- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03365050
A Study of the Safety of Targeted AAA Screening
Data Linkage Between NHS AAA Screening Programme and Primary Care Data to Determine the Safety of a Targeted Screening Programme.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
An abdominal aortic aneurysm (AAA) is present in 5-10% of men aged between 65 and 79 years and may be defined as an abdominal aortic diameter 3cm or above. In 2013 the NHS AAA screening programme (NAAASP) was fully rolled out across England with the aim of reducing AAA mortality in men aged 65 and over, based on evidence that screening reduces AAA-related mortality, and is highly cost effective. Within NAAASP, men with a large AAA (≤5.5cm) are referred for consideration of surgery whilst men with small AAA (≥5.4cm) are referred into surveillance (3.0-4.4cm: 1 year surveillance, 4.5-5.4cm: 3 months surveillance) as per standard operating procedures. In England 284,583 men were offered ultrasound screening (2015-2016), however, the number of men identified with AAA was 2,549 at a cost of approximately £7,755,000. This highlights one of the main problems with AAA screening in that the majority of men screened do not have disease. This also brought the number of men within AAA surveillance to 13,1047 whom do not require early surgery.
Several studies have investigated quality of life (QoL) in those who are screened for AAA, with one reporting short-term decreases in QoL at 1 year and four demonstrating no clinically important decrease in QoL in those screened positive compared with an unscreened control group. This has raised the issue of harms versus benefit however, AAA screening is not the same worldwide. For example, within The U.S. Preventive Services Task Force AAA Screening is recommended only for men aged 65-75 who have ever smoked as this group "stands to benefit the most from early detection and reparative surgical treatment due to a relatively higher prevalence of larger AAAs" . The screening programme described thus deemed men who have never smoked as lower risk for AAA and lower risk for rupture yet in England, we screen every man at the age of 65.
Although several risk factors for AAA have been identified, smoking is the only modifiable risk factor that has been associated with the development, expansion and rupture of AAA with a causative link revealed in vivo within a mouse model. Population based studies have also demonstrated that smoking prevalence over time is linked to changes in AAA mortality. It is possible that screening based on a history of smoking is feasible and safe, however, no evidence exists that this would be the case. In England details for men eligible for AAA screening is identified based on primary care data in that men registered with a General Practitioner (GP) who are 65 within that year are invited to screening. Primary care data may also be able to identify men with a history of smoking and other known risk factors for AAA including hypertension, heart disease and stroke.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Matthew Bown, PhD
- Phone Number: 4783 0116 204
- Email: mjb42@le.ac.uk
Study Contact Backup
- Name: David Sidloff, MD
- Phone Number: 4783 0116 204
- Email: ds343@le.ac.uk
Study Locations
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-
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Leicester, United Kingdom, LE3 9QP
- University of Leicester
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Contact:
- Dr David Sidloff, MD
- Phone Number: 4783
- Email: ds343@le.ac.uk
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Contact:
- Dr Atanasios Saratzis, PhD
- Phone Number: 4783
- Email: as875@leicester.ac.uk
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- All men invited into the English AAA Screening Programme
Exclusion Criteria:
- All men not within the screening programme or who dissent from their data being used for research.
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
death from AAA after screening
Time Frame: long term mortality - 10 years
|
AAA-related mortality after screening based on ONS ICD codes
|
long term mortality - 10 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
cost effectiveness analysis
Time Frame: long term - 10 years
|
cost per QALY gained (cost-utility analysis) will be used to compare the current model of screening to a targeted model of screening as per NICE guidance.
|
long term - 10 years
|
Feasibility of targeted screening
Time Frame: 1 year
|
Number of individuals identified with AAA in modelling study who have AAA at screening.
|
1 year
|
All-Cause mortality.
Time Frame: long term mortality - 10 years
|
Death after screening based on ONS ICD codes
|
long term mortality - 10 years
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- 0635
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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