- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06029244
Eyecontrol coMmunication Platform for dEliRium manaGemEnt in Intensive Care Units (EMERGE) (EMERGE)
March 6, 2024 updated by: Somnath Bose, MD, Beth Israel Deaconess Medical Center
Eyecontrol coMmunication Platform for dEliRium manaGemEnt in Intensive Care Units (EMERGE) : A Multicenter Randomized Controlled Trial
The purpose of this research is to investigate whether addition of the EyeControl-Pro platform as an adjunct to standard guideline-based intensive care unit management of critically ill patients is effective in reducing delirium incidence and severity.
Study Overview
Status
Recruiting
Intervention / Treatment
Detailed Description
This is a prospective, binational, single-blind, multicenter, randomized control trial, conducted according to international good clinical practice (GCP) ethical and quality standards.
Critically ill, mechanically ventilated patients aged >=50 years with Richmond Agitation Sedation Scale (RASS) score of -3 to +1 (at time of screening) who are anticipated to require ventilation for >=24 hours will be eligible for recruitment.
The study will be conducted simultaneously at Beth Israel Deaconess Medical Center (BIDMC) Boston, USA, Assuta Ashdod Medical Center (Ashdod, Israel) and Rabin Medical Center (Petah Tikvah, Israel) with BIDMC contributing up to 50% of the total enrollment.
Participants will be randomized to either a) sham device or b) active intervention arm (details described below).
Legally appointed representatives, patients and caregiver teams will be administered an optional questionnaire to assess their experience with the study device at the conclusion of the study protocol.
Study subjects will be administered the telephone-Montreal Cognitive Assessment (t-MoCA); total score of 22 - missing 8 points present in Montreal Cognitive Assessment (MoCA) pertaining to drawing/executive function not feasible over phone) or MoCA (if still in-hospital; assessed out of total score of 30) and Hospital Anxiety and Depression Scale (HADS) questionnaire 30 days post-randomization.
Hebrew versions of these questionnaires will be used at Israeli sites.
Study Type
Interventional
Enrollment (Estimated)
160
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: Alkanada Behera
- Phone Number: 617-667-7000
- Email: abehera@bidmc.harvard.edu
Study Contact Backup
- Name: Van Nguyen, BS
- Phone Number: 617-632-8065
- Email: vnguye17@bidmc.harvard.edu
Study Locations
-
-
-
Ashdod, Israel
- Not yet recruiting
- Assuta Ashdod Medical Center
-
Contact:
- Ami Mayo, MD
-
Petah tikva, Israel
- Not yet recruiting
- Rabin Medical Center
-
Contact:
- Itai Ben David, MD
-
-
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02215
- Recruiting
- Beth Israel Deaconess Medical Center
-
Contact:
- Somnath Bose, MD
- Phone Number: 617-667-7000
- Email: sbose2@bidmc.harvard.edu
-
-
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
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Mechanically ventilated patients aged >=50 years
- RASS score of -3 to +1 and
- Anticipated to require >=24 hours of mechanical ventilation
Exclusion Criteria:
- Not expected to survive >=24 hours
- Have limitations in care (Do Not Resuscitate, or comfort-focused care orders)
- Receiving paralytic neuromuscular blocking agent (NMBA) infusion or anticipated need for NMBA use
- Have advanced dementia or cognitive impairment including post-concussive syndrome.
- Have acute or subacute neurological disorders.
- Have severe uncorrected psychiatric disorders.
- Have uncorrected hearing or visual impairment.
- Have an unstable cervical spine or collar in place limiting movement.
- Enrolled in a clinical trial which prohibits co-enrollment.
- Incarcerated
- Have no identified legally appointed representative (LAR)
- Are unable to communicate in the predominant local language (English at US site and Hebrew in Israel)
- Refusal of treating clinical team.
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: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: EyeControl-Pro assisted active intervention arm
The device will be placed on patient's heads.
Once the device is properly positioned, patient's will undergo a training session/tutorial lasting 2-3 minutes to orient them to the device usage.
Personalized family messages recorded by LARs or others will be played at regular intervals up to 5 times per day (between 08:00-18:00) (8 am to 6 pm).
Personalized music/brown noise will be played for 15 minutes every 4 hours, which will be modulated according to your reactions/choices.
