Vibration Response Imaging (VRI) in Dyspnea Patients Presenting to the ED
Recruitment status was Recruiting
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Purpose
For the patient with acute dyspnea in the ED, early differentiation between CHF and non-CHF causes is essential for proper management. The capacity to triage patients quickly and accurately has a beneficial impact upon outcome, disposition, stratification and length of stay in the ED and required length of hospital admission.
The ability to assess pulmonary status rapidly by quantitative regional vibration technology offers significant potential advantage for earlier diagnosis. The VRI technique may provide a quick and accurate method of differentiating between dyspnea due to HF and dyspnea due to pulmonary causes; thereby improving management and outcomes.
| Condition |
|---|
|
Dyspnea |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Assessment of the Utility of Vibration Response Imaging (VRI) in Evaluating Dyspnea Patients Presenting to the Emergency Department |
- Assess the ability of the VRI to improve clinical outcomes via accurate, early classification of the cause of acute dyspnea as HF or other (i.e. COPD, PE etc). [ Time Frame: Baseline testing at ED presentation ] [ Designated as safety issue: No ]
The primary efficacy analysis set (PEAS) consists of all patients who have Gold Standard (GS) diagnosis (CHF/non-CHF) & VRI records.
- Accuracy rate is defined as the accuracy between the GS and VRI.
- Accuracy parameters between the GS and VRI will be calculated using accuracy rate, sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) & likelihood ratios (+,-).
- Assess the agreement to aid in classifying the cause of acute dyspnea as HF or other of the VRI in comparison to BNP/NTproBNP assays. [ Time Frame: Baseline testing at ED presentation ] [ Designated as safety issue: No ]
The secondary efficacy analysis set (SEAS) consists of all patients who have final diagnosis (CHF/non-CHF), BNP/NT-proBNP & VRI results.
- Agreement rate (2X2 agreement table) between BNP/NT-proBNP (based on separate decision cut-offs for each assay) and VRI will be calculated for dyspnea due to CHF or other causes.
- The discordant observations (from the agreement table) will be further evaluated between the VRI and GS.
- Logistic regression will be used in order to find the significance and strength contribution of the VRI and the BNP on the goal-function.
- Assess the ability of the VRI to aid in classifying the cause of acute dyspnea as HF or COPD [ Time Frame: Baseline testing at ED presentation ] [ Designated as safety issue: No ]
The tertiary efficacy analysis set (TEAS) consists of all patients who have final diagnosis (CHF/COPD) & VRI results.
-Similar to the previous objectives - accuracy (with the GS) and agreement rates (with BNP/NT-proBNP); comparisons based only on CHF and COPD patients.
- Evaluate the ability of the VRI to monitor changes in clinical status following treatment in comparison with other standard testing methods (e.g. ECG, serial chest x-rays, etc.) [ Time Frame: Baseline testing and repeated testing after 2 hours ] [ Designated as safety issue: No ]
The fourth efficacy analysis set consists of patients who have baseline & after treatment follow-up clinical data & VRI recordings.
- Descriptive statistics will be used in order to evaluate the changes following treatment in comparison to baseline condition.
- The changes will be categorized to status of improved, worse or same and will be compared, when available, to existing tools.
Biospecimen Retention: None Retained
Blood drawn for BNP testing
| Estimated Enrollment: | 530 |
| Study Start Date: | August 2010 |
| Estimated Study Completion Date: | June 2011 |
| Estimated Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
| ED patients presenting with dyspnea |
Eligibility| Ages Eligible for Study: | 41 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
Patients presenting to the ED with acute dyspnea who are greater than 40 years of age and consisting of both male and females
Inclusion Criteria:
Able and willing to provide Informed Consent;
->40 years of age;
- Estimated Body Mass Index >19;
- Patient presented to the emergency department with a chief complaint of acute dyspnea.
Exclusion Criteria:
- Patients with obvious trauma or acute anxiety as a cause of dyspnea;
- Patient has already received directed therapy in the ED and symptoms are remarkably improved;
- Physician concern regarding possible harm to patient caused by positioning or ambulating the patient for VRI testing;
- Intubated or mechanically ventilated;
- Acute hemodynamic or ventilator instability requiring immediate resuscitation;
- Body habitus or skin condition that might prevent the placement of the sound sensors on the back (e.g. severe scoliosis, kyphosis, chest wall deformation, skin lesion on the back or compression fracture);
- Hirsutism.
Contacts and Locations| Contact: Charles V. Pollack, MD | 215-829-7549 | cvpollack@gmail.com |
| United States, Delaware | |
| Christiana Care Health System | Recruiting |
| Newark, Delaware, United States, 19718 | |
| Contact: Barbara Davis, RN, BSN 302-733-4189 bdavis@christianacare.org.org | |
| Principal Investigator: Jason T. Nomura, MD | |
| United States, Nevada | |
| University of Nevada School of Medicine | Not yet recruiting |
| Las Vegas, Nevada, United States, 89106 | |
| Contact: David E Slattery, MD 702-383-7885 ext 5 dslatts@mac.com | |
| Principal Investigator: David E Slattery, MD | |
| United States, New York | |
| Lincoln Medical and Mental Health Center | Recruiting |
| Bronx, New York, United States, 10451 | |
| Contact: Muhammad Waseem, MD 718-579-6010 waseemm2001@hotmail.com | |
| Principal Investigator: Muhammad Waseem, MD | |
| Mount Sinai School of Medicine | Recruiting |
| New York, New York, United States, 10029 | |
| Contact: Janice Lam 212-824-8078 Janice.Lam@mountsinai.org | |
| Principal Investigator: Denise Nassisi, MD | |
| United States, Ohio | |
| Metrohealth Medical Center | Recruiting |
| Cleveland, Ohio, United States, 44122 | |
| Contact: Julie Nichols, RN 216-957-6488 jnichols@metrohealth.org | |
| Principal Investigator: Rita Cydulka, MD | |
| United States, Pennsylvania | |
| Pennsylvania Hospital | Recruiting |
| Philadelphia, Pennsylvania, United States, 19107 | |
| Contact: Charles Pollack 215-829-7549 cvpollack@gmail.com | |
| Principal Investigator: Charles V Pollack, MD | |
| United States, Texas | |
| Baylor College of Medicine | Not yet recruiting |
| Houston, Texas, United States, 77030 | |
| Contact: Syed S Ali, MD 713-873-8555 syeda@bcm.tmc.edu | |
| Principal Investigator: Syed S Ali, MD | |
| Israel | |
| Beilinson Hospital, Rabin Medical Center | Not yet recruiting |
| Petah Tikva, Israel, 49100 | |
| Contact: Zvi Rotenberg, Dr 9723-937-7000 zrotenberg@clalit.org.il | |
| Principal Investigator: Zvi Rotenberg, Dr | |
| Principal Investigator: | Charles V. Pollack, MD | Pennsylvania Hospital |
More Information
Publications:
| Responsible Party: | Merav Gat, VP of Clinical & Regulatory Affairs, Deep Breeze |
| ClinicalTrials.gov Identifier: | NCT01206621 History of Changes |
| Other Study ID Numbers: | DB051 |
| Study First Received: | September 21, 2010 |
| Last Updated: | May 12, 2011 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Deep Breeze:
|
dyspnea COPD CHF asthma |
Additional relevant MeSH terms:
|
Dyspnea Respiration Disorders Respiratory Tract Diseases Signs and Symptoms, Respiratory Signs and Symptoms |
ClinicalTrials.gov processed this record on May 19, 2013