- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00067613
Benchmarking Initiative to Reduce Bronchopulmonary Dysplasia (Benchmarking)
Randomized Controlled Trial of Benchmarking to Reduce Bronchopulmonary Dysplasia to Reduce Bronchopulmonary Dysplasia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
In 1998, 55% of Very Low Birth Weight (VBLW) infants (those born at <1,250g) born at centers in the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN) either died or developed BPD.
Previous studies within the NICHD Neonatal Research Network showed substantial differences in the incidence of BPD between centers. These differences were not explained by birth weight, gestational age, race, frequency of antenatal steroid use, or incidence of respiratory distress syndrome. Practice differences may contribute to BPD incidence variation. This study evaluated the efficacy of a Benchmarking Initiative to modify clinical care practices and decrease incidence of BPD in VLBW infants.
This study tested whether Neonatal Intensive Care Unit (NICU) teams trained in benchmarking -- comparing care practices between different NICUs to see which practices prevent bronchopulmonary dysplasia (BPD) -- and quality improvement would change practices and improve rates of survival without BPD in inborn neonates with birth weights of <1250 grams. Benchmarking is a method involving detailed comparisons of processes between similar organizations. For this study, three NRN centers with the lowest rates of BPD have been identified as Benchmark centers. During a 6-month pre-intervention period, details of care practices and management style at these centers were carefully assessed. Based on practices at these Benchmarking sites, we developed a quality improvement program. For this study, 14 other NRN sites were randomized to either implement the benchmarking intervention (intervention sites) or continue with their usual care practices (control sites). After the 1-year intervention period, we compared changes in the rate of survival without BPD at 36 weeks corrected age between the intervention and control sites.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35233
- University of Alabama at Birmingham
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California
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Palo Alto, California, United States, 94304
- Stanford University
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San Diego, California, United States, 92103-8774
- University of California at San Diego
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Connecticut
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New Haven, Connecticut, United States, 06504
- Yale University
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Florida
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Miami, Florida, United States, 33136
- University of Miami
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Georgia
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Atlanta, Georgia, United States, 30303
- Emory University
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Indiana
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Indianapolis, Indiana, United States, 46202
- Indiana University
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Michigan
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Detroit, Michigan, United States, 48201
- Wayne State University
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New York
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Rochester, New York, United States, 14642
- University of Rochester
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North Carolina
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Charlotte, North Carolina, United States, 27157
- Wake Forest University
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Durham, North Carolina, United States, 27710
- Duke University
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Durham, North Carolina, United States, 27705
- RTI International
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Ohio
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Cincinnati, Ohio, United States, 45267
- Cincinnati Children's Medical Center
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Cleveland, Ohio, United States, 44106
- Case Western Reserve University, Rainbow Babies and Children's Hospital
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Rhode Island
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Providence, Rhode Island, United States, 02905
- Brown University, Women & Infants Hospital of Rhode Island
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Texas
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Dallas, Texas, United States, 75235
- University of Texas Southwestern Medical Center at Dallas
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Houston, Texas, United States, 77030
- University of Texas Health Science Center at Houston
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria
- Infants 501-1,249g birthweight
- Registered in a participating site
Exclusion Criteria
- Diagnosed with a syndrome as defined by the Neonatal Research Network's Generic Database Study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Active Comparator: Intervention
Clinical sites randomized to intervention will receive training in the benchmarking BPD management methods identified at the Benchmark sites.
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The Benchmarking intervention included:
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Placebo Comparator: Control
Clinical sites randomized to Control will continue with their normal management practices for BPD.
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Centers assigned to the control group continued to receive routine information on their own center's outcomes, and all information routinely supplied within the NRN.
Control centers did not participate in organized discussions of the interventions applied within the Benchmarking centers.
