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发表于 2013-8-14 06:46:41
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PIC/S关于质量风险管理方法学中文译稿
1. Introduction 介绍
Since a couple of years Quality Risk Management (or QRM) has become a mandatory regulatory requirement towards healthcare organizations either they are active in the sectors of Medical Devices* or in Pharmaceuticals†.
多年以来,质量风险管理已经成为对医疗卫生机构强制性的管理要求,无论他们是医疗器械部门还是制药部门。
The ICH-Q9 guideline concerning Quality Risk Management in thepharmaceutical field (active substances and medicinal products) was adopted by the European Union and PIC/S‡ in Annex 20 of the EU and PIC/S GMP Guides. It is gradually being applied by drug manufacturers in particular as regards sections 1.5 and 1.6 of part I of the aforementioned§.
ICH-Q9指南侧重于制药领域(活性成分和药物)的质量风险管理,曾被欧盟、PIC/S 在EU 、PIC/S 的GMP指南附录20中采用,尤其是一些药品生产商正在逐渐地使用这项指南,这部分可参考上文的第一部分的1.5和1.6的内容。
1.5 Quality risk management is a systematic process for the assessment, control, communication and review of risks to the quality of the medicinal product. It can be applied both proactively and retrospectively.
1.5 质量风险管理是一套为了评估,控制,沟通和回顾药品质量的风险的系统性流程,既可以用于前瞻预测,也可以用于事后回顾。
1.6 The quality risk management system should ensure that:
- the evaluation of the risk to quality is based on scientific knowledge, experience with the process and ultimately links to the protection of the patient
1.6质量风险管理系统应该确保
--质量风险的评估要以科学的知识和丰富的生产经验为基础,并最终与保护病人的安全联系起来。
- the level of effort, formality and documentation of the quality risk management process is commensurate with the level of risk
However, the practical methods for the implementation of these new requirements are still perceived as being singularly difficult to interpret and implement.
--质量风险管理程序的执行力度、正式程度、文件化水平都应该和风险的程度相匹配。但是这些新要求的实际的推行方法的解释和实施还是应该被看作是相当困难的。
In this context, a small, informal Working Group within PIC/S has started to develop an objective and pragmatic example of methodology, directly usable by the widest audience. It is also able to meet the demands of both operators and inspectors and to comply with all regulatory requirements.
在此背景下,一个PIC/S内的非正式的工作小组已经开始开发一个可以直接供广大读者使用,客观实用的研究方法,它也能满足经营者和检查员的要求,并符合所有的管理要求。
This example of methodology is not intended to be issued later by PIC/S as a recommendation or as a guideline for industry and / or for GMP inspectors but it could be used by PIC/S for training purposes. Whether this example is used by industry for other purposes is of no concern to PIC/S and will not influence the outcome of PIC/S inspections.
此研究方法并非想要由PIC/S出版来推荐给产业或GMP巡查员,也不会作为指南,但是可以用作PIC/S的培训资料。
2. Description of the methodology 方法描述
2.1. Objective of the Quality Risk Management 质量风险管理的目标
For any pharmaceutical organization, Quality Risk Management should aim at raising the level of protection for the patient, by the reduction of the risk to which that patient is exposed at the time he receives a drug product.
对于任何药品生产企业来说,质量风险管理应该致力于通过降低病人接触到药品时出现的风险来提高保护病人的水平。
This general objective can only be achieved if the implemented policy of Quality Risk Management exceeds the unique intend of GMP compliance by increasing the control of the Organization on developed (or under development) processes to improve:
只有质量风险管理实施方针超出了GMP独特的意愿才可以实现总体目标,可要求GMP进一步提高对成熟或欠成熟相关机构的管理。
Relevance of implemented processes;推行这套流程的相关原则
Knowledge within the Organization;机构内部需要有足够的知识
Confidence in performed operations.对执行要充满信心
At the opposite, Quality Risk Management should not set for finality:
相反,质量风险管理不应该终止:
Adjustment of controls to the currently available resources in the Organization;
在组织机构内部对可利用的资源进行调控管理;
 rovision of a wrongfully validated excuse not to comply with the regulatory requirements.
