Pediatric Adenotonsillectomy for Snoring (PATS)
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|ClinicalTrials.gov Identifier: NCT02562040|
Recruitment Status : Recruiting
First Posted : September 29, 2015
Last Update Posted : February 3, 2017
|Condition or disease||Intervention/treatment|
|Sleep-Disordered Breathing||Procedure: Early Adenotonsillectomy (eAT) Behavioral: Watchful Waiting with Supportive Care (WWSC)|
Adenotonsillectomies are performed more than 500,000 times per year in the United States, and is the most common surgery performed under general anesthesia in children. The majority of surgeries are performed for obstructed breathing rather than for infection or other indications.
The role of adenotonsillectomy (AT) in improving the 7-month neurocognitive, behavioral and health outcomes of children with frank obstructive sleep apnea (OSA) was recently addressed in the Childhood Adenotonsillectomy Trial (CHAT). The results of this rigorous, multicenter, randomized controlled trial provided critically important data indicating that adenotonsillectomy compared to watchful waiting resulted in improved behavior, quality of life, sleep-disordered breathing (SDB) symptoms and polysomnographic parameters.
However, the Childhood Adenotonsillectomy Trial addressed the role of surgery in the minority of operative candidates who have frank obstructive sleep apnea, only one form of sleep disordered breathing on a spectrum that includes a more common phenotype, primary snoring (also termed mild sleep disordered breathing (MSDB)). Mild sleep disordered breathing is characterized by snoring without frank obstruction or gas exchange abnormalities, and has a population prevalence of about 10% in children. Since most surgeries for obstructed breathing are performed for mild sleep disordered breathing rather than obstructive sleep apnea, the next logical question is whether surgery is also effective in improving symptoms and health outcomes in this large group of children.
The Pediatric Adenotonsillectomy Trial for Snoring (PATS) intends to take advantage of a successful collaboration of leaders in sleep medicine, otolaryngology and clinical trials to efficiently leverage experiences from the CHAT trial to evaluate the role of adenotonsillectomy in children with mild sleep disordered breathing while also aiming to resolve uncertainties regarding management approaches for pediatric mild sleep disordered breathing by addressing several critical issues:
- Assess outcomes important to children and their families, particularly patient-reported outcomes such as behavior, quality of life, and sleep disturbances.
- Examine differences in treatment responses among children who are at increased risk for mild sleep disordered breathing, such as pre-school children, minorities, and children with asthma or obesity.
- Evaluate health care utilization of children with mild sleep disordered breathing.
- Assess moderating influences such as second hand smoke, insufficient sleep, socioeconomic status and family functioning
- Examine longer term (12 month) outcomes that were not feasible in the Childhood Adenotonsillectomy Trial (CHAT).
These aims have substantial public health significance given the high morbidity of sleep disordered breathing in children.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||460 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Single (Outcomes Assessor)|
|Official Title:||Impact of Treatment of Mild Sleep-Disordered Breathing on Children's Health|
|Study Start Date :||June 2016|
|Estimated Primary Completion Date :||July 2019|
|Estimated Study Completion Date :||October 2019|
Active Comparator: Watchful Waiting with Supportive Care
All Watchful Waiting with Supportive Care participants will receive information about healthy sleep habits for children and appropriate clinical referrals for management of co-morbidities such as asthma.
Behavioral: Watchful Waiting with Supportive Care (WWSC)
Information about healthy sleep habits for children and appropriate clinical referrals for management of co-morbidities.
Experimental: Early Adenotonsillectomy
All Early Adenotonsillectomy participants will receive information about healthy sleep habits for children, undergo adenotonsillectomy within 4 weeks of randomization and receive appropriate clinical referrals for management of co-morbidities
Procedure: Early Adenotonsillectomy (eAT)
Standard clinical adenotonsillectomy within 4 weeks post randomization in addition to information about healthy sleep habits for children and appropriate clinical referrals for management of co-morbidities.
- Change from baseline in Behavior Rating Inventory of Executive Function (BRIEF) Global Composite Score. [ Time Frame: 12 months ]Change from baseline in executive behavior relating to self-regulation and organizational skills (as measured by the Behavior Rating Inventory of Executive Function (BRIEF) Global Composite Score.
- Change from baseline in Go-No-Go (GNG) signal detection parameter (d'). [ Time Frame: 12 months ]Change from baseline in vigilance as measured on the Go-No-Go (GNG) signal detection parameter (d').
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02562040
|Contact: Michael G Morricalemail@example.com|
|Contact: Jessie P Bakker, PhDfirstname.lastname@example.org|
|United States, Michigan|
|University of Michigan Health System||Recruiting|
|Ann Arbor, Michigan, United States, 48109|
|Principal Investigator: Ronald D Chervin, MD|
|United States, Ohio|
|Cincinnati Children's Hospital Medical Center||Recruiting|
|Cincinnati, Ohio, United States, 45229|
|Principal Investigator: Raouf S Amin, MD|
|University Hospitals-Case Medical Center||Recruiting|
|Cleveland, Ohio, United States, 44106|
|Principal Investigator: Carol Rosen, MD|
|United States, Pennsylvania|
|Children's Hospital of Philadelphia||Recruiting|
|Philadelphia, Pennsylvania, United States, 19104|
|Principal Investigator: Ignacio Tapia, MD|
|United States, Texas|
|University of Texas Southwestern Medical Center||Recruiting|
|Dallas, Texas, United States, 75390|
|Principal Investigator: Ronald Mitchell, MD|
|Principal Investigator:||Susan S Redline, MD, MPH||Brigham and Women's Hospital|
|Principal Investigator:||Rui Wang, PhD||Brigham and Women's Hospital|
|Principal Investigator:||Carole L Marcus, MBBCh||Children's Hospital of Philadelphia|