A study team member will assess patient's mental status by asking thinking and memory questions twice a day (AM and PM).
The device will perform the same assessments within 30 minutes of those performed by the study team.
The device will be removed at 1800/2000 hrs to ensure adequate sleep.
Patient's will be in this study arm for up to 7 days of start of study.
The device will be removed on day 7 or sooner if patient's do not need ventilator support and standard care will continue as before device usage.
|
Based on artificial intelligence (AI)-powered eye-tracking technology, the EyeControl-Pro wearable device and smart platform enable 24/7 customizable communication and monitoring between ventilated patients who cannot speak, their families, and medical teams
|
Sham Comparator: Sham Control
The device will be placed on patient's heads.
Once the device is properly positioned, patient's will undergo a training session/tutorial lasting 2-3 minutes to orient them to the device usage.
Patient's will not receive any of the orientation or family messages and no music will be played through the earphones of the device.
A study team member will assess patient's mental status by asking thinking and memory questions twice a day (AM and PM).
The device will perform the same assessments within 30 minutes of those performed by the study team.
The device will be removed at 1800/2000 hrs to ensure adequate sleep.
Patient's will be in this study arm for up to 7 days of start of study.
The device will be removed on day 7 or sooner if patient's do not need ventilator support and standard care will continue as before device usage.
|
No intervention
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Prevalence of CAM ICU+ assessments during the first 7 days in ICU post-randomization or ICU discharge/death (whichever is sooner)
Time Frame: Upto 7 days or liberation from ventilator whichever is sooner.
|
To evaluate if study subjects randomized to active EyeControl-Pro arm have a higher proportion of delirium free assessments as assessed by CAM (confusion assessment method)-ICU during device usage for up to 7 days when compared with those in the sham EyeControl-Pro arm.
CAM-ICU is a validated assessment tool for detection of ICU delirium.
|
Upto 7 days or liberation from ventilator whichever is sooner.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Prevalence of severe delirium assessments (defined as CAM ICU 7>6) during the first 7 days in ICU post-randomization or ICU discharge/death (whichever is sooner)
Time Frame: Upto 7 days or discharge from intensive care unit (ICU) whichever is sooner
|
To evaluate if study subjects in the active EyeControl-Pro arm have lower prevalence of severe delirium assessments as measured by CAM-ICU7 within first 7 days post randomization or ICU discharge (whichever is sooner) when compared to sham control arm.
CAM-ICU 7 is a validated instrument for measurement of delirium severity with scores ranging from 0-7.
|
Upto 7 days or discharge from intensive care unit (ICU) whichever is sooner
|
Mean number of days with delirium (defined as the total number of days with at least one CAM ICU positive delirium assessment) within 7 days post-randomization or up to discharge from the ICU/death, whatever occurs earlier.
Time Frame: Upto 7 days or discharge from intensive care unit (ICU) whichever is sooner
|
To evaluate if subjects randomized to the active EyeControl-Pro arm have lower delirium incidence (as measured by CAM-ICU) within first 7 days post randomization or ICU discharge whichever is sooner when compared to sham EyeControl-Pro arm.
|
Upto 7 days or discharge from intensive care unit (ICU) whichever is sooner
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
ICU days alive and free of delirium and coma
Time Frame: Upto 7 days or discharge from intensive care unit (ICU) whichever is sooner
|
To evaluate if subjects randomized to the active EyeControl-Pro arm have higher number of days free of coma and delirium within first 7 days post randomization or ICU discharge whichever is sooner when compared to sham EyeControl-Pro arm
|
Upto 7 days or discharge from intensive care unit (ICU) whichever is sooner
|
Cognitive scores
Time Frame: 30 days post-randomization.
|
To compare cognitive function at 30 days post enrollment using the t-MoCA (telephone-Montreal Cognitive Assessment) or MoCA (if still in-hospital) questionnaire.
