Clinical study of 99 subjects (18-60 years) comparing Zmachine algorithm to consensus human scores
>1 (certified polysomnographic technologists)
Indications for Use
The CRI Zmachine is a single-channel, EEG acquisition and analysis system, designed for use in the home or clinical environments. This device is intended to be used by qualified healthcare practitioners to monitor the wake and sleep states of adult patients and as an adjunct to their diagnosis of sleep disorders.
Device Story
Battery-operated, single-channel EEG acquisition/analysis system; uses differential-mastoid EEG channel input; processes data to determine wake/sleep states (wake, light sleep, deep sleep, REM) in 30-second epochs; used in home or clinical settings by healthcare practitioners; provides summary sleep statistics to assist in evaluating treatment efficacy; aids clinicians in diagnosing sleep disorders.
Clinical Evidence
Clinical study of 99 subjects (18-60 years, 52F/47M) comparing Zmachine algorithm output against consensus human scoring (R&K guidelines) of PSG data. Overall kappa agreement was 0.716 across 85,206 epochs. P1 (sensitivity) and P2 (positive predictive value) metrics for Wake, Light Sleep, Deep Sleep, and REM were calculated and compared favorably to the Sleep Profiler predicate.
Technological Characteristics
Single-channel EEG acquisition system; differential-mastoid electrode placement; battery-powered; proprietary algorithm using time and frequency domain features; real-time EEG analysis; provides summary sleep statistics.
Indications for Use
Indicated for adult patients to monitor wake and sleep states as an adjunct to the diagnosis of sleep disorders. No specific contraindications listed.
Regulatory Classification
Identification
An electroencephalograph is a device used to measure and record the electrical activity of the patient's brain obtained by placing two or more electrodes on the head.
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Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002
January 20, 2015
Consolidated Research Of Richmond, Inc % Richard Kaplan President 26250 Euclid Ave Suite 709 Euclid. Ohio 44132
K142825 Re:
> Trade/Device Name: Zmachine DT-200 Regulation Number: 21 CFR 882.1400 Regulation Name: Electroencephalograph Regulatory Class: Class II Product Code: OLZ, OLV, OMC Dated: December 15, 2014 Received: December 19, 2014
Dear Dr. Kaplan,
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device
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Sincerely yours,
# Felipe Aquel -S
Carlos L. Peña. PhD. MS for Director Division of Neurological and Physical Medicine Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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### Indications for Use
510(k) Number (if known) K142825
Device Name Zmachine DT-200
Indications for Use (Describe)
The CRI Zmachine is a single-channel, EEG acquisition and analysis system, designed for use in the home or clinical environments. This device is intended to be used by qualified healthcare practitioners to monitor the wake and sleep states of adult patients and as an adjunct to their diagnosis of sleep disorders.
| Type of Use (Select one or both, as applicable) | |
|-------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------|
| <div> <span> <span style="text-decoration: overline;">X</span> Prescription Use (Part 21 CFR 801 Subpart D) </span> </div> | <div> <span> Over-The-Counter Use (21 CFR 801 Subpart C)</span> </div> |
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## 510(k) Summary
## Zmachine® 510(k) Notification Consolidated Research of Richmond, Inc.
| 510(k) Owner | Consolidated Research of Richmond, Inc. |
|---------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Address | 26250 Euclid Avenue, Suite 709<br>Euclid, Ohio 44132<br>Phone: (216) 289-2331<br>Fax: (216) 393-0079 |
| Contact Person | Richard F. Kaplan, Ph.D., President<br>Phone: (216) 289-2331 Extension 1001<br>E-mail: kaplan@cri-systems.com |
| Date Prepared | December 16, 2014 |
| Trade Name | Zmachine® DT-200 |
| Common Name | Sleep monitoring system |
| Classification Name | Electroencephalograph<br>21 CFR 882.1400 |
| Product Codes | OLZ, OLV and OMC |
| Indications for Use | The CRI Zmachine is a single-channel, EEG acquisition and analysis<br>system, designed for use in the home or clinical environments. This<br>device is intended to be used by qualified healthcare practitioners to<br>monitor the wake and sleep states of adult patients and as an adjunct to<br>their diagnosis of sleep disorders. |
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| Device<br>Description | The CRI Zmachine is a battery-operated, single-channel, EEG<br>acquisition and analysis system. The Zmachine system includes the<br>Zmachine device, disposable EEG sensors, sensor cable, and a wall<br>charger. The device operates on data from the differential-mastoid<br>EEG channel to determine the wake and sleep states (wake, light sleep,<br>deep sleep and REM) of the patient every 30 seconds. |
|----------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Substantial<br>Equivalence | The Zmachine DT-200 is substantially equivalent to the Zmachine DT-<br>100 (K101830) by Consolidated Research of Richmond, Inc., sharing<br>the same indications for use, the same primary wake/sleep detection<br>algorithm, and the same hardware platform. The firmware of<br>Zmachine DT-200 has been upgraded to further subdivide epochs<br>detected as sleep by the primary wake/sleep detection algorithm into<br>light sleep (stages N1 and N2), deep sleep (N3) and REM. The further<br>subdivision of sleep stages are substantially equivalent to the Sleep<br>Profiler algorithm (K120450) by Advanced Brain Monitoring, Inc. |
The table below summarizes the technological characteristics of the Zmachine DT-200 in comparison to the predicate devices.