At the completion of the study, Control Centers were offered a workshop on the Benchmarking techniques.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
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Survival without BPD
Time Frame: 36 weeks of life
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36 weeks of life
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
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Bronchopulmonary Dysplasia
Time Frame: 36 weeks of life
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36 weeks of life
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Shahnaz Duara, MD, University of Miami
- Principal Investigator: Jon E. Tyson, MD MPH, The University of Texas Health Science Center, Houston
- Principal Investigator: Abbot R. Laptook, MD, University of Texas Southwestern Medical Center
- Study Director: Michele C. Walsh, MD, Case Western Reserve University, Rainbow Babies & Children's Hospital
Publications and helpful links
General Publications
- Laptook AR, Salhab W, Allen J, Saha S, Walsh M. Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range? J Perinatol. 2006 Jun;26(6):337-41. doi: 10.1038/sj.jp.7211500.
- Bhandari V, Finer NN, Ehrenkranz RA, Saha S, Das A, Walsh MC, Engle WA, VanMeurs KP; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Synchronized nasal intermittent positive-pressure ventilation and neonatal outcomes. Pediatrics. 2009 Aug;124(2):517-26. doi: 10.1542/peds.2008-1302. Epub 2009 Jul 27.
- Shankaran S, Langer JC, Kazzi SN, Laptook AR, Walsh M; National Institute of Child Health and Human Development Neonatal Research Network. Cumulative index of exposure to hypocarbia and hyperoxia as risk factors for periventricular leukomalacia in low birth weight infants. Pediatrics. 2006 Oct;118(4):1654-9. doi: 10.1542/peds.2005-2463.
- Walsh M, Laptook A, Kazzi SN, Engle WA, Yao Q, Rasmussen M, Buchter S, Heldt G, Rhine W, Higgins R, Poole K; National Institute of Child Health and Human Development Neonatal Research Network. A cluster-randomized trial of benchmarking and multimodal quality improvement to improve rates of survival free of bronchopulmonary dysplasia for infants with birth weights of less than 1250 grams. Pediatrics. 2007 May;119(5):876-90. doi: 10.1542/peds.2006-2656.
- Walsh M, Engle W, Laptook A, Kazzi SN, Buchter S, Rasmussen M, Yao Q; National Institute of Child Health and Human Development Neonatal Research Network. Oxygen delivery through nasal cannulae to preterm infants: can practice be improved? Pediatrics. 2005 Oct;116(4):857-61. doi: 10.1542/peds.2004-2411.
- Wilson-Costello D, Walsh MC, Langer JC, Guillet R, Laptook AR, Stoll BJ, Shankaran S, Finer NN, Van Meurs KP, Engle WA, Das A; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Impact of postnatal corticosteroid use on neurodevelopment at 18 to 22 months' adjusted age: effects of dose, timing, and risk of bronchopulmonary dysplasia in extremely low birth weight infants. Pediatrics. 2009 Mar;123(3):e430-7. doi: 10.1542/peds.2008-1928. Epub 2009 Feb 9.
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- NICHD-NRN-0025
- U10HD021364 (U.S. NIH Grant/Contract)
- U10HD021373 (U.S. NIH Grant/Contract)
- U10HD021385 (U.S. NIH Grant/Contract)
- U10HD027851 (U.S. NIH Grant/Contract)
- U10HD027853 (U.S. NIH Grant/Contract)
- U10HD027856 (U.S. NIH Grant/Contract)
- U10HD027871 (U.S. NIH Grant/Contract)
- U10HD027880 (U.S. NIH Grant/Contract)
- U10HD027904 (U.S. NIH Grant/Contract)
- U10HD034216 (U.S. NIH Grant/Contract)
- U10HD021415 (U.S. NIH Grant/Contract)
- U10HD027881 (U.S. NIH Grant/Contract)
- M01RR008084 (U.S. NIH Grant/Contract)
- M01RR006022 (U.S. NIH Grant/Contract)
- M01RR000750 (U.S. NIH Grant/Contract)
- M01RR000070 (U.S. NIH Grant/Contract)
- M01RR000997 (U.S. NIH Grant/Contract)
- U10HD021397 (U.S. NIH Grant/Contract)
- U10HD034167 (U.S. NIH Grant/Contract)
- M01RR001032 (U.S. NIH Grant/Contract)
- M01RR002172 (U.S. NIH Grant/Contract)
- M01RR002635 (U.S. NIH Grant/Contract)
- U01HD036790 (U.S. NIH Grant/Contract)
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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