- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05637814
Dynamic Critical Congenital Heart Screening With Addition of Perfusion Measurements
September 24, 2023 updated by: Heather Siefkes, University of California, Davis
The purpose of this study is to implement and externally validate an inpatient ML algorithm that combines pulse oximetry features for critical congenital heart disease (CCHD) screening.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
The study will externally validate an algorithm that combines non-invasive oxygenation and perfusion measurements as a screening tool for CCHD.
In a previous study, the investigators created an algorithm that combines non-invasive measurements of oxygenation and perfusion over at least two measurements using machine learning (ML) techniques.
The prior model was created and tested using internal validation (k-fold validation).
Thus, the investigators will test the model on an external sample of patients to test generalizability of the model.
Additionally, the team will trial a repeated measurement for any "failure" of the screen to assess impact on the false positive rate.
Study team will also use repeated pulse oximetry measurements (up to 4 total and including measurements after 48 hours of age, which may be done outpatient) to create a new algorithm that incorporates new data over time.
The central hypothesis is that the addition of non-invasive perfusion measurements will be superior to SpO2-alone screening for CCHD detection and a model that incorporates repeated measurements will enhance detection of CCHD while preserving the specificity.
Study Type
Interventional
Enrollment (Estimated)
240
Phase
- Not Applicable
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: Heather Siefkes, MD, MSCI
- Phone Number: 916-713-7697
- Email: hsiefkes@ucdavis.edu
Study Contact Backup
- Name: Harshitha Naidu, BS
- Phone Number: 916-734-4489
- Email: htnaidu@ucdavis.edu
Study Locations
-
-
California
-
Davis, California, United States, 95616
- Recruiting
- UC Davis Medical Center
-
Contact:
- Heather Siefkes, MD, MSCI
- Email: hsiefkes@ucdavis.edu
-
Principal Investigator:
- Heather Siefkes, MD, MSCI
-
-
New York
-
Queens, New York, United States, 11040
- Not yet recruiting
- Cohen Children's Medical Center
-
Contact:
- Robert Koppel, MD
- Email: rkoppel@northwell.edu
-
Principal Investigator:
- Robert Koppel, MD
-
-
Utah
-
Salt Lake City, Utah, United States, 84102
- Not yet recruiting
- University of Utah Health Care
-
Contact:
- Whitnee Hogan, MD
- Email: whitnee.hogan@hsc.utah.edu
-
Principal Investigator:
- Whitnee Hogan, MD
-
-
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
1 second to 3 weeks (Child)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- Age < 22 days
- Fetuses suspected to have congenital heart disease
- Newborns with suspected/confirmed critical congenital heart disease
- Asymptomatic newborn undergoing SpO2 screening for CCHD
Exclusion Criteria:
- Echocardiogram completed prior to enrollment as the newborn would then no longer be considered "asymptomatic undergoing SpO2 screening for CCHD"
- For Newborns with confirmed/suspected congenital heart disease (CHD): a) Patent ductus arteriosus and/or atrial septal defect/patent foramen ovale without other defects, b) Corrective cardiac surgical or catheter intervention performed before enrollment or c) Current infusions of vasoactive medications other than prostaglandin therapy.
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
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: SpO2 and PIx Measurement
Non-invasive measurements of oxygenation (SpO2) and perfusion (PIx) will be measured with pulse oximeters and a ML CCHD screening algorithm will be assigning a prediction every minute.
|
Right upper and any lower extremity oxygen saturation (SpO2) and perfusion index (PIx) will be measured and an online ML inference model will be used to classify a newborn as healthy versus CCHD as new pulse oximetry data is collected.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Area under the curve for receiver operating characteristics for critical congenital heart disease using ML inpatient algorithm.
Time Frame: Through study completion, an average of 4 years
|
Receiver operating characteristics reflect a combination of sensitivity and specificity of a test.
The investigators will identify the true positive and true negative rates for CCHD by confirming health status to a minimum of 2 months of age.
The investigators will also utilize birth defect and death registries for missing infants.
|
Through study completion, an average of 4 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sensitivity for critical congenital heart disease using ML inpatient algorithm (0-24 hours and 24-48 hours)
Time Frame: Through study completion, an average of 4 years
|
The investigators will identify the true positive rate for CCHD by confirming health status to a minimum of 2 months of age.