| | Zmachine DT-200<br>(New) | Zmachine DT-100<br>(K101830) | Sleep Profiler<br>(K120450) |
|------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Manufacturer<br>Name | Consolidated<br>Research of<br>Richmond, Inc. | Consolidated<br>Research of<br>Richmond, Inc. | Advanced Brain<br>Monitoring, Inc. |
| 510(k) Number | This 510(k) | K101830 | K120450 |
| Classification<br>Regulation | 882.1400 | 882.1400 | 882.1400 |
| Product Code | OLZ, OLV and<br>OMC | OLV and OMC | OLZ |
| | Zmachine DT-200 | Zmachine DT-100 | Sleep Profiler |
| Indications for Use | (New)<br>The CRI Zmachine<br>is a single-channel,<br>EEG acquisition and<br>analysis system,<br>designed for use in<br>the home or clinical<br>environments. This<br>device is intended to<br>be used by qualified<br>healthcare<br>practitioners to<br>monitor the wake<br>and sleep states of<br>adult patients and as<br>an adjunct to their<br>diagnosis of sleep<br>disorders. | (K101830)<br>The CRI Zmachine<br>is a single-channel,<br>EEG acquisition and<br>analysis system,<br>designed for use in<br>the home or clinical<br>environments. This<br>device is intended to<br>be used by qualified<br>healthcare<br>practitioners to<br>monitor the wake<br>and sleep states of<br>adult patients and as<br>an adjunct to their<br>diagnosis of sleep<br>disorders. | (K120450)<br>Sleep Profiler is<br>intended for the<br>diagnostic<br>evaluation by a<br>physician to assess<br>sleep quality in<br>adults only. The<br>Sleep Profiler is a<br>software-only<br>device to be used<br>under the<br>supervision of a<br>clinician to analyze<br>physiological<br>signals and<br>automatically score<br>sleep study results,<br>including the<br>staging of sleep,<br>detection of<br>arousals and<br>snoring. |
| Patient Population | Adults | Adults | Adults |
| Type of Device | EEG-based sleep<br>monitor | EEG-based sleep<br>monitor | EEG-based sleep<br>staging software |
| No. of EEG<br>Channels | 1 | 1 | 1 |
| Electrode<br>Placement | Mastoid | Mastoid | Frontal |
| Analyzes EEG<br>Data in Real Time | Yes | Yes | Yes |
| Sleep<br>Classification | Wake and N1+N2<br>(light sleep). N3<br>(deep sleep), and<br>REM | Wake and Sleep | Wake and N1, N2,<br>N3, and REM |
| EEG Analysis<br>Methodology | Proprietary<br>algorithm using<br>time and frequency<br>domain features | Proprietary<br>algorithm using<br>time and frequency<br>domain features | Proprietary<br>algorithm using<br>time and frequency<br>domain features |
| | Zmachine DT-200<br>(New) | Zmachine DT-100<br>(K101830) | Sleep Profiler<br>(K120450) |
| Provides<br>Information to<br>Assist the<br>Healthcare<br>Provider in<br>Evaluation of<br>Treatment<br>Efficacy? | Yes | Yes | Yes |
| Calculates<br>Summary Sleep<br>Statistics? | Yes | Yes | Yes |
| Battery Powered? | Yes | Yes | Yes |
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### Performance Testing - Clinical
A clinical study was conducted in which overnight laboratory polysomnographic (PSG) data, and data from the differential-mastoids (A1-A2), were acquired from 99 subjects (52F/47M, 18-60 years, median age 32.7 years), including those reporting normal sleep and those reporting complaints consistent with various sleep disorders.
The standard PSG channels were scored independently by two to four certified polysomnographic technologists, using the Rechtschaffen and Kales (R&K) visual sleep staging guidelines. The individual score files were then combined, on a 30-second epoch basis, using a majority voting rule, to generate a single score file per subject ("Human Scores"). EEG data acquired from A1-A2 was processed by the Zmachine Algorithm which determines wake, light sleep (N1&N2), deep sleep (N3) and REM on a 30-second epoch basis.
The performance of the Zmachine Algorithm was evaluated by comparing against the Human Scores for stages wake, light sleep (N1&N2), deep sleep (N3) and REM. Overall, kappa agreement between Zmachine Algorithm and Human Scores for 85,206 epochs is 0.716, with P1 (the probability that Zmachine will correctly assign an epoch when the PSG Consensus assigns the epoch to a particular stage) and P2 (when the Zmachine assigns an epoch to a particular stage, the probability of such assignment is correct) for each stage summarized in the table below.
| Zmachine DT-200 | | | | |
|-----------------|-------|-------------|------------|-------|
| | Wake | Light Sleep | Deep Sleep | REM |
| P1 | 0.908 | 0.835 | 0.738 | 0.721 |
| P2 | 0.843 | 0.848 | 0.782 | 0.732 |
Using the performance data published in K120450 (44 subject study) of the predicate Sleep Profiler algorithm, stages N1 and N2 were combined into Light Sleep for both the
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algorithm and scorers (to permit a direct comparison with the Zmachine Algorithm) with a resulting P1 and P2 for each stage summarized in the table below.
| Sleep Profiler | | | | |
|----------------|-------|-------------|------------|-------|
| | Wake | Light Sleep | Deep Sleep | REM |
| P1 | 0.789 | 0.855 | 0.757 | 0.719 |
| P2 | 0.831 | 0.812 | 0.787 | 0.782 |
The P1 and P2 values obtained during clinical validation of the Zmachine Algorithm are similar to those obtained by the predicate Sleep Profiler algorithm, which was validated using its own data set.
### Conclusion
This submission demonstrates that the Zmachine is substantially equivalent to the predicate devices based on descriptive information and clinical performance testing.
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