Junior Emergency Physician Learning Curve to Perform Transcranial Doppler on Brain-damage Patients (Transcranius)

Transcranius : Junior Emergency Physician Learning Curve to Perform Transcranial Doppler on Brain-damage Patients

Transcranial Doppler is a noninvasive tool. Using velocity measurements and pulsatility index it allows the evaluation of cerebral haemodynamics. In patients presenting brain injury cerebral perfusion may be impaired. Indirect cerebral blood flow can be monitored and risk of neurological worsening can be detected using transcranial Doppler. Education and performance of emergency physicians must be evaluated on brain-injured patients because this tool is operator dependent. The main objective of this study is to estimate the average number of exams required to learn transcranial Doppler within junior emergency physicians with the achievement of their learning curve. We will perform a prospective, monocentric, observational study within the neurosurgical resuscitation department of Grenoble Alpes University Hospital.

Study Overview

• Status: Terminated
• Conditions: Brain Damage

Detailed Description

The transcranial dopplers will be carry out on 75 brain-damaged patients by 13 emergency residents physicians after a theoretical and practical training. They will be evaluated by 8 experts. The primary endpoint will be the mean number of transcranial dopplers required to have an excellent concordance between resident and expert. The concordance between the Doppler findings of the resident and the expert would exceed 0.8 before 30 examinations. The learning curve assessed on the duration necessary to acquire good quality data should decrease rapidly with the repetition of the examinations. Validating the transcranial Doppler learning curve for junior emergency physician would allow them to perform this exam safely and efficiently. Transcranial Doppler may be easy and fast to learn but the persistence of its competency over time should be evaluated.

• Study Type: Observational
• Enrollment (Actual): 33

Contacts and Locations

Study Locations

• France
  • Auvergne Rhonalpes
    • Grenoble, Auvergne Rhonalpes, France, 38043
      • University Hospital Grenoble

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 100 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Brain-damaged patients hospitalized in neurosurgical resuscitation or intensive care unit.

Description

Inclusion Criteria:

• Adult patients : ≥ 18 year and older
• Hospitalized in the neurosurgical resuscitation or intensive care unit
• Brain - damaged patients

Exclusion Criteria:

• Any craniotemporal lesion impeding satisfactory TDC examination : no transtemporal doppler window, patient with craniectomy.
• Patient with meningo-encephalitis
• Patient with cerebral vasculitis
• Patient without health insurance coverage
• Patient subject to a legal protection measure
• Pregnant woman , parturient or nursing

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The mean number of transcranial doppler required to reach a kappa over 0,8 between the conclusions of the resident and expert.	Learning curve	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration in seconds for the junior to achieve the transcranial doppler	Time between the beginning of the exam (ultrasound probe caring) to the velocities and pulsatility index measurements	3 months
Analysis of the spectral envelope quality	analysis of the plot of spectral envelope: good or bad	3 months
Analysis of the evolution of the estimated difficulty of transcranial doppler realization	evaluation of the difficulty of transcranial doppler realization: easy or difficult	3 months
Analysis of the failure to perform the transcranial doppler	number of failures to perform the transcranial doppler after 10 minutes	10 minutes
Analysis of the diastolic velocities and pulsatility index concordance between junior and expert	number of examen required for junior velocities measurement to reach those of the expert	3 months

Collaborators and Investigators

• Sponsor: University Hospital, Grenoble
• Investigators: Principal Investigator: Batistin MARTINON, MD, University Hospital, Grenoble

Study record dates

Study Major Dates

• Study Start (Actual): December 18, 2018
• Primary Completion (Actual): June 30, 2019
• Study Completion (Actual): December 31, 2019

Study Registration Dates

• First Submitted: December 14, 2018
• First Submitted That Met QC Criteria: January 31, 2019
• First Posted (Actual): February 1, 2019

Study Record Updates

• Last Update Posted (Actual): April 2, 2021
• Last Update Submitted That Met QC Criteria: March 30, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: emergency; traumatic brain injury; transcranial doppler; learning curve
• Additional Relevant MeSH Terms: Pathologic Processes; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Wounds and Injuries; Disease Attributes; Craniocerebral Trauma; Trauma, Nervous System; Emergencies; Brain Injuries
• Other Study ID Numbers: 38RC18.211; 2018-A02346-49 (Other Identifier: IDRCB)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No