- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04569097
Novel Pharyngeal Metrics to Predict Dysphagia Outcomes
Defining Novel Pharyngeal Pressure Metrics to Predict Dysphagia Treatment Outcomes and Clinical Prognosis Using High-resolution Manometry
This multi-site trial will follow a cohort of Veterans with dysphagia for 8 weeks as they undergo clinically guided oropharyngeal exercises with oropharyngeal strengthening as the primary goal. Veterans with dysphagia will be assessed at three time points: baseline, 4 weeks after treatment initiation, and 8 weeks after treatment initiation. A non-dysphagic Veteran control group will also undergo data collection at parallel time points, without completion of a treatment paradigm. The investigators will then compare patients to non-dysphagic controls using manometry, videofluoroscopy, diet assessment, functional reserve tests, and patient-reported outcome measures.
The investigators aim to 1) quantify change in pressure measures of swallowing function resulting from dysphagia treatment; 2) determine which combination of standard of care and/or pressure-based metrics best track with outcome measures; and 3) develop multimodal prognostic algorithms that predict treatment success. This research will establish a precise outcome measurement paradigm suitable for dysphagia clinical care and research, thus improving clinical confidence and paving the way for a personalized medicine approach for dysphagia rehabilitation in Veterans.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Aaron F Heneghan, PhD
- Phone Number: 17801 (608) 256-1901
- Email: Aaron.Heneghan@va.gov
Study Contact Backup
- Name: Jenna W Quinto, PhD
- Phone Number: 17865 (680) 256-1901
- Email: jenna.quinto@va.gov
Study Locations
-
-
Illinois
-
Hines, Illinois, United States, 60141-3030
- Recruiting
- Edward Hines Jr. VA Hospital, Hines, IL
-
Contact:
- Laura Chalcraft, MS
- Phone Number: 708-202-4934
- Email: laura.chalcraft@va.gov
-
-
Ohio
-
Cincinnati, Ohio, United States, 45220-2213
- Recruiting
- Cincinnati VA Medical Center, Cincinnati, OH
-
Contact:
- Kathy Welden, PhD
- Phone Number: 5226 513-861-3100
- Email: kathy.welden@va.gov
-
-
Wisconsin
-
Madison, Wisconsin, United States, 53705-2254
- Recruiting
- William S. Middleton Memorial Veterans Hospital, Madison, WI
-
Contact:
- Aaron F Heneghan, PhD
- Phone Number: 17801 608-256-1901
- Email: Aaron.Heneghan@va.gov
-
Contact:
- Jenna W Quinto, PhD
- Phone Number: 17865 (680) 256-1901
- Email: jenna.quinto@va.gov
-
Principal Investigator:
- Timothy M. McCulloch, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Signed an informed consent form
- Receive a dysphagia diagnosis by a speech-language pathologist
- Must have a dysphagia treatment plan with the goal of strengthening the oropharyngeal musculature
- English speaking
Exclusion Criteria:
- history of allergic response to barium
- history of allergic response to topical anesthetics
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Patient group
lingual strengthening
|
standard or care lingual strengthening approaches with outcome measured with novel pressure metrics
|
No Intervention: Controls
No history of dysphagia (swallowing disorder) or minimal to mild dysphagia not requiring a strengthening program
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
pHRM pressure change
Time Frame: Baseline, 4 weeks, and 8 weeks
|
Will assess the change in pressure by pharyngeal high resolution manometry over the time frame The primary measure of interest is Integral Pressure during the 10 mL swallow at the tongue base Range is From: 0 mmHg*sec, no pressure recorded to up to 250 mmHg*sec., very high pressures recorded, normal range is age and sex dependent Range (114+/-50 to167 +/-80) Positive change would be a movement toward normal range of pressure.
This metric is measured automatically in both Software systems used to evaluate pharyngeal pressure (WiscMano and Swallow gateway)
|
Baseline, 4 weeks, and 8 weeks
|
Swallowing clinical and fluoroscopic change
Time Frame: Baseline, 4 weeks, and 8 weeks
|
Will assess the change in fluoroscopy and clinical assessments over the time frame The primary tool of measurement is the combined score of the MBSImP this is a 17 item standardized tool to measure impairment of swallow identified using contrast barium swallows. We will use the composite pharyngeal score which ranges from 0 to 3, the higher the score the more abnormal the swallow function, Normal swallows will score 5 or less and severe dysphagia will score 9 or higher. Movement toward 0 is a positive or improved swallow function, movement toward 23 is negative or worsening swallow function |
Baseline, 4 weeks, and 8 weeks
|
Patient reported outcome changes
Time Frame: Baseline, 4 weeks, and 8 weeks
|
Sydney swallowing questionnaire (SSQ) The SSQ is a patient reported symptom scale with 17 questions, each scaled from 0+ no dysfunction to 100 equal extreme dysfunction using a 100mm visual analogue scale with 0 and 100 as anchors.
the total score can be recorded for 0 to 1700, Normal swallowers will average 40 with a range of 200 to 0, Dysphagia patients average 800 with a range of 150 to 1600.
Movement toward 0 will be considered an improvement, movement toward 1700 worsening in swallowing ability preserved by the patient.
|
Baseline, 4 weeks, and 8 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient reported outcome changes
Time Frame: Baseline, 4 weeks, and 8 weeks
|
Eating assessment tool -10, The Eat 10 is a short 10 question swallowing assessment tool 10 questions each scaled 0 to 4, total can be between 0 and 40. The normal swallowers will score under 2. The mean (+/- SD) EAT-10 score of the normal cohort was 0.40 +/- 1.01. The mean EAT-10 score for those with oropharyngeal dysphagia, 23.10 +/- 12.22 Changes toward 0 will be identified as improved swallow symptom function, changes toward 40 worsening symptoms |
Baseline, 4 weeks, and 8 weeks
|
Patient reported outcome changes, Diet change
Time Frame: Baseline, 4 weeks, and 8 weeks
|
International Dysphagia Diet Standardization initiative, Functional Oral intact scale Standardize scale of diet (liquid and solid food) iddsi.org
foods scaled from regular diet 7 to liquidized 3, and liquids scaled from thin liquids 0 to extremely think 4 Improvement in diet will be report if patients move toward 0 in liquid intake and toward 7 in solid food intact and movement in the opposite directions will be evidence of poorly food and liquid tolerance
|
Baseline, 4 weeks, and 8 weeks
|
Collaborators and Investigators
Investigators
- Principal Investigator: Timothy M. McCulloch, MD, William S. Middleton Memorial Veterans Hospital, Madison, WI
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- N3221-R
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
product manufactured in and exported from the U.S.
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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