FDA Digital Health and Artificial Intelligence Glossary – Educational Resource
FAQs FDA-Regulated Research
Investigational Drugs
What is a drug?
“...articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease…” and “...articles (other than food) intended to affect the structure or any function of the body of man or other animals.” 21 U.S.C. 321(g)(1)
What is a drug clinical investigation?
“...any experiment in which a drug is administered or dispensed to, or used involving one or more human subjects...” – “...an experiment is any use of a drug except for the use of a marketed drug in the course of medical practice...”
Clinical investigations may involve testing (collecting safety or effectiveness data) on a drug* including an FDA approved drug; unapproved use of an FDA approved drug; and/or an investigational drug?
What is a biologic?
A wide range of products (not chemically synthesized) such as virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component...allergic product, protein applicable to the diagnosis, prevention, treatment, or cure of a disease or condition of humans.
Investigational biologics fall under the FDA Investigational New Drug (IND) regulations.
When is a dietary supplement considered to be a drug?
Dietary supplements are regulated as drugs when intended to test their ability to diagnosis, cure, mitigation, treatment, or prevention of disease.
For more details, see the ORI Dietary Supplement Study FAQ.
What guidance does FDA provide on other unusual products that may be considered as investigational test articles depending on use in research? (e.g., Cellular Based Tissue Products, Fecal Transplant, Tobacco, Items Generally Recognized as Safe)
Is your drug clinical investigation exempt from Investigational New Drug (IND) requirements?
Check the flow chart on the ReGARDD IND website and FDA's IND Exempt Guidance. If still uncertain, you may seek advice from the FDA Review Division responsible for the relevant therapeutic area of the proposed trial.
What training does the UK IRB require for a Sponsor-Investigator holding an IND?
IRB policy requires mandatory training for investigators who are also serving as sponsors of an IND. This involves completion of the Good Clinical Practice Course for Clinical Trials Involving Investigational Drugs on CITI. The ReGARDD training below may be substituted for the CITI GCP course upon request, by providing completion documentation to the ORI HSP Training Support Team.
ReGARDD Training Modules on IND Sponsor-Investigator Responsibilities
What do I complete in the E-IRB application for a drug investigation?
Complete the study device section and attach the Study Device Form as well as applicable product information or correspondence.
What resources are available to help with submitting an IND to FDA?
- FDA Investigator Initiated Investigational New Drug Applications webpage
- FDA Guidance for Industry: Investigational New Drug Applications Prepared and Submitted by Sponsor-Investigators
- FDA IND Forms
- FDA IND Pilot Portal (NextGen IND Portal designed to automate and ease application process)
- ReGARDD IND Template
How do you maintain an IND?
What guidance is available for a Phase I or first-in-man study?
What resources are available for investigational drug storage and accountability?
University of Kentucky Investigational Drug Services - Pharmacy Services (HTML) (Requires linkblue login)
- For non-oncology studies: centralids@uky.edu
- For oncology-related studies: IDSOncology@uky.edu
What is the procedure to request Emergency Use of an investigational drug for a patient?
If time is sufficient, contact the UK Office of Research Integrity (ORI) at (859) 257-9428 to reach an IRB Chair for confirmation that use meets FDA criteria. Follow the steps in the Emergency Use SOP and use the Checklist for documentation.
What is the procedure to gain Expanded Access to an investigational drug for a patient with an immediately life-threatening condition where no comparable alternative is available?
The FDA Expanded Access program provides a pathway for investigational treatment outside of clinical trials for life-threatening conditions or serious disease with no comparable or satisfactory therapy options. Expanded Access requires FDA approval, IRB approval, and the company’s agreement to provide the investigational product.
- FDA Expanded Access Website
- ORI Emergency and Early/Expanded Access Program for Drugs and Devices (PDF)
- Individual Patient Expanded Access Applications: Form FDA 3926
- Expanded Access Program Search Navigator
- FDA Expanded Access Instructional Videos
- FDA Expanded Access Requests for Investigational Oncology Products
- FDA Expanded Access Sample Consent Template (PDF)
Medical Device
What is a medical device?
An instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is:
- intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals, or
- intended to affect the structure or any function of the body of man or other animals, and which does not achieve primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of any of its primary intended purposes.
What is a device clinical investigation?
A clinical investigation or research involving one or more subjects to determine the safety or effectiveness of a device. 21 CFR 812.3
What do I complete in the E-IRB application for a device investigation?
Complete the study section and attach the Study Device Form as well as applicable product information or correspondence.
When is a mobile app or software considered to be a mobile medical app (MMA) or software as a medical device (SaMD)?
App or software used as an accessory to a regulated medical device; or used to transform a mobile platform into a regulated medical device (e.g., control the function of operation of a medical device, used in active patient monitoring to analyze patient-specific medical device data).
See the FDA Policy for examples of software or apps that are not considered medical devices, those that are devices, but FDA will not enforce regulations because they are low-risk, and those that FDA will regulate.
See the FDA Digital Health Policy Navigator Tool designed to help product developers understand whether a software function is potentially subject to or the focus of the FDA's regulatory oversight as a device, and if so, the considerations that may assist in determining the applicable FDA-specific legal and regulatory requirements and recommendations.
