Evidence map›Paper›PMID 42086335›Full record

ArticleStatistics in medicine2026

Innovative Clinical Trial Approach for Evaluating Digital Medical Devices Under European Fast-Track Regulatory Frameworks.

Moreno Ursino, Sandrine Boulet, Corinne Collignon, Florence Francis-Oliviero, Edouard Lhomme, Raphaël Porcher, Florence Saillour, Gaël Varoquaux, Vincent Vercamer, Rodolphe Thiébaut and 1 more

Abstract read
In one paragraph

Article in Statistics in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Moreno UrsinoInserm, Inria, Université Paris Cité, UMRS 1346, HeKA, Paris, France.ORCID https://orcid.org/0000-0002-5709-4322
Sandrine BouletInserm, Inria, Université Paris Cité, UMRS 1346, HeKA, Paris, France.
Corinne CollignonHaute Autorité de santé, Saint Denis, France.
Florence Francis-OlivieroUniversité de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, U1219, Bordeaux, France.
Edouard LhommeUniversité de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, U1219, Bordeaux, France.
Raphaël PorcherUniversité Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS), Paris, France.ORCID https://orcid.org/0000-0002-5277-4679
Florence SaillourUniversité de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, U1219, Bordeaux, France.
Gaël VaroquauxInria, Soda, Palaiseau, France.
Vincent VercamerDigital Health Delegation, French Ministry of Health, Paris, France.
Rodolphe ThiébautUniversité de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, U1219, Bordeaux, France.
Sarah ZoharInserm, Inria, Université Paris Cité, UMRS 1346, HeKA, Paris, France.

Funding

Agence Nationale de la Recherche ANR-22-PESN-0003
6 · The paper itself

Abstract

To address patient demand for rapid access to innovative digital medical devices (DMDs), several health technology assessment (HTA) authorities in European Union countries provide transitional or provisional access and reimbursement pathways. These pathways are available when only incomplete clinical trial data are accessible, and significant uncertainty remains regarding the clinical benefits, even after CE (European conformity) marking has been obtained. Once manufacturers complete the clinical studies, additional real-world data (RWD) may become available as a result of the device's use in the target population. Consequently, regulators can draw on both sources of information to support their final decision-making processes. For a statistically principled evaluation of such settings, we propose a statistical framework suitable for DMD evaluation under European HTA fast-track requirements, integrating both clinical trial data and RWD. The framework consists of three key steps: (1) an interim analysis of clinical trial data, which can support temporary regulatory authorization and enable the collection of RWD; (2) a final analysis of the clinical trial data; and (3) a meta-analysis combining the clinical trial data and RWD, contingent upon obtaining temporary authorization. To optimize the timing of the interim analysis and the application for temporary authorization, we introduce several metrics. The proposed framework was assessed by means of an extensive simulation study. This framework should be complemented by a post-market evaluation of the DMD once it has been widely adopted, aligning with the principles of phase IV studies.

Indexed as

Clinical Trials as TopicTechnology Assessment, BiomedicalDigital HealthEuropeEuropean UnionHumansMeta-Analysis as TopicBayesianinterim analysismeta‐analysisrandomized clinical trialreal‐world data

Identifiers

PMID42086335
PMCPMC13143562

What OpenQuestion holds

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Registered trials

None linked

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.