Early and contemporary strategies for the use of biocompatibility tests to assess the safety of materials. Testing begins at the bottom of the pyramid and works up. The number of tests needed decreases with the progress of testing because unacceptable materials are theoretically eliminated in the early testing stages. A, The earliest strategy, in which the testing strategy is focused on toxicity only. Unspecific toxicity refers to tests not necessarily related to the use of the material, whereas tests under specific toxicity are more relevant. Clinical trials are equivalent to usage tests in this scheme. B, The contemporary strategy used in most standards documents.