Evaluation Reports from static dead binders into living, mathematically backed claims connected directly to your product knowledge graph.