Long title | An Act to amend the Public Health Service Act to establish the authority for the regulation of mammography services and radiological equipment, and for other purposes. |
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Acronyms (colloquial) | MQSA |
Nicknames | Mammography Quality Standards Act of 1992 |
Enacted by | the 102nd United States Congress |
Effective | October 1, 1994 |
Citations | |
Public law | 102-539 |
Statutes at Large | 106 Stat. 3547 |
Codification | |
Titles amended | 42 U.S.C.: Public Health and Social Welfare |
U.S.C. sections created | 42 U.S.C. ch. 6A § 263b |
U.S.C. sections amended | 42 U.S.C. ch. 6A § 201 et seq. |
Legislative history | |
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The Mammography Quality Standards Act (MQSA) was enacted by the United States Congress to regulate the quality of care in mammography. The act was officially effective in 1994, and was extended in 2004 to continue through 2007. The U.S. Food and Drug Administration (FDA) began inspections of mammography facilities to ensure compliance in 1995. In 1997, more comprehensive regulation was added to become effective in 1999.
The FDA explains MQSA: [1]
The Mammography Quality Standards Act requires mammography facilities across the nation to meet uniform quality standards. Congress passed this law in 1992 to assure high-quality mammography for early breast cancer detection, which can lead to early treatment, a range of treatment options leading to an increased chance of survival. Under the law, all mammography facilities must: 1) be accredited by an FDA-approved accreditation body, 2) be certified by FDA, or its State, as meeting the standards, 3) undergo an annual MQSA inspection, and 4) prominently display the certificate issued by the agency.
In a nationwide survey of mammography facilities conducted in 1985, called Nationwide Evaluation of X-ray Trends (NEXT), the U.S. Food and Drug Administration found 36 percent to be producing mammographic images of unacceptable quality. [2] The FDA also found that 15 percent of facilities were using general purpose X-ray equipment for mammography. The American College of Radiology responded by initiating a voluntary accreditation program for these facilities in August 1987 and found that 30 percent of facilities failed on their first application for accreditation. [2] [3]
Evidence from a 1990 General Accounting Office (GAO) study showed that many mammography providers lacked adequate quality assurance programs. From June 20 to 22, 1990, NBC Nightly News correspondent Michelle Gillen presented a three-part series on the quality problems of mammography. [3] In 1992, hearings held by the Senate Committee on Labor and Human Resources found numerous quality issues in the field of mammography. [2]
Congress enacted the MQSA on October 7, 1992. [3] [4] Responsibility for implementing MQSA was delegated to the FDA by the Secretary of the U.S. Department of Health and Human Services (DHHS) on June 2, 1993. The act became effective October 1, 1994, and requires all mammography facilities to meet quality standards as promulgated by the Food and Drug Administration (FDA). The FDA published interim regulations on December 21, 1993, as a mechanism for accrediting and certifying of facilities by October 1, 1994. [2]
The FDA found 10,142 certified facilities operating as of December 15, 1994. [5] During the first year of MQSA, 26 percent of facilities had significant violations, while 10 percent did on the second round of inspections. [6] On October 28, 1997, the FDA published a set of comprehensive final regulations, which become effective on April 28, 1999, guiding the accreditation process. They accredited and certified 10,161 mammography facilities as of December 31, 1997. [2]
A 1998 estimate concluded that inspections cost each facility $1,549 annually and the average cost to reach compliance with MQSA was $18,000. [7] Costs of meeting the interim regulations, including staff training, equipment upgrades, enhancement of quality assurance programs, and improved notification of examination results to patients, was estimated to be $24 million annually. The additional cost of facility compliance with the 1997 regulations increased this figure to $62 million annually. [2]
The number of certified facilities operating on December 31, 1997, was about 4 percent less than prior to when MQSA went into effect on October 1, 1994. Of the 369 closures just prior to October 1, 113 could be directly attributed to MQSA. [2]
On November 9, 1997, the Senate passed S. 537, "The Mammography Quality Standards Reauthorization Act," by unanimous consent, to reauthorize MQSA for another five years. [2]
MQSA requires facilities to "be accredited by an FDA-approved accreditation body." Currently the only nationally-approved body is the American College of Radiology (ACR).
State-level alternatives to the ACR are the Arkansas Department of Health, Iowa Department of Public Health, and Texas Department of State Health Services.
MQSA is intended to maintain high quality mammography in the United States and its territories. Changes in the final regulations directly affecting regular patients include:
The United States Food and Drug Administration is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food safety, tobacco products, caffeine products, dietary supplements, prescription and over-the-counter pharmaceutical drugs (medications), vaccines, biopharmaceuticals, blood transfusions, medical devices, electromagnetic radiation emitting devices (ERED), cosmetics, animal foods & feed and veterinary products.
