- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02819778
Study Assessing Evaluation of the Interest of Serum S100B Protein Determination in the Management of Pediatric Mild Traumatic Brain Injury (PROS100B)
Interventional Study Assessing Evaluation of the Interest of Serum S100B Protein Determination in the Management of Pediatric Mild Traumatic Brain Injury
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Based on initial results from a previous prospective study, a multicenter interventional study will be necessary to validate the routine use of this biomarker .The ultimate goal is to include serum S100B assay in the current recommendations for m traumatic brain injury (mTBI) management based on the study of Kupperman et al. (2009), as mTBI accounts for 5-8% of pediatric emergency admissions in France (60-100 per 100,000 children). The study of Kuppermann et al. strongly dictated the recommendations for mTBI management by the French Society of Emergency Medicine (SFMU) . Then, from these 2 publications, the French Society of Pediatrics (SFP) redacted their recommendations after adjustment method recommendations for clinical practice, used by the French High Authority of Health (HAS) .
The use of serum S100B assay as part of the management of pediatric mTBI should make it possible to reduce the number of additional examinations, in particular a 30% reduction in the number of CCT-scans, with a resultant reduction in radiation exposure, known to be a risk factor for cancer. The study protocol corresponds to a diagnostic prospective, controlled, multicenter study using a randomized stepped wedge cluster design, in which pediatric patients (aged ≤ 16 years) presenting to the pediatric emergency room for mTBI with a GCS score of 15 will benefit from usual care ("conventional management" arm) in the control group, and from S100B management in the interventional group.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Bron, France, 69677
- Hospices Civils de Lyon
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Clermont-Ferrand, France, 63003
- Chu Clermont-Ferrand
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Limoges, France, 87042
- Limoges Teaching hospital
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Marseille, France, 13385
- Assistance Publique des Hôpitaux de Marseille
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Montpellier, France, 34090
- Montpellier Teaching hopsital
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Nantes, France, 44036
- Nantes Teaching Hospital
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Nice, France, 06200
- Nice Teaching Hospital
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Nimes, France, 30900
- Nimes Teaching Hospital
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Reims, France, 51092
- Reims Teaching Hospital
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Saint-Etienne, France, 42055
- Saint-Etienne Teaching Hospital
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Vichy, France, 03200
- Vichy Hospital Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≤ 16 years Therapeutic management within 3 hours after TBI
GCS score of 15 classically requiring hospitalization and/or CCT-scan as per SFP recommendations (Lorton et al., 2014). These criteria are:
- For children aged under 2 years (CCT-scan or hospitalization recommended according to physician's evaluation):
- Parietal or occipital scalp hematoma,
- Loss of consciousness for more than 5 seconds,
- Trauma due to serious accident (road accident with passenger ejected from vehicle or death of another person or rollover; pedestrian hit by a moving vehicle; cyclist not wearing a helmet; fall from a height greater than 0.9 meter),
- Abnormal behavior in the opinion of parents.
- For children 2 years and older (CCT-scan or hospitalization recommended according to physician's evaluation):
- Loss of consciousness at time of accident,
- Vomiting,
- Trauma due to serious accident (road accident with passenger ejected from vehicle or death of another person or rollover; pedestrian hit by a moving vehicle; cyclist not wearing a helmet; fall from a height greater than 1.5 meter),
- Severe headache.
Exclusion Criteria:
- Patient already enrolled in another therapeutic trial with drug administration Down syndrome Melanoma Refusal of child Refusal of parents or legal guardian Trauma more than 3 hours earlier GCS score of 13 or 14, or signs of skull fracture or lesions of the skull base (CCT-scan recommended)
Children with TBI not requiring hospitalization and/or CCT-scan as per SFP recommendations (Lorton et al., 2014). This group is defined by the absence of the following criteria:
- GCS score different from 15,
- Age < 3 months,
- Seriousness of accident:
- road accident with passenger ejected from vehicle or death of another person or rollover,
- pedestrian hit by a moving vehicle,
- cyclist not wearing a helmet.