See the FDA Infographic to determine whether Clinical Decision Software is a medical device.
Is your device clinical investigation exempt from IDE requirements?
Check the flow chart on the ReGARDD IDE website. If still uncertain, you may seek regulatory guidance from the FDA Device Advice Website or email FDA DICE.
Is your study a significant-risk (SR) device trial requiring an Investigational Device Exemption (IDE) application to FDA?
For studies that are not exempt, sponsors are responsible for making the initial risk determination (SR or NSR) and presenting it to the Institutional Review Board (IRB). A device is significant-risk (SR), if use in the study presents potential for serious risk to health, safety, or welfare of a subject, particularly if it
- is an implant;
- is used to support or sustain life;
- is used to diagnose, cure, mitigate, or treat disease, or otherwise prevent impairment of human health; or
- otherwise presents a potential for serious risk to health, safety, or welfare of the subject.
21 CFR 812.32
An SR device study requires an IDE be submitted to FDA and full IDE requirements apply.
If the IRB does not concur with the sponsor SR/NSR designation, the FDA serves as the final arbiter. To obtain a written risk determination from FDA submit correspondence labeled “Study Determination” in triplicate to USFDA, CDRH, Document Mail Center – WO66-G609, 10903 New Hampshire Ave., Silver Spring, MD 20993-0002.
Is your study a nonsignificant risk (NSR) device trial?
A device is NSR, if use in the study does NOT meet above SR definition as assessed by sponsor-investigator and confirmed by IRB.
An NSR device study has Abbreviated IDE requirements and is conducted under the purview of the IRB.
If the IRB does not concur with the sponsor SR/NSR designation, the FDA serves as the final arbiter. To obtain a written risk determination from FDA submit correspondence labeled “Study Determination” in triplicate to USFDA, CDRH, Document Mail Center – WO66-G609, 10903 New Hampshire Ave., Silver Spring, MD 20993-0002.
What training does the UK IRB require for a Sponsor-Investigator holding an IDE or conducting a NSR devices study?
FDA IDE Responsibilities for sponsor-investigators of SR Device Studies
IRB policy requires mandatory training for investigators holding IDEs or serving as sponsor-investigator for SR or NSR device trials. This involves completion of the Good Clinical Practice Course for Clinical Trials Involving Investigational Medical Devices on CITI. The ReGARDD training below may be substituted for the CITI GCP course upon request, by providing completion documentation to the ORI HSP Training Support Team.
ReGARDD Training Modules on IDE Sponsor-Investigator Responsibilities
What resources are available to help with submitting an IDE to FDA?
How do you maintain an IDE?
How do you conduct a SR trial in compliance with IDE Responsibilities?
How do you conduct an NSR trial in compliance with Abbreviated IDE Responsibilities?
What resources are available for investigational device storage and accountability?
What guidance is available for Humanitarian Use Devices (HUD)?
What is the procedure to request Emergency Use of an investigational medical device for a patient?
If time is sufficient, contact the UK Office of Research Integrity (ORI) main line to reach an IRB Chair for confirmation that use meets FDA criteria. Follow steps in the Emergency Use SOP and use the Checklist for documentation.
What is the procedure to gain Compassionate Use of an investigational device for a patient with an immediately life-threatening condition where no comparable alternative is available?
The compassionate use provision provides a path to accessing investigational devices where a patient has a life-threatening or serious disease or condition; there is no comparable or satisfactory alternative therapy to diagnose, monitor, or treat the disease or condition; and potential patient benefit justifies the potential risks of the investigational device. Compassionate use requires FDA approval, IRB approval, and manufacturer agreement to provide the investigational device.
How do I find out if the software/application/algorithm I’m creating is a Medical Device?
Consult the FDA Digital Center for Excellence and use the Digital Health Policy Navigator to determine if subject to FDA oversight and applicable FDA legal and regulatory requirements
How do I find out if the Clinical Decision Support (CDS) software/application/algorithm I’m creating is a Medical Device?
Consult the FDA website and Graphic, Final FDA Guidance, and/or consult the Digital Center for Excellence with questions.
I’ve used the FDA Digital Health Policy Navigator tool and found that the (software, algorithm, app) I’m developing may be subject to FDA oversight as a medical device. How do I classify or engage FDA to determine procedure for clearance or approval?
For formal classification of a product, a 513(g) request for information with the applicable Office of Health Technology (OHT). You may also engage FDA or request feedback through the Pre-Submission program.
How is FDA regulating the clearance and approval of Artificial Intelligence medical devices that use Machine Learning?
Is there an FDA list of AI/ML Enabled Medical Devices?
How do I determine what other laws and regulations apply to the software or mobile application I’m developing?
