Evidence map›Paper›PMID 39875652›Full record

ArticleTherapeutic innovation & regulatory science2025

Impact of Rule 11 on the European Medical Software Landscape: Analysis of EUDAMED and Further Databases Three Years After MDR Implementation.

Arndt A Schmitz, Miriam Font-Nieves, Toumani Doucouré, Hans-Peter Podhaisky

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Article in Therapeutic innovation & regulatory science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Arndt A SchmitzBayer AG, Pharmaceuticals R&D, Bayer AG, Muellerstr. 178, 13342, Berlin, Germany.ORCID http://orcid.org/0000-0002-7104-6191
Miriam Font-NievesBayer Hispania, S.L., Regulatory Affairs, Sant Joan Despi, Spain.ORCID http://orcid.org/0009-0001-8423-6189
Toumani DoucouréBayer AG, Pharmaceuticals R&D, Bayer AG, Muellerstr. 178, 13342, Berlin, Germany.ORCID http://orcid.org/0009-0009-0510-5948
Hans-Peter PodhaiskyBayer AG, Pharmaceuticals R&D, Bayer AG, Muellerstr. 178, 13342, Berlin, Germany. hans-peter.podhaisky@bayer.com.ORCID http://orcid.org/0000-0003-3414-9252

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Medicine is increasingly supported by software, with digital health technologies offering innovative ways to capture insights and drive therapies. Globally, medical device software must follow regulatory processes based on risk classification. The introduction of MDR represents a significant shift in risk-based classification for Medical Devices in Europe, including classification Rule 11 for software, which has caused significant discussions among European regulators. Three years after implementation, we conducted a systematic impact assessment of MDR classification Rule 11 for MDSW through a qualitative and quantitative analysis of over 2000 software entries from the European Medical Device database, complemented by data from other public databases such as the German DiGA directory and mHealthBELGIUM. Our results indicate that classification Rule 11 of the MDR results in a narrow bandwidth for class I software, whereas this used to be the most frequent classification for software under the MDD: while most of legacy software in EUDAMED falls in the lowest risk category as MDD Class I (53%), the situation reverses after the implementation of MDR with the most entries in Class IIa (55%). Analyzing the legacy MDD patient apps in Germany implies that three quarters will have to re-classify as MDR Class IIa at the end of the transition period in 2028. A comparison of the European and US regulatory landscapes, along with a systematic review of software features for Class I vs. Class IIa products, explains our findings and enables us to recommend a regulatory strategy for developing MDSW compliant with MDR Class I rules, ensuring fast access to the European market.

Indexed as

SoftwareDatabases, FactualEuropeHumansDHTDiGAMDRMDSWRegulatory strategySaMD

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.