MoCA is a validated instrument for assessment of cognition with range 0-30 (0-22 for telephonic version) score of over 26 indicates normal.
|
30 days post-randomization.
|
Depression anxiety scores
Time Frame: 30 days post-randomization.
|
To compare depression and anxiety scores at 30 days post enrollment using the HADS (Hospital Anxiety and Depression Scale) questionnaire.HADS ranges from 0-21 with higher scores indicating worse depression or anxiety
|
30 days post-randomization.
|
CAM ICU concordance
Time Frame: During device usage upto 7 days
|
Agreement between CAM ICU assessment between Eyecontrol and investigator administered CAM-ICU in active intervention arm
|
During device usage upto 7 days
|
Cumulative dose of sedatives
Time Frame: During device usage or upto 7 days whichever is sooner
|
Dose of intravenous sedatives between 2 groups (in mgs/mcgs)
|
During device usage or upto 7 days whichever is sooner
|
Days free of restraints
Time Frame: Upto 7 days or discharge from intensive care unit
|
Comparison of days free of restraints between 2 groups
|
Upto 7 days or discharge from intensive care unit
|
Use of rescue medications for delirium and agitation
Time Frame: Upto 7 days or discharge from intensive care unit
|
Use of medications for agitated delirium
|
Upto 7 days or discharge from intensive care unit
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Somnath Bose, MD, Beth Israel Deaconess Medical Center
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr, Inouye SK, Bernard GR, Dittus RS. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004 Apr 14;291(14):1753-62. doi: 10.1001/jama.291.14.1753.
- Pandharipande PP, Girard TD, Jackson JC, Morandi A, Thompson JL, Pun BT, Brummel NE, Hughes CG, Vasilevskis EE, Shintani AK, Moons KG, Geevarghese SK, Canonico A, Hopkins RO, Bernard GR, Dittus RS, Ely EW; BRAIN-ICU Study Investigators. Long-term cognitive impairment after critical illness. N Engl J Med. 2013 Oct 3;369(14):1306-16. doi: 10.1056/NEJMoa1301372.
- Girard TD, Pandharipande PP, Ely EW. Delirium in the intensive care unit. Crit Care. 2008;12 Suppl 3(Suppl 3):S3. doi: 10.1186/cc6149. Epub 2008 May 14.
- Ely EW, Gautam S, Margolin R, Francis J, May L, Speroff T, Truman B, Dittus R, Bernard R, Inouye SK. The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med. 2001 Dec;27(12):1892-900. doi: 10.1007/s00134-001-1132-2. Epub 2001 Nov 8.
- Milbrandt EB, Deppen S, Harrison PL, Shintani AK, Speroff T, Stiles RA, Truman B, Bernard GR, Dittus RS, Ely EW. Costs associated with delirium in mechanically ventilated patients. Crit Care Med. 2004 Apr;32(4):955-62. doi: 10.1097/01.ccm.0000119429.16055.92.
- Mart MF, Williams Roberson S, Salas B, Pandharipande PP, Ely EW. Prevention and Management of Delirium in the Intensive Care Unit. Semin Respir Crit Care Med. 2021 Feb;42(1):112-126. doi: 10.1055/s-0040-1710572. Epub 2020 Aug 3.
- Smith CD, Grami P. Feasibility and Effectiveness of a Delirium Prevention Bundle in Critically Ill Patients. Am J Crit Care. 2016 Dec;26(1):19-27. doi: 10.4037/ajcc2017374.
- Kinchin I, Mitchell E, Agar M, Trepel D. The economic cost of delirium: A systematic review and quality assessment. Alzheimers Dement. 2021 Jun;17(6):1026-1041. doi: 10.1002/alz.12262. Epub 2021 Jan 21.
- Hayhurst CJ, Pandharipande PP, Hughes CG. Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment. Anesthesiology. 2016 Dec;125(6):1229-1241. doi: 10.1097/ALN.0000000000001378.
- Pun BT, Badenes R, Heras La Calle G, Orun OM, Chen W, Raman R, Simpson BK, Wilson-Linville S, Hinojal Olmedillo B, Vallejo de la Cueva A, van der Jagt M, Navarro Casado R, Leal Sanz P, Orhun G, Ferrer Gomez C, Nunez Vazquez K, Pineiro Otero P, Taccone FS, Gallego Curto E, Caricato A, Woien H, Lacave G, O'Neal HR Jr, Peterson SJ, Brummel NE, Girard TD, Ely EW, Pandharipande PP; COVID-19 Intensive Care International Study Group. Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort study. Lancet Respir Med. 2021 Mar;9(3):239-250. doi: 10.1016/S2213-2600(20)30552-X. Epub 2021 Jan 8. Erratum In: Lancet Respir Med. 2021 Jan 27;:
- Nikooie R, Neufeld KJ, Oh ES, Wilson LM, Zhang A, Robinson KA, Needham DM. Antipsychotics for Treating Delirium in Hospitalized Adults: A Systematic Review. Ann Intern Med. 2019 Oct 1;171(7):485-495. doi: 10.7326/M19-1860. Epub 2019 Sep 3.
