ADVANCE-FORSEE. ADVANCEd Video Monitoring FOR Early Signaling of Adverse Events and Optimal dischargE Planning.

March 17, 2026 updated by: Lukas Dekker, Catharina Ziekenhuis Eindhoven

In this study cameras placed at the bedside will be evaluated for their ability to safely and accurately measure vital signs, such as heart rate and breathing, continuously after heart surgery. Camera-based measurements will be compared with the usual checks that nurses perform several times a day using sensors on the skin or finger clip.

The goal is to see whether camera monitoring can help notice changes in a patient's condition earlier. Another aim of the study is to find out whether the camera monitoring can predict if a patient's health is improving or worsening.

Patients and healthcare staff will be asked by the investigators about their experience to learn whether this type of monitoring is acceptable in daily care.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Rationale: Over the past decades cardiothoracic surgery has advanced substantially resulting in reduced complication rates. However, when postoperative complications do occur they potentially can have a life-changing impact and sometimes even have death as a result. Therefore, timely detection of clinical deterioration is essential as early treatment may limit the severity of the complication and sometimes prevent their occurrence. The current method of vital signs monitoring, by nurses, usually 3 times a day, often leads to delayed detection of deterioration since early warning signs are missed and to standardized discharge protocols.

Objective: The primary objective of the ADVANCE FORSEE project is to evaluate the feasibility and acceptability of continuous video-based monitoring for early detection of postoperative deterioration as well as confirmation of uneventful recovery in cardiothoracic surgery patients. Secondary objectives are (1) to timely detect specific complications such as: atrial fibrillation, tamponade and acute coronary syndrome, (2) to assess the robustness of the video-based monitoring system, (3) to explore if additional physiological and other parameters can reliably be extracted and (4) to develop and evaluate a data management solution capable of efficiently handling large-scale video data.

Study design: Observational study, prospective for the data generation and retrospective for the data analysis. User-Centered Design with action research, allowing design and practice-oriented research to iteratively-reinforce each other.

Study population: 200-300 cardiac surgery patients.

Main study parameters/endpoints: The primary study endpoints are the performance of the deterioration detection and uneventful recovery algorithm assessed using a ROC-analysis. The secondary endpoints are (1) sensitivity, specificity and the time interval between algorithm-based deterioration detection and clinical confirmation by medical staff, (2) the accuracy of heart rate and respiratory rate for varying conditions, (3) the accuracy and feasibility of extracting additional parameters, (4) assessing the data management solution using RMSE as a function of bitrate across compression and storage models, (5) assessment of data loss, incorrect ROI detection and occlusion reported as percentages with 95% CI and compared to reference standards and (6) acceptability of the video-based monitoring system assessed by questionnaires, focus group and interviews.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Participation to the study is not accompanied by clinical risk to the patient as the proposed technology is completely unobtrusive. Given the objective and hypothesis, the use of video-based monitoring in cardiac surgery patients has potential benefits to patients that outweigh the ethical constraints.

Furthermore, the technique has the potential to support Value-Based Health Care (VBHC) principles since it is expected to reduce the number of unexpected adverse events, better risk prediction, reduce hospital stay, reduce the workload of the nursing staff and hereby increase patient wellbeing by freeing up staff time for the patient.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
250

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Netherlands
    • North Brabant
      • Eindhoven, North Brabant, Netherlands, 5623 EJ
        • Catharina Ziekenhuis Eindhoven

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The intended population for this study will be cardiac surgery patients admitted to the cardiothoracic ward of the Catharina hospital in Eindhoven. The research team will approach eligible patients who are scheduled to undergo cardiac surgery, in collaboration with the cardiothoracic surgeons. Due to the limited number of rooms equipped with the video-monitoring technology, patient placement on these rooms will be supported by the EuroSCORE II. When a room with the video-monitoring equipment is available, the EuroSCORE II ranking can be used as guidance by the day coordinator of the CTC to assign the room to an incoming patient with the highest estimated operative risk. Final room allocation will remain the responsibility of the CTC day coordinator.

Description

Inclusion Criteria:

  • Patients admitted to the cardiothoracic ward after cardiac surgery
  • Age ≥ 18
  • Willing and able to sign informed consent form

Exclusion Criteria:

  • Pregnancy
  • Inability to provide written informed consent
  • Mental disability
  • Language barrier

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
The primary study endpoints are the performance of the deterioration detection and uneventful recovery algorithms and the acceptability of the video-based monitoring system among healthcare staff and patients.
Time Frame: From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Algorithm performance will be assessed using receiver operating characteristics (ROC) analysis expressed as the area under the curve (AUC) with corresponding 95% confidence intervals. As a comparison a ROC curve will be made based on the conventional EWS data. Sensitivity, specificity, positive and negative predictive value will be calculated accordingly.
From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Sensitivity, specificity and time interval between algorithm-based detection and clinical confirmation.
Time Frame: From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Agreement between algorithm-based detection and clinical confirmation of postoperative complications. Sensitivity, specificity, and the time interval between the algorithm detection and confirmation by medical staff for events such as atrial fibrillation, acute coronary syndrome, tamponade, and other complications will be assessed.
From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Accuracy and data coverage of video-derived heart rate and respiratory rate measurements under varying conditions.
Time Frame: From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Accuracy of video-derived heart rate and respiratory rate are compared with telemetry measurements under varying conditions. Data coverage is defined as the proportion of the monitoring period with usable video-based data.
From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Accuracy and feasibility of extracting physiological and behavioral parameters such as oxygen saturation, eye movement, paleness and patient movement using the camera monitoring system.
Time Frame: From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Accuracy and feasibility of video-derived metrics including oxygen saturation, eye movement, paleness and patient movement using the camera monitoring system will be evaluated by comparing camera-based measurements with reference clinical measurements (telemetry-based monitoring) and clinical staff assessments. Measurement validity will be expressed using metrics such as sensitivity, specificity, correlation coefficients and agreement rates. Feasibility will be assessed based on the proportion of usable recordings and successful parameters extractions during postoperative monitoring.
From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Performance of the data management solution
Time Frame: From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Performance is evaluated by calculating the RMSE of vital sign measurements using various data-management techniques.
From arrival on the cardiothoracic surgery ward until discharge (typically 2-7 days after surgery).
Quantitative assessment of acceptability of the video-based monitoring
Time Frame: At postoperative day 5 or at hospital discharge whichever occurs first.
Quantitative assessment of the acceptability of the video-based monitoring in terms of privacy, comfort, feeling of safety, ease of use and trust in the system will be assessed using structured questionnaires (Likert scale).
At postoperative day 5 or at hospital discharge whichever occurs first.
Qualitative assessment of acceptability of the video-based monitoring
Time Frame: At postoperative day 5 or at hospital discharge whichever occurs first.
Qualitative assessment of the acceptability of the video-based monitoring in terms of privacy, comfort, feeling of safety, ease of use and trust in the system using semi-structured interviews and focus groups.
At postoperative day 5 or at hospital discharge whichever occurs first.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Catharina Ziekenhuis Eindhoven

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
ZonMw: The Netherlands Organisation for Health Research and Development

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 1, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
July 1, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 9, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 17, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 20, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 20, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 17, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • ADVANCE_FORSEE_1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The video data collected in this study are highly sensitive and contain personal information. To protect participant privacy, no individual participant data will be shared.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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