Regulation of Laboratory-Developed Tests: A Clinical Laboratory Perspective

Abstract

Objectives: To provide a clinical laboratory perspective on the Verifying Accurate Leading-edge IVCT Development Act (VALID) discussion draft. This potential legislative effort, if enacted,would overhaul the regulatory oversight of in vitro diagnostics (IVDs) in the United States and create a single system forregulation of conventional IVDs and laboratory-developed tests(LDTs). Methods: A concise literature-based review of LDT regulation is presented followed by a discussion of key concerns pertinent to clinical laboratories that should be considered in future IVD regulatory reform efforts. Results: Key issues identified include the importance of fostering innovation, preserving patient safety, protecting the practice of laboratory medicine, and minimizing undue regulatory burden. Clinical laboratories are not equivalent to manufacturing facilities and would therefore encounter challenges inimplementing device-centric regulatory oversight models. Conclusions: It is imperative that a clinical laboratory perspective on LDTs isunderstood and incorporated prior to advancement of future legislative proposals.