- Neufeld KJ, Yue J, Robinson TN, Inouye SK, Needham DM. Antipsychotic Medication for Prevention and Treatment of Delirium in Hospitalized Adults: A Systematic Review and Meta-Analysis. J Am Geriatr Soc. 2016 Apr;64(4):705-14. doi: 10.1111/jgs.14076. Epub 2016 Mar 23. Erratum In: J Am Geriatr Soc. 2016 Oct;64(10 ):2171-2173.
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)
March 1, 2024
Primary Completion (Estimated)
April 30, 2025
Study Completion (Estimated)
May 31, 2025
Study Registration Dates
First Submitted
September 1, 2023
First Submitted That Met QC Criteria
September 1, 2023
First Posted (Actual)
September 8, 2023
Study Record Updates
Last Update Posted (Actual)
March 7, 2024
Last Update Submitted That Met QC Criteria
March 6, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2023P000563
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
Yes
product manufactured in and exported from the U.S.
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.
Clinical Trials on Delirium
-
Efficacy Care R&D LtdHadassah Medical OrganizationUnknownDelirium | Delirium, Cause Unknown | Delirium of Mixed Origin | Delirium Confusional State | Delirium Drug-InducedIsrael
-
Imperial College Healthcare NHS TrustRecruitingCardiac Surgery | Intensive Care Unit Delirium | Post Operative DeliriumUnited Kingdom
-
Oslo University HospitalUniversity of Melbourne; Norwegian Academy of MusicCompletedDelirium in Old Age | Delirium of Mixed Origin | Delirium Superimposed on Dementia | Delirium Confusional StateNorway
-
Universidad de SantanderUnknownDelirium of Mixed Origin | Hypoactive Delirium | Hyperactive DeliriumColombia
-
Menoufia UniversityCompleted
-
Chinese PLA General HospitalBeijing Tiantan HospitalRecruiting
-
Charite University, Berlin, GermanyBARMERRecruitingDelirium in Old AgeGermany
-
Mayo ClinicCompletedPost-Operative DeliriumUnited States
-
Johns Hopkins UniversityNational Institute on Aging (NIA)Active, not recruitingDelirium | Delirium on Emergence | Hearing Loss | Hearing Loss, High-Frequency | Hearing Loss, Sensorineural | Delirium, Cause Unknown | Hearing Loss, Bilateral | Hearing Disability | Delirium in Old Age | Delirium of Mixed Origin | Delirium Superimposed on Dementia | Delirium Confusional State | Delirium With... and other conditionsUnited States
-
Qin ZhangNational Natural Science Foundation of ChinaRecruiting
Clinical Trials on Control
-
Claudia M. WittCompleted
-
University of California, San FranciscoWithdrawn
-
The George InstituteChanghai Hospital; University of CalgaryNot yet recruiting
-
Universidad Nacional de Educación a DistanciaMinisterio de Economía y Competitividad, SpainUnknownChronic Pain | FibromyalgiaSpain
-
University of California, Los AngelesThe National Council on Aging; City of Los Angeles Department of Aging; Los Angeles...Completed
-
Queen's University, BelfastPublic Health Agency, Health and Social Care Research and Development; Tiny...Completed
-
National Taiwan University HospitalEnrolling by invitationCognitive Function | Atrial Fibrillation, PersistentTaiwan
-
Takeshi MorimotoUniversity of the RyukyusActive, not recruitingCoronary Artery Disease | Hypertension | Type 2 Diabetes | DyslipidemiaJapan
-
Johnson & Johnson Vision Care, Inc.TerminatedRefractive Error CorrectionUnited States
-
Vanderbilt University Medical CenterCompleted