Sparrow App Guided Evaluation (SAGE) Vanguard Trial for Aortic Stenosis in Adults Aged Seventy and Older (SAGE-AS)
The purpose of this research is to look at an approved intervention (Stethophone application) to obtain additional information about improving detection of moderate or severe aortic stenosis when compared with usual standard of care.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This study employs a stepped-wedge cluster randomized design involving four primary care practices affiliated with KMH Cardiology. Each family practice constitutes a single cluster.
All participating practices will start as usual standard of care. At three-month intervals, one practice will be randomly selected to crossover from usual standard of care (control group) to the intervention group. There will be a 2-week wash in period when a family practice crosses over from control to intervention. This process will continue until all practices have implemented the intervention, resulting in full intervention by 15 months.
Investigators hypothesize that the Sparrow screening pathway will result in a higher proportion of patients with a positive echo for moderate or severe aortic stenosis than usual care without protocol driven screening.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 70 years or older at the time of consent.
- Written informed consent from participant
- Receiving care at a participating primary care practice during the study period.
Exclusion Criteria:
- Known moderate or severe aortic stenosis before enrolment.
- Prior surgical or transcatheter aortic valve replacement.
- Any condition that, in the opinion of the investigator or treating clinician, would preclude informed consent or make participation impractical or unsafe.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Intervention
During intervention periods, trained clinic personnel will obtain heart sound recordings at three standard chest positions using the Stethophone application, with at least 30 seconds of recording at each position. |
The device is a FDA & HC approved mobile application, the Stethophone (developed by Sparrow BioAcoustics), that transforms a smartphone into a digital stethoscope and analytic tool able to identify murmurs that may indicate aortic stenosis. |
|
No Intervention: Standard of Care
No study procedures. Patients will be consented for obtaining data related to ECHO confirmation for of moderate or severe aortic stenosis (if applicable) followed by referral for valve clinic assessment (if need be) for the duration of this study. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of new diagnosis of moderate or severe aortic stenosis on transthoracic echo/1000 patients screened of patients over 70 years
Time Frame: Within 3 months after enrolment.
|
Determine whether Sparrow app based screening increases the number of patients with a new diagnosis of moderate or severe aortic stenosis confirmed by transthoracic echo within 3 months |
Within 3 months after enrolment.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of eligible participants screened during intervention periods
Time Frame: From enrollment until Day 1
|
Proportion of eligible participants screened during intervention periods |
From enrollment until Day 1
|
|
Distribution of algorithm outputs
Time Frame: From enrollment until Day 1
|
Distribution of algorithm outputs as normal, suggestive of aortic stenosis, other murmur detected, or inconclusive |
From enrollment until Day 1
|
|
Proportion completing transthoracic echocardiography after an abnormal or inconclusive result
Time Frame: Enrollment to 3 months
|
Proportion of participants completing transthoracic echocardiography after an abnormal or inconclusive result |
Enrollment to 3 months
|
|
Average time from abnormal screen to echocardiography
Time Frame: Enrollment to transthoracic echocardiography, assessed up to 3 months
|
Average time from abnormal screen to echocardiography |
Enrollment to transthoracic echocardiography, assessed up to 3 months
|
|
Average time from confirmed diagnosis to referral to valve clinic, where applicable
Time Frame: ECHO confirmation to valve clinic referral, an average of 3 months
|
Average time from confirmed diagnosis to referral to valve clinic, where applicable |
ECHO confirmation to valve clinic referral, an average of 3 months
|
|
Diagnostic yield of transthoracic echocardiography
Time Frame: enrollment to ECHO confirmation or valve clinic referral whichever comes last, an average of 3 months
|
|
enrollment to ECHO confirmation or valve clinic referral whichever comes last, an average of 3 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Nicolas Bowers, MD MSc FRCPC FACC FSCAI, Sunnybrook Health Sciences Centre
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Aortic Valve Disease
- Cardiovascular Diseases
- Neoplasms
- Heart Diseases
- Immune System Diseases
- Neoplasms by Histologic Type
- Heart Valve Diseases
- Ventricular Outflow Obstruction
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Lymphoma
- Hemic and Lymphatic Diseases
- Aortic Valve Stenosis
- Lymphoma, Follicular
Other Study ID Numbers
Other Study ID Numbers
- SAGE-AS
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
The Aggregate data will be presented and/or published. The IPD will not be available keeping patients privacy in mind.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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