- Fall:
- of more than 0.9 m before age 2 years,
- of more than 1.5 m after age 2 years.
- Loss of consciousness for 5 seconds or more,
- Inconsolable crying,
- Agitation, drowsiness, feeling "slowed down", obnubilation,
- Vomiting or headache,
- Facial or cranial hematoma,
- Otorrhea, rhinorrhea,
- Child under 2 years old,
- Loss of consciousness for less than 5 seconds,
- Unusual behaviour,
- Concern of family members
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Control group
The study protocol corresponds to a diagnostic prospective, controlled, multicenter study using a randomized stepped wedge cluster design, in which pediatric patients (aged ≤ 16 years) presenting to the pediatric emergency room for mTBI with a GCS score of 15 will benefit from usual care ("conventional management" arm) in the control group, and from S100B management in the interventional group
|
|
Other: interventional group
The study protocol corresponds to a diagnostic prospective, controlled, multicenter study using a randomized stepped wedge cluster design, in which pediatric patients (aged ≤ 16 years) presenting to the pediatric emergency room for mTBI with a GCS score of 15 will benefit from usual care ("conventional management" arm) in the control group, and from S100B management in the interventional group
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
utility of serum S100B measurement in the management of pediatric mTBI
Time Frame: at day 1
|
Evaluate the utility of serum S100B measurement in the management of pediatric mTBI by demonstrating a decrease in the proportion of CCT-scan prescribed in the "S100B management" intervention arm compared with the "conventional management" control arm, hypothesizing a 30% decrease in the number of CCT-scan between the intervention versus control arms.
|
at day 1
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
utility of serum S100B measurement with respect to reduction in the time spent in the pediatric emergency room
Time Frame: at day 1
|
at day 1
|
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utility of serum S100B measurement with respect to reduction in the duration of hospitalization
Time Frame: at day 1
|
at day 1
|
|
utility of serum S100B measurement with respect to reduction in radiation exposure (mSv)
Time Frame: at day 1
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at day 1
|
|
utility of serum S100B measurement with respect to detection of complications
Time Frame: at day 1
|
detection of complications (intracranial lesions) by CCT-scan which can occur at a rate of 0-7% in patients with mTBI (American Academy of Pediatrics, 1999)
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at day 1
|
utility of serum S100B measurement with respect to absence of intercurrent events at 48 hours and 3 weeks after mTBI
Time Frame: at 48 hours and 3 weeks after mTBI
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at 48 hours and 3 weeks after mTBI
|
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utility of serum S100B measurement with respect to compliance of emergency physicians with the S100B assay
Time Frame: at day 1
|
at day 1
|
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utility of serum S100B measurement with respect to reduction of the cost of management
Time Frame: at day 1
|
at day 1
|
Collaborators and Investigators
Publications and helpful links
General Publications
- Bouvier D, Fournier M, Dauphin JB, Amat F, Ughetto S, Labbe A, Sapin V. Serum S100B determination in the management of pediatric mild traumatic brain injury. Clin Chem. 2012 Jul;58(7):1116-22. doi: 10.1373/clinchem.2011.180828. Epub 2012 Apr 23.
- The management of minor closed head injury in children. Committee on Quality Improvement, American Academy of Pediatrics. Commission on Clinical Policies and Research, American Academy of Family Physicians. Pediatrics. 1999 Dec;104(6):1407-15.
- Bouvier D, Balayssac D, Durif J, Mourgues C, Sarret C, Pereira B, Sapin V. Assessment of the advantage of the serum S100B protein biomonitoring in the management of paediatric mild traumatic brain injury-PROS100B: protocol of a multicentre unblinded stepped wedge cluster randomised trial. BMJ Open. 2019 May 24;9(5):e027365. doi: 10.1136/bmjopen-2018-027365.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CHU-0269
- 2016-A00195-46 (Other Identifier: 2016-A00195-46)
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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