提供与监管要求不一致,经过不正当验证的理由。
2.2. General approach 常规方法
The scheme of a Quality Risk Management process as proposed by ICHQ9 is reproduced below:
该方案的质量风险管理过程ICHQ9重现了如下
For a practical implementation of this process, the guidance draws up the list of the principal known methods of risk analysis and gives a description of their specificities.
对具体实施过程中,该指南拟定了已知的风险识别列表,并给与特性描述。
Among those one will retain for example:
FMEA (Failure Mode Effect Analysis) 故障模式效应分析
FTA (Fault Tree Analysis) 故障树分析
HAZOP (Hazard Operability Analysis) 危害与可操作性分析
HACCP (Hazard Analysis and Critical Control Points) 危害分析与关键控制点
If these tools often proved to be efficient and reliable in risk assessment and/or risk control, they, by design, remain limited when they have to support a global policy of Risk Management. Moreover, it has been noticed that a systematic use of these tools to address all explicit and implicit issues of ICH-Q9 would generally be incompatible with available resources.
如果这些工具在风险评估或风险控制中表现为经常有效和可靠,那么当他们必须支持风险管理全球政策是就会被设定成维持有限。此外,已经注意到的是系统地使用这些工具去处理ICH-Q9中清晰或者含蓄的问题一般会和现有资源不兼容。
In this context, the example of methodology presented hereafter is aimed at providing training, help, inspiration or assistance to interested and volunteered stakeholders.
由此而论,以下呈现的研究方法例证旨在为感兴趣自愿的利益相关者提供培训,帮助,启发或者援助。
2.3. Description of QRM methodology 质量风险管理方法的描述
2.3.1. Preamble 序文
A Risk (R) is a mathematical expression with two parameters: severity (S) and Frequency (F). The risk is then expressed as: R = S x F.
风险是一个包含两个参数的数学表达式。所以风险被表达为:R = S x F.
A risk evaluation is then nothing but addressing a quantified answer to the double question:
风险评估也就是对两个问题寻求一个量化的解
What probability? 什么可能性?
Which consequences? 哪种后果?
Quantification should follow a qualitative step of hazards inventory. A hazard is defined as an event, which has the potential to have a negative impact on the considered objective (i.e.: patient safety). To comply with the ICH-Q9 diagram provided in scheme S1; hazards and risks have then to be considered in a two consecutive stages process with:
量化应该根据一个对危害清单的步骤。把一种危害定义为一个事件,这个事件对预想目标(病患的安全)会有消极影响。遵守计划S1当中的ICH-Q9;然后在两个连续阶段的流程中考虑危害和风险。
Risk Assessment (stage of qualitative categorization and
quantitative estimate of the identified hazards)
风险评估(对已识别的危害进行定性分类和定性估计的阶段)
Risk Control (stage of risk reduction and acceptance decision)
风险控制:风险减少和接受决定的阶段
Finally, Risk Management should integrate these stages of Risk Assessment and Risk Control in a policy established to maintain the relevance and the efficiency of the analytical work.
最后,风险管理应该整合既定政策下的风险评估和风险控制的这些不同阶段,来保持分析工作的关联和效率。
2.3.2. Design of methodology 方法设计
To meet the requirement of exhaustiveness of hazards and risks reviewing, the methodology should initially proceed to the inventory of all the activities
implemented in the processes covered by the quality system as applicable within the Organization. These activities should then be themselves divided into elementary steps, which are then individually introduced in the decisional diagram given below:
为了满足危害和风险评估的穷尽性的要求,此研究方法应该首先编制在有效的质量体系框架内实施全部活动的项目目录。然后这些活动应该被分成最初的步骤,之后这些步骤会被单独的引入到以下的决定性图表中。
Thus, for each elementary step, the method of Risk Management initially envisages an intrinsic evaluation of the primary risk, which, if it is not directly acceptable, will claim/require an iterative series of risk mitigation measures aiming at obtaining an acceptable residual risk.In this diagram, S indicates severity, F the frequency and D the detectability.
