Standard Document
First Edition
Method Evaluation

CLSI EP49

Framework for Developing Evidence of Clinical Validity of Medical Laboratory Test Methods

CLSI EP49 provides a practical, holistic, standards‑based framework to help manufacturers and laboratories that develop their own tests clearly establish and communicate the clinical validity of medical laboratory test methods.

This document supports informed decision‑making by aligning clinical validity with the test’s intended use and role in patient care as well as its analytical performance. The result is a framework that supports sustained confidence in performance across the test lifecycle and it applies to qualitative, semi-quantitative, and quantitative assays.

Clinical validity is increasingly central to regulatory review, clinical adoption, and post‑market confidence. CLSI EP49 helps organizations:

  • Establish a clear, defensible rationale for a test’s clinical validity
  • Design and document clinical performance studies that support real‑world use
  • Align clinical and analytical validation
  • Anticipate questions from regulators, reviewers, and clinical stakeholders
  • Support ongoing confidence in test performance after launch


CLSI EP49 is intended for:

  • IVD manufacturers developing or updating test methods
  • Clinical laboratories establishing or validating LDTs
  • Teams responsible for clinical performance studies and evidence generation
  • Organizations preparing for regulatory review or internal governance
  • Professionals seeking alignment with internationally recognized best practices

Need multiple copies? We offer discounted pricing for volume purchases. Contact CustomerService@clsi.org or 610.688.0100 for assistance.

March 19, 2026
Michelle Campbell, MS, MLS(ASCP)CM, MBCM, SCCM; Natalya Benina, MS

{{FormatPrice(currentPrice)}}

Free

{{FormatPrice(nonMemberPrice)}} List Price
This is your member pricing.
Notify Me About New Editions
Abstract

CLSI EP49, Framework for Developing Evidence of Clinical Validity of Medical Laboratory Test Methods provides test developers (both manufacturers and laboratories that create laboratory-developed tests) with a framework for establishing evidence of clinical validity for a medical laboratory test method. Clinical validation is defined and discussed in the context of clinical utility and analytical validation during the establishment of a test method. CLSI EP49 focuses on evaluating clinical validity through a clinical performance study, comparing a candidate test method with a comparator for assessing a target condition based on the test method’s intended use. Purposes and categories of tests are described along with measures of a test method’s clinical performance. Considerations are outlined for components of a study protocol and clinical performance study report, as well as for monitoring clinical validity postlaunch. 

Additional topics discussed in CLSI EP49 include obtaining samples for clinical performance studies, use of real-world data, potential biases in subject selection, and ethical considerations.

Product Details
EP49Ed1E
978-1-68440-322-6
68
Additional Details

This document is available in electronic format only.

Authors
Michelle R. Campbell, MS, MLS(ASCP)CM, MBCM, SCCM
Natalya Benina, MS
Romiya Barry, PhD
J. Rex Astles, PhD, FADLM
Marvin Berman, PhD
Kate L. DeRosa, PhD, MA
Mark Kellogg, MLS(ASCP), PhD, DABCC
Marina V. Kondratovich, PhD
Dana Li, MD, PhD
Kristen Meier, PhD
Aimee Tan Aleksei Tikhonov, PhD, MS
Brigit Quinn, MS
Min Yu, MD, PhD, MBA
Abstract

CLSI EP49, Framework for Developing Evidence of Clinical Validity of Medical Laboratory Test Methods provides test developers (both manufacturers and laboratories that create laboratory-developed tests) with a framework for establishing evidence of clinical validity for a medical laboratory test method. Clinical validation is defined and discussed in the context of clinical utility and analytical validation during the establishment of a test method. CLSI EP49 focuses on evaluating clinical validity through a clinical performance study, comparing a candidate test method with a comparator for assessing a target condition based on the test method’s intended use. Purposes and categories of tests are described along with measures of a test method’s clinical performance. Considerations are outlined for components of a study protocol and clinical performance study report, as well as for monitoring clinical validity postlaunch. 

Additional topics discussed in CLSI EP49 include obtaining samples for clinical performance studies, use of real-world data, potential biases in subject selection, and ethical considerations.

Additional Details

This document is available in electronic format only.

Authors
Michelle R. Campbell, MS, MLS(ASCP)CM, MBCM, SCCM
Natalya Benina, MS
Romiya Barry, PhD
J. Rex Astles, PhD, FADLM
Marvin Berman, PhD
Kate L. DeRosa, PhD, MA
Mark Kellogg, MLS(ASCP), PhD, DABCC
Marina V. Kondratovich, PhD
Dana Li, MD, PhD
Kristen Meier, PhD
Aimee Tan Aleksei Tikhonov, PhD, MS
Brigit Quinn, MS
Min Yu, MD, PhD, MBA