Mammography is the process of using low-energy X-rays to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses or microcalcifications.
Hazard analysis and critical control points, or HACCP, is a systematic preventive approach to food safety from biological, chemical, and physical hazards in production processes that can cause the finished product to be unsafe and designs measures to reduce these risks to a safe level. In this manner, HACCP attempts to avoid hazards rather than attempting to inspect finished products for the effects of those hazards. The HACCP system can be used at all stages of a food chain, from food production and preparation processes including packaging, distribution, etc. The Food and Drug Administration (FDA) and the United States Department of Agriculture (USDA) require mandatory HACCP programs for juice and meat as an effective approach to food safety and protecting public health. Meat HACCP systems are regulated by the USDA, while seafood and juice are regulated by the FDA. All other food companies in the United States that are required to register with the FDA under the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, as well as firms outside the US that export food to the US, are transitioning to mandatory hazard analysis and risk-based preventive controls (HARPC) plans.
Current good manufacturing practices (cGMP) are those conforming to the guidelines recommended by relevant agencies. Those agencies control the authorization and licensing of the manufacture and sale of food and beverages, cosmetics, pharmaceutical products, dietary supplements, and medical devices. These guidelines provide minimum requirements that a manufacturer must meet to assure that their products are consistently high in quality, from batch to batch, for their intended use.
The United States Federal Food, Drug, and Cosmetic Act is a set of laws passed by the United States Congress in 1938 giving authority to the U.S. Food and Drug Administration (FDA) to oversee the safety of food, drugs, medical devices, and cosmetics. The FDA's principal representative with members of congress during its drafting was Charles W. Crawford. A principal author of this law was Royal S. Copeland, a three-term U.S. senator from New York. In 1968, the Electronic Product Radiation Control provisions were added to the FD&C. Also in that year the FDA formed the Drug Efficacy Study Implementation (DESI) to incorporate into FD&C regulations the recommendations from a National Academy of Sciences investigation of effectiveness of previously marketed drugs. The act has been amended many times, most recently to add requirements about bioterrorism preparations.
Regulatory affairs (RA), is a profession that deals with an organization’s adherence to regulatory compliance.
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A biomedical engineering/equipment technician/technologist or biomedical engineering/equipment specialist is typically an electro-mechanical technician or technologist who ensures that medical equipment is well-maintained, properly configured, and safely functional. In healthcare environments, BMETs often work with or officiate as a biomedical and/or clinical engineer, since the career field has no legal distinction between engineers and engineering technicians/technologists.
The process of establishing documentary evidence demonstrating that a procedure, process, or activity carried out in testing and then production maintains the desired level of compliance at all stages. In the pharmaceutical industry, it is very important that in addition to final testing and compliance of products, it is also assured that the process will consistently produce the expected results. The desired results are established in terms of specifications for outcome of the process. Qualification of systems and equipment is therefore a part of the process of validation. Validation is a requirement of food, drug and pharmaceutical regulating agencies such as the US FDA and their good manufacturing practices guidelines. Since a wide variety of procedures, processes, and activities need to be validated, the field of validation is divided into a number of subsections including the following:
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The Breast Imaging-Reporting and Data System (BI-RADS) is a quality assurance tool originally designed for use with mammography. The system is a collaborative effort of many health groups but is published and trademarked by the American College of Radiology (ACR).
The Office of Global Regulatory Operations and Policy (GO), also known as the Office of Regulatory Affairs (ORA), is the part of the U.S. Food and Drug Administration (FDA) enforcing the federal laws governing biologics, cosmetics, dietary supplements, drugs, food, medical devices, radiation-emitting electronic devices, tobacco products, and veterinary medicine products which may have potentially harmful side effects for the consumer.
Molecular breast imaging (MBI), also known as scintimammography, is a type of breast imaging test that is used to detect cancer cells in breast tissue of individuals who have had abnormal mammograms, especially for those who have dense breast tissue, post-operative scar tissue or breast implants.
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The Food and Drug Administration (FDA) of the Philippines, formerly the Bureau of Food and Drugs, is a health regulatory agency under the Department of Health created on 1963 by Republic Act No. 3720, amended on 1987 by Executive Order 175 otherwise known as the "Food, Drugs and Devices, and Cosmetics Act", and subsequently reorganized by Republic Act No. 9711 otherwise known as "The Food and Drug Administration Act of 2009". The agency is responsible for licensing, monitoring, and regulation of cosmetics, drugs, foods, household hazardous products, medical devices and electromagnetic radiation emitting devices, pesticides, tobacco and related products, and vaccines for safety, efficacy, and quality in the Republic of the Philippines.
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