因此,在每个基本步骤中,起初风险管理方法假设主要风险的内在评估,如果只要风险不可直接受,就需要重复系列的只在获得一个可以接受的剩余风险的风险消减措施。在这个图标中S代表严重性,F代表频率,D代表可检验性。
In a traditional manner, the risk (R) is expressed as the multiplication of Severity (S) by the frequency (F) of occurrence of the hazard: R = S X F.
The detectability is not integrated in the calculation of the risk value and would only be considered under specific condition to decide whether the risk could be accepted or not.
在传统习惯中,风险是风险发生的严重性和频率的乘积:R=S X F.
可检测性不被计入到风险价值的计算中,只在要决定风险是否可接受的特定条件下才会考虑这个要素。
According to the diagram S2, there are two levels of risks, which are
submitted/proposed to acceptation:
primary Risks Rsp
residual Risks Rsr
根据图表S2,有两个水平的风险,它们被提交为接受:
主要风险Rsp
剩余风险Rsr
2.3.3. Input and output 输入和输出
The starting point of methodology thus consists in the inventory of all elementary steps entering the scope of Quality Risk Management. This inventory could be the result of the internal work of a multi-disciplinary team within the Organization or could be acquired from the “Shared Structure” platform according to the operating process described in paragraph 3 (or both).
研究方法的起点在于所有基本步骤要进入到质量风险管理的范围。基本步骤的确定应该是机构内部多学科团队内部工作的结果,或者是按照段落3中的操作流程,从“Shared Structure” 平台中获取。
Each elementary step treated according to the decision tree called “Risk Treatment Process” and depicted on Scheme 2 will allow to establish the risk assessment (relevant tools such as rationale, FMEA, FTA may be integrated here) through the implementation of reduction measures to primary risks related to elementary steps.
按照风险处理流程决策体系和计划2中描述的去处理基本步骤会允许通过图形减少与基本步骤相关的主要风险来建成风险评估(诸如基本原理,FMEA,FTA等相关工具会被整合到这里)。
If as for the inventory stage, primary risks may be originated from the results of multi-disciplinary working team or acquired from the database maintained by “Shared Structure” platform, reduction measures proposal and actual implementation will lie with the user.
假如在列清单的阶段,主要风险可能会来自于多学科工作小组的结果或者“shared Structure”平台中保留的数据,减少风险的措施的提出和措施实施将取决于使用者。
Risk assessment for a given elementary step is then documented as an output of the Risk Treatment Process.
既定基本步骤的风险评估会形成文件,作为风险处理流程输出。
The compilation of these outputs is permanently challenged for their capacity with being in adequacy with the evolutions of the regulatory framework applicable and periodically reviewed to take into consideration relevant new information coming generally from.
因为可应用的监管框架会在定期的评估中将相关的新信息纳入考虑,所以它是不断演变的,这些输出结果与这些演变的的适应能力会给输出结果的编制带来永久性的挑战。而这些新信息逐渐来自于:
CAPA: Corrective Action Preventive Action
纠正措施与预防措施
Internal Information: refers to relevant data coming from the Organization but not directly linked to the concerned.manufacturing process.
内部信息:指的是来自机构内部的相关数据,但是跟有关的生产流程并非直接相连。
External Information: refers to relevant data coming from the
outside of the Organization and related subsidiary; e.g.:guidance and regulatory notes issued from national agencies The result of an event or periodic revision (at least annual) is materialized
by a new version of the document compiling the output data of Quality Risk Management of the Organization.
外部信息:指的是来自机构外部和相关附属部门的相关数据;例如:国家学术机构的指导和监管记录。项目结果或定期修正(至少每年一次)被新版本的文件具体化,这个文件收集了机构质量风险管理的输出数据。
The permanent control of the outputs as described here constitutes the main difference between Risk Analysis and Risk Management and is essential to its efficiency.
永久性的控制这里描述的输出构成了风险分析和风险管理之间的主要区别,并且对它的功效有必不可少的作用。
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