Clinical Evidence
Why Clinical Studies Matter Under MDR
- Clinical safety
- Clinical performance
- Clinical benefit
This is achieved through a Clinical Evaluation (Article 61, Annex XIV), often supported by clinical investigations (Annex XV). For many Class IIa, IIb, and III devices, clinical studies are no longer optional they are a regulatory and commercial necessity. Strong clinical evidence doesn’t just satisfy regulators, it builds trust with clinicians, payers, and patients.
Strong clinical evidence doesn’t just satisfy regulators—it builds trust with clinicians, payers, and patients.
Prospective Clinical Studies
A prospective clinical study is a planned investigation where patients are followed forward in time after receiving the device. Outcomes are predefined and collected according to a Clinical Investigation Plan (CIP). These studies may be:
- Single-arm (device only)
- Comparative (against standard of care or literature benchmarks)
When Prospective Studies Work Best
Prospective studies are widely accepted under MDR when:
- The device is Class IIa or IIb
- The technology is incremental or well-established
- Clinical benefit is already known
- Randomization is impractical or unethical
Key Benefits
- Faster study start-up
- Lower cost and complexity
- Strong real-world relevance
- Often sufficient for CE marking when well justified
Limitations
- Higher potential for bias
- Weaker evidence for novel or high-risk devices
- May not support superiority claims
Randomized Controlled Trials (RCTs)
When MDR Typically Expects an RCT
Notified Bodies often expect RCTs for:
- Class III devices
- Implantable devices
- Novel or breakthrough technologies
- Claims of superior clinical performance
Key Benefits
- Highest level of scientific credibility
- Minimizes bias
- Strong support for benefit–risk assessment
- Highly persuasive for regulators and investors
Limitations
- Higher cost and longer timelines
- Operational and ethical challenges
- Not always feasible for every device
Prospective Study vs RCT — At a Glance
| Feature | Prospective Study | Randomised Controlled Trial |
|---|---|---|
| Study design | Observational or comparative | Comparative |
| Randomisation | No | Yes |
| Evidence strength | Moderate | High |
| Typical MDR use | Class IIa / IIb | Class IIb / III |
| Cost & complexity | Lower | Higher |
| Suitable for novel devices | Sometimes | Preferred |
Choosing the Right Clinical Strategy
A Prospective Study May Be Sufficient If:
- Your device is an iteration of existing technology
- You can justify a state-of-the-art comparison
- The risk profile is moderate
- You aim for efficient market entry
An RCT Is Advisable If:
- Your device is innovative or implantable
- Clinical benefit is not yet established
- You claim superiority over existing solutions
- Long-term market acceptance is critical
Choosing the wrong study design is one of the most common causes of MDR delays.
Beyond CE Marking: The Market Value of Strong Clinical Evidence
Well-designed clinical studies can help you:
- Accelerate Notified Body approval
- Strengthen clinical adoption
- Support pricing and reimbursement
- Increase investor confidence
- Reduce post-market compliance risk
Clinical evidence is not just regulatory documentation—it is a commercial asset.
How We Help
We support medical device manufacturers with:
- Clinical strategy aligned to MDR expectations
- Study design (Prospective studies & RCTs)
- Clinical Investigation Plans (CIP)
- Clinical Evaluation Reports (CER)
- PMCF planning and execution
From clinical evidence to CE marking—and beyond.
Ready to Define Your Clinical Path?
The right clinical strategy can mean the difference between regulatory delay and market success. Let’s build evidence that regulators accept and markets trust.
Talk to us about your device class, novelty, and target claims to define a study approach that supports both CE marking and commercial adoption.
service related FAQ’s
Absolutely. We can take over PMCF activities for devices already CE-marked and on the EU market, ensuring that your data collection, evaluation, and reporting fully meet MDR requirements — even if your existing documentation needs corrective action before the next Notified Body audit.
As part of our commitment to regulatory compliance and risk management, we recommend that all non EU manufacturers have valid Product Liability Insurance when appointing us as their European Authorized Representative (EC REP). While it is not a legal requirement under MDR/IVDR for the EC REP to request proof of insurance, many Competent Authorities and Notified Bodies may inquire about the manufacturer’s liability coverage during inspections or audits. Having proper insurance also demonstrates due diligence and protects your business in the event of product-related claims in the European market. We do not provide insurance ourselves, but we can guide you on what to include based on your device risk class and market exposure.
Yes. According to MDR and IVDR requirements, the EC REP’s name and address must be clearly visible on the product labeling, outer packaging, or accompanying documents, allowing EU authorities to easily identify the representative.
Yes, we provide full support for UDI implementation and registration in compliance with EU MDR 2017/745 and IVDR 2017/746 requirements. Our team assists manufacturers in assigning and structuring UDI-DI and UDI-PI codes based on the device classification and intended use. We also help in ensuring proper placement of UDI on labeling, packaging, and Instructions for Use (IFU), as well as preparing for UDI module submission once it becomes fully functional within EUDAMED.
Our services cover:
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UDI-DI and UDI-PI structure guidance
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Compliance with GS1, HIBCC, or ICCBBA issuing agencies
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UDI label and packaging review
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Preparation for EUDAMED UDI/Device registration module
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UDI-related documentation for your Technical File and CE submission
By integrating UDI properly, we help ensure device traceability, reduce market delays, and support full regulatory compliance across the EU.
Yes, manufacturers / exporter any time they can transfer the US Agent. We are happy to act as US Agent for any non-US manufacturers. Please bring us the FDA FURLS account login details to update the Agent Information.
