Abstract
The Ambient Intelligence (AmI) paradigm has increasingly been adopted to build what we name Ambient Intelligent Medical Software (AmI-MS) to face the complexity of designing software-based systems for monitoring medical conditions and supporting physician in making decisions. When this kind of systems are directly related to the safety of people, they are subject to pass an approval process as Medical Devices to ascertain their quality regarding safety and effectiveness. Currently, building an AmI-MS follows a conventional approach which employs two processes: the first for developing the software and the second for identifying, assessing, and managing the related risks. This method hides its complexity within the interaction between the processes mentioned above, which is not standardised and left to manufacturer quality management. For AmI-MS, it is even worse due to the multitude of environmental conditions to be analysed from both a design and a risk perspective which leads to inappropriate, or insufficient evidence, and undiscovered, or not adequately controlled, risk scenarios. In this work, we propose a novel risk-driven, evidence-oriented V-model methodology which addresses the previous issues by defining a seamless and unified development process. The novelty of our approach consists of interleaving risk management with software development activities and employing assurance cases for driving and controlling quality concerns. A concrete application on a case study is presented to show the strengths and weaknesses of this approach.





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Directive, Council (1993) 93/42/EEC of 14 June 1993 concerning medical devices, pp 1–46. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri= CONSLEG:1993L0042:20071011:en:PDF
FDA (2007) Title 21 Food and Drugs Chapter I Food and Drug Administration Department of Health and Human Services Subchapter H Medical Devices Part 820 Quality System Regulation. U.S. Department of Health and Human Services. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=820. Accessed Sept 2016
ISO 13485 (2003) Medical devices-quality management systems-requirements for regulatory purposes. International Organization for Standardization, Geneva
Association for the Advancement of Medical Instrumentation (2007) Medical devices: application of risk management to medical devices. Association for the Advancement of Medical Instrumentation
International Electrotechnical Commission (2006) Medical device software: software life cycle processes. IEC
Eagles S, Wu F (2014) Reducing risks and recalls: safety assurance cases for medical devices. Biomed Instrum Technol 48(1):24–32
Lee I, Sokolsky O, Chen S, Hatcliff J, Jee E, Kim B, King A, Mullen-Fortino M, Park S, Roederer A, Venkatasubramanian KK (2012) Challenges and research directions in medical cyberphysical systems. In: Proceedings of the IEEE. IEEE, pp 75–90
Naeem MR, Zhu W, Memon AA, Khalid A (2014) Using V-model methodology, UML process-based risk assessment of software and visualization. In: International conference on cloud computing and internet of things (CCIOT). IEEE, pp 197–202
McCaffery F, McFall D, Donnelly P, Wilkie FG, Sterritt R (2005) A software process improvement lifecycle framework for the medical device industry. In: 12th IEEE international conference and workshops on the engineering of computer-based systems (ECBS’05). IEEE, pp 273–280
McHugh M, Cawley O, McCaffcry F, Richardson I, Wang X (2013) An agile v-model for medical device software development to overcome the challenges with plan-driven software development lifecycles. In: 2013 5th International workshop on software engineering in health care (SEHC). IEEE, pp 12–19
Ray A (2012) Assurance cases: their use today and the challenges ahead. Biomed Instrum Technol 46(3):195–200
Food and Drug Administration (2016) Guidance for industry and FDA staff: total product life cycle: infusion pump: premarket notification [510(k)] submissions. http://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm209337.pdf. Accessed Sept 2016
IEEE Standard-Adoption of ISO/IEC 15026-2 (2011) Systems and software engineering—systems and software assurance—part 2: assurance case. In: IEEE Std 15026-2-2011, pp 1–28. doi:10.1109/IEEESTD.2011.6045293, http://lorg/stamp/stamp.jsp?tp=&arnumber=6045293&isnumber=6045292
Kelly T, Weaver R (2004) The goal structuring notation. A safety argument notation. In: Proceedings of the dependable systems and networks 2004 workshop on assurance cases, Citeseer
http://www.icar.cnr.it/en/node/533. Accessed 21 Mar 2017
Stallbaum H, Metzger A, Pohl K (2008) An automated technique for risk-based test case generation and prioritization. In: Proceedings of the 3rd international workshop on automation of software test. ACM, pp 67–70
Utting M, Pretschner A, Legeard B (2012) A taxonomy of model based testing approaches. Softw Test Verif Reliab 22(5):297–312
Akhlaki KB, Tun MC, Terriza JH, Morales LM (2007) A methodological approach to the formal specification of real-time systems by transformation of UML-RT design models. Sci Comput Program 65(1):41–56
Benghazi K, Hurtado MV, Hornos MJ, Rodrguez ML, Rodrguez-Domnguez C, Pelegrina AB, Rodrguez-Frtiz MJ (2012) Enabling correct design and formal analysis of ambient assisted living systems. J Syst Softw 85(3):498–510
Hrgarek N (2012) Certification and regulatory challenges in medical device software development. In: Proceedings of the 4th international workshop on software engineering in health care. IEEE Press, pp 40–43
Acampora G, Cook DJ, Rashidi P, Vasilakos AV (2013) A survey on ambient intelligence in healthcare. Proc IEEE 101(12):2470–2494
Jordan P (2006) Standard IEC 62304-medical device software-software lifecycle processes. In: The Institution of Engineering and Technology Seminar on software for medical devices. IET, pp 41–47
Höss A, Lampe C, Panse R, Ackermann B, Naumann J, Jäkel O (2014) First experiences with the implementation of the European standard EN 62304 on medical device software for the quality assurance of a radiotherapy unit. Radiat Oncol 9(1):1
Becchetti C, Neri A (2013) A medical instrument design and development: from requirements to market placements. Wiley, New York
Munassar NMA, Govardhan A (2010) A comparison between five models of software engineering. IJCSI 5:95–101
Zema M, Rosati S, Gioia V, Knaflitz M, Balestra G (2015) Developing medical device software in compliance with regulations. In: 37th Annual international conference of the IEEE, Engineering in Medicine and Biology Society (EMBC). IEEE, pp 1331–1334
McHugh M, McCaffery F, Fitzgerald B, Stol KJ, Casey V, Coady G (2013) Balancing agility and discipline in a medical device software organisation. In: International conference on software process improvement and capability determination. Springer, Berlin, pp 199-210
Weinstock CB, Goodenough JB (2009) Towards an assurance case practice for medical devices (No. CMU/SEI-2009-TN-018). Carnegie-Mellon University Software Engineering Institute, Pittsburgh
Jee E, Lee I, Sokolsky O (2010) Assurance cases in model-driven development of the pacemaker software. In: International symposium on leveraging applications of formal methods, verification and validation. Springer, Berlin, pp 343–356
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Cicotti, G. An evidence-based risk-oriented V-model methodology to develop ambient intelligent medical software. J Reliable Intell Environ 3, 41–53 (2017). https://doi.org/10.1007/s40860-017-0039-9
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DOI: https://doi.org/10.1007/s40860-017-0039-9