Mobile Health App Interactive Tool for determining which laws and rules may apply – Federal Trade Commission
Additional Resources
UK ORI Interactive FDA Flow Chart
Drugs/Biologics Trials
FDA Resources [D116.0000]
General
Glossaries
Drug Research
Drug (Food, Drug, and Cosmetic Act): “articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease . . .” and “articles (other than food) intended to affect the structure or any function of the body of man or other animals.” Biological products subject to licensure under section 351 of the Public Health Service Act (42 U.S.C. 262) may also be considered drugs within the meaning of the FD&C Act. It is important to note that the drug definition is not limited to compounds intended for therapeutic purposes but also includes compounds intended to affect the structure or function of the body without regard to influence on a disease process.
2013 FDA Determining Whether Human Research Studies Can Be Conducted Without an IND
University of Kentucky (UK) Summary of FDA Exemption from IND Requirements
2004 FDA Guidance on IND exemptions for marketed products in cancer treatment
FDA Information for Sponsor-Investigator’s submitting an IND
FDA IND TABLE of links to information for Investigator-Initiated IND Applications
IND Applications for Clinical Treatment: Contents and Format
FDA Investigator’s Checklist for IND Application Submission
FDA Best Practices for Communication Between IND Sponsors and FDA During Drug Development
Biologic
Expanded Access Drugs
Dietary Supplements, Botanicals, Foods, Cosmetics Complementary Medicine Research
FDA Q and A on Dietary Supplements
FDA: Is the product a cosmetic, drug, or both, or a soap?
FDA Determining Whether Human Research Studies Can Be Conducted Without an IND- Section V.
FDA FAQ on Botanical Drug Products
FDA Complementary and Alternative Medicine Products
Device Research
Device (Food, Drug & Cosmetic Act) - A medical device is an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component, part, or accessory, which is recognized in the official National Formulary, or the United States Pharmacopeia, or any supplement to them, intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals, or intended to affect the structure or any function of the body of man or other animals, and which does not achieve its primary intended purposes through chemical action within or on the body …. and which is not dependent upon being metabolized for the achievement of its primary intended purposes.
Is the product a medical device?
2006 FDA Frequently Asked Questions about Medical Devices
2006 Significant Risk and Nonsignificant Risk Medical Device Studies
UK Summary of FDA Exemption from IDE Requirements
FDA PRE-IDE Submission Guidance
In Vitro Diagnostic (IVD) Device Studies – FAQ
UK IRB Review of Device Studies
Medical Device Clinical Investigations, Compassionate Use, and Treatment IDE SOP [C3.0150]
2013 IDE Exemptions for Early Feasibility Studies, including certain First in Human (FIH) Studies
Software, Mobile Applications, & Digital Health Content
Digital Health Policy Navigator Tool
FDA Digital Health Center of Excellence
Guidance with Digital Health Content – links to multiple guidance on software as a medical device
Examples of Software Functions for Which the FDA Will Exercise Enforcement Discretion
2022 Clinical Decision Support Software
2019 General Wellness: Policy for Low Risk Devices
2022 Policy for Device Software Functions and Mobile Medical Applications
2019 Off-The-Shelf Software Use in Medical Devices
Artificial Intelligence and Machine Learning in Software as a Medical Device
Expanded Access Devices
Humanitarian Use Device (HUD) Resources
FDA Presentations
Combination Drug and Device Research
IND and IDE Responsibilities for sponsor-investigators
IND Application Procedures: Investigator’s Responsibilities
Sponsor and Investigator IDE Responsibilities for SR and NSR Device Studies
UK Sponsor-Investigator training on CITI- description and instructions
UK Summary of FDA Requirements For Investigators Who Are Also Considered Sponsors of New Drug
FDA Inspections
Corrective and Preventive Action Plans (CAPA)
Clinicaltrials.gov
Guidance regarding which trials must be registered by the study sponsor (or sponsor-investigator)
Information on access to UK ‘s account on Clinicaltrials.gov
FDA’s Role: Clinicaltrials.gov Information
NIH Guidance on compliance with the FDA clinicaltrials.gov registration requirements
NIH Flowchart: Identifying an “Applicable Clinical Trial”
FDA Safety Reporting
Informed Consent Guidance
Real World Data
FDA Contacts
- Drugs - Center for Drug Evaluation & Research (CDER)
- 855-543-3784 or 301-796-3400
- druginfo@fda.hhs.gov
- Biologics - Center for Biologics Evaluation & Research (CBER)
- 800-835-4709 or 240-402-8010
- ocod@fda.hhs.gov
- Device – Center for Devices & Radiological Health (CDRH)
- 301-796-7100 or 800-638-2041
- DICE@fda.hhs.gov
- DigitalHealth@fda.hhs.gov
- Foods - Office of Food Additive Safety, Center for Food Safety and Applied Nutrition, Food And Drug Administration
- 888-723-3366
- Dietary Supplements - Division of Dietary Supplement Programs, Center for Food Safety and Applied Nutrition, Food And Drug Administration
- 888-723-3366 or 240-402-2375
- INDsFoodsDietarySuppCosmetics@fda.hhs.gov
- Cosmetics - Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition
- 888-723-3366
- Office of Clinical Policy (Good Clinical Practice)
- 301-796-8340
- gcp.questions@fda.hhs.gov
- Division of Small Manufacturers, International and Consumer Assistance
- 800-638-2041 or 301-796-7100
- dsmica@fda.hhs.gov