- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05336760
Dysphagia, QoL and Attitudes Towards PEG in ALS Patients (ALSDPEG)
September 18, 2023 updated by: University Rehabilitation Institute, Republic of Slovenia
Dysphagia, Quality of Life and Attitudes Towards Percutaneous Endoscopic Gastrostomy in Patients With Amyotrophic Lateral Sclerosis
In Amyotrophic Lateral Sclerosis, dysphagia has a high incidence.
With deterioration of swallowing function, percutaneous endoscopic gastrostomy (PEG) tube is recommended to ensure sufficient and safe oral intake.
Dysphagia and PEG placement alter quality of life (QoL).
However, QoL and attitudes toward PEG remain largely unexplored.
The purpose of this study is to monitor the swallowing function in relationship to QoL and attitudes toward PEG tube insertion and feeding.
Study Overview
Status
Recruiting
Conditions
Detailed Description
The purpose of this study is to monitor the deterioration of swallowing function in ALS patient population, and to explore its impact on QoL and attitudes toward PEG tube insertion and feeding in the course of the disease.
It will take maximum of 60 minutes to fully evaluate the swallowing function and complete the questionnaires.
The evaluation procedure will be repeated every 3 months until PEG tube insertion, which will allow us to closely monitor the swallowing function in a relation to attitudes toward PEG and QoL.
The data obtained from this study should contribute significantly to the knowledge of QoL in ALS patients with dysphagia, and it will allow for a comparison of QoL in ALS patients with and without PEG tube.
This study will also expand the understanding of attitudes in ALS patients and their relatives toward PEG, and the impact of those attitudes on the decision-making process.
Study Type
Observational
Enrollment (Estimated)
60
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Metka Moharić, MD, PhD
- Phone Number: +386 1 4758441
- Email: metka.moharic@ir-rs.si
Study Locations
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Ljubljana, Slovenia, 1000
- Recruiting
- University Medical Centre Ljubljana
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Contact:
- Blaž Koritnik, MD, PhD
- Phone Number: +386 1 5221501
- Email: blaz.koritnik@kclj.si
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Sampling Method
Non-Probability Sample
Study Population
The study will include adult ALS patients able to visit the study site for in-person procedures every 3 months, and their close relatives.
Description
Inclusion Criteria for patients:
- 18 years of age or older
- diagnosis of ALS
- follow-up at University Medical Centre Ljubljana, Division of Neurophysiology, every 3 months
- be able to visit the study site for in-person procedures every 3 months
Inclusion Criteria for relatives:
- at least 18 years of age
Exclusion Criteria for patients:
- co-existing illness or disorder that could influence the swallowing function independently of the ALS diagnosis
- clinically significant cognitive deterioration or dementia at enrollment, as determined by the ALS study neurologist
Exclusion criteria for relatives:
- signs of probable cognitive deterioration or dementia at enrollment
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
ALS Patients
Patients with confirmed amyotrophic lateral sclerosis.
|
IOPI measures the peak pressure of the tongue strength and endurance using a disposable bulb placed on a hard palate behind the front teeth or at the base of the tongue.
The participants will be asked to press the bulb with their tongue with maximum pressure, three times.
To measure the endurance, the participants will be asked to hold the pressure for as long as they can.
MASA is a standard clinical swallowing assessment protocol including general patient examination, on-the-outside visible signs of oral preparatory and transportation phase and pharyngeal phase of swallowing function.
The subjects will ingest up to 10 boluses ranging in thickness and volume (from thin to extremely-thick and a cookie).
Respiratory function measurements will include forced vital capacity (FVC), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), all expressed in percentage of predicted values.
Conventional methods of testing will be applied.
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Relatives
Close relatives of the patients included in the study.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Penetration-Aspiration Scale (PAS) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
|
PAS is an 8-point scale used to determine swallowing safety.
Levels 1 and 2 are considered safe, levels >3 indicate penetration or aspiration and are considered unsafe.
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Yale Residue Severity Rating Scale (YRSRS) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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YRSRS is a validated measure of swallowing efficiency using an image-based assessment to determine post-swallow pharyngeal residue: location and severity.
It is assessed using a 5-point ordinal scale (from 1=0 % residue to 5=50 % residue).
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Iowa Oral Performance Instrument (IOPI) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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IOPI is a device which measures tongue strength (in kilopascals; kPa) and endurance (in seconds) while the participant presses the bulb with the front or the base of their tongue to the hard palate.
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Mann Assessment of Swallowing Ability (MASA) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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MASA is a standard clinical swallowing assessment protocol administered by the speech-language therapist.
Total score ranges from 38-200.
Lower score indicates higher impairment.
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Eating Assessment Tool 10 (EAT-10) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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EAT-10 is a validated self-administered dysphagia severity symptom survey including 10 items and a five-point scale (0=no problem to 4=sever problem).
Higher total score indicates higher impairment.
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Swallowing Quality of Life Questionnaire (SWAL-QoL) change
Time Frame: At baseline and every 3 months until PEG insertion, 3 and 6 months after PEG insertion
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SWAL-QoL is a 44-item standardised psychometric scale that measures swallowing-related QoL across 10 domains.
Scores for each individual domain and a total SWAL-QoL score are calculated.
Total score ranges from 0-100 (100 indicating the most favourable state).
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At baseline and every 3 months until PEG insertion, 3 and 6 months after PEG insertion
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Questionnaire on Attitudes Toward PEG Tube Feeding and Insertion Procedure change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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The questionnaire comprises 10 questions.
The participants specify their level of agreement on a five-point Likert-type scale (1=strongly disagree, 5= strongly agree).
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
ALS Functional Rating Scale-Revised (ALSFRS-R) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
|
ALSFRS-R is a 12-tem ALS-specific assessment of global functioning using a five-point scale (0=not able, 4= normal ability), with 48 points representing normal function.
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Functional Oral Intake Scale (FOIS) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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FOIS is a validated 7-point scale demonstrating an individual's ability of daily oral food intake (1=no oral intake, 7=total oral intake with no restrictions).
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Dysphagia Outcome and Severity Scale (DOSS) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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DOSS is a 7-point scale that rates the functional severity of dysphagia based on objective assessment and provides information on diet recommendations, independence level and type of nutrition necessary (level 7=normal swallowing function, level 1=severe dysphagia).
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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BMI change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Body mass index (in kg/m^2)
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Forced Vital Capacity (FVC) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Standard clinical respiratory assessment of FVC (in %)
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Peak Cough Flow (PCF) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Standard clinical respiratory assessment of PCF (in L/min)
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Maximal Inspiratory Pressure (MIP) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Standard clinical respiratory assessment of MIP (in cmH2)
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Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Maximal Expiratory Pressure (MEP) change
Time Frame: Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Standard clinical respiratory assessment of MEP (in cmH2)
|
Difference between baseline and PEG insertion (usually in 6-25 months after diagnosis, maximum follow-up 30 months)
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Blaž Koritnik, MD, PhD, University Medical Centre Ljubljana
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
January 1, 2023
Primary Completion (Estimated)
March 31, 2026
Study Completion (Estimated)
March 31, 2026
Study Registration Dates
First Submitted
March 16, 2022
First Submitted That Met QC Criteria
April 14, 2022
First Posted (Actual)
April 20, 2022
Study Record Updates
Last Update Posted (Actual)
September 21, 2023
Last Update Submitted That Met QC Criteria
September 18, 2023
Last Verified
September 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- URIS202201
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
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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