CCHD will be defined based on echocardiogram or parent report if echocardiogram not present.
The investigators will also utilize birth defect and death registries for missing infants.
|
Through study completion, an average of 4 years
|
Specificity for critical congenital heart disease using ML inpatient algorithm (0-24 hours and 24-48 hours)
Time Frame: Through study completion, an average of 4 years
|
The investigators will identify the true negative rate by confirming health status to a minimum of 2 months of age.
CCHD will be defined based on echocardiogram or parent report if echocardiogram not present.
The investigators will also utilize birth defect and death registries for missing infants.
|
Through study completion, an average of 4 years
|
Area under the curve for receiver operating characteristics for critical congenital heart disease using dynamic ML algorithm
Time Frame: Through study completion, an average of 4 years
|
Receiver operating characteristics reflect a combination of sensitivity and specificity of a test.
The investigators will identify the true positive and true negative rates for CCHD by confirming health status to a minimum of 2 months of age.
The investigators will also utilize birth defect and death registries for missing infants.
|
Through study completion, an average of 4 years
|
Sensitivity for critical congenital heart disease using dynamic ML algorithm
Time Frame: Through study completion, an average of 4 years
|
The investigators will identify the true positive rate for CCHD by confirming health status to a minimum of 2 months of age.
CCHD will be defined based on echocardiogram or parent report if echocardiogram not present.
The investigators will also utilize birth defect and death registries for missing infants.
|
Through study completion, an average of 4 years
|
Specificity for critical congenital heart disease using dynamic ML model
Time Frame: Through study completion, an average of 4 years
|
The investigators will identify the true negative rate by confirming health status to a minimum of 2 months of age.
CCHD will be defined based on echocardiogram or parent report if echocardiogram not present.
The investigators will also utilize birth defect and death registries for missing infants.
|
Through study completion, an average of 4 years
|
Sensitivity for critical coarctation of the aorta using dynamic ML algorithm
Time Frame: Through study completion, an average of 4 years
|
Critical coarctation of the aorta is the most commonly missed CCHD.
The investigators will identify the true positive rate by confirming health status to a minimum of 2 months of age.
The investigators will also utilize birth defect and death registries for missing infants.
|
Through study completion, an average of 4 years
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Frequency of repeated inpatient ML measurements
Time Frame: Through study completion, an average of 4 years
|
If a newborn has an initial "fail" during the inpatient ML screening algorithm, then 1 repeated measurement will occur within 3 hours after waiting at least 30 minutes.
If the next repeated measurement is a "fail" then the final classification assigned will be a "fail."
If the repeat measurement is a "pass" the final classification will be a "pass."
To gauge impact on nursing time for repeated measurements, The investigators will quantify how often these repeated measurements occur.
|
Through study completion, an average of 4 years
|
Feasibility: Number of minutes needed to obtain simultaneous artifact free hand and foot measurements such that all pulse oximetry features can be included.
Time Frame: Through study completion, an average of 4 years
|
In order to incorporate the radiofemoral delay component of the pulse oximetry features, the hand and foot waveforms need to be artifact free simultaneously.
The pulse oximetry device will give a result every minute to give the investigators an idea on how long it may take to reach simultaneously artifact free waveforms.
|
Through study completion, an average of 4 years
|
Feasibility: Number of outpatient pulse oximetry measurements obtained
Time Frame: Through study completion, an average of 4 years
|
Pulse oximetry measurements are not currently conducted in the outpatient setting.
Thus, the investigators will assess feasibility for future trials based on how many outpatient measurements are obtained versus missed in the study protocol.
|
Through study completion, an average of 4 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
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)
August 17, 2023
Primary Completion (Estimated)
June 30, 2027
Study Completion (Estimated)
December 31, 2027
Study Registration Dates
First Submitted
November 22, 2022
First Submitted That Met QC Criteria
December 1, 2022
First Posted (Actual)
December 5, 2022
Study Record Updates
Last Update Posted (Actual)
September 26, 2023
Last Update Submitted That Met QC Criteria
September 24, 2023
Last Verified
September 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1933258
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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