- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06038864
Development of a Clinical Screening, Diagnostic and Evaluation Tool for Patients With Lower Limb Lymphedema: Aim 4 (EvaLymph-Leg4)
Development of a Clinical Screening, Diagnostic and Evaluation Tool for Patients With Lower Limb Lymphedema: Development of an Evaluation Set for Patients With LLL
Research investigating measurement properties for evaluating the decongestive treatment effect on different edema characteristics (e.g. water volume, hardness of the skin, water content,..) at the level of the lower limbs is missing. Information about the clinical relevant change criteria after treatment for nearly all these edema characteristics, is not present and requires investigation.
To assess the merits of each treatment in a reproducible manner, a reliable way of measuring limb volume and other edema characteristics must be established, as the evaluation of treatment effects without appropriate tools might lead to biased treatment effects.
First of all, in clinical practice, it is of utmost importance to know which edema characteristics need to be evaluated in order to assess the clinical evolution of a patient with lymphedema during and after treatment. Secondly, in order to draw proper conclusions about the treatment effect, it is necessary that to know from which criterion (or cut-off value) one can speak of a real clinical change for a certain lymphedema characteristic. Given that the edema characteristics that are most responsive to treatment and their corresponding criteria for clinically significant and relevant changes at the lower limbs have never been investigated before, the need for this research is high.
Therefore, the research questions in this study are: Which measurement tool(s) are able to detect clinically relevant changes in the lymphedema characteristics after the intensive treatment and during the maintenance treatment? When can a clinician speak of a clinically relevant change?
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Tessa De Vrieze, Dr.
- Phone Number: 003216345006
- Email: tessa.devrieze@kuleuven.be
Study Contact Backup
- Name: Nele Devoogdt, Prof. Dr.
- Phone Number: 0032 16 342515
- Email: nele.devoogdt@kuleuven.be
Study Locations
-
-
-
Leuven, Belgium, 3000
- University Hospitals of Leuven
-
-
-
-
-
Drachten, Netherlands, 9202
- Nij Smellinghe Hospital
-
Contact:
- Ad Hendrickx, PhD
- Email: a.hendrickx@nijsmellinghe.nl
-
Contact:
- Robert Damstra, PhD
- Email: r.damstra@nijsmellinghe.nl
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Intensive treatment group: Patients planned to start with intensive decongestive lymphatic therapy at one or both legs.
Maintenance treatment group: patienst who have ended their intensive treatment phase at least 3 months ago (= currently receiving maintenance decongestive lymphatic therapy)
Description
Inclusion Criteria:
Intensive treatment group
- Unilateral or bilateral, primary or secondary LLL
- No active metastases
- If cancer-related lymphedema, time interval since surgery/ radiotherapy/ chemotherapy is ≥3 months
- Objective diagnosis of lymphedema: ≥ 5% volume difference OR ≥ 2 minor/ 1 major criteria on lymphoscintigraphy OR presence of ICG dermal backflow
- Age ≥ 18 years
- Able to read, understand and speak Dutch
- Planned to start with intensive decongestive lymphatic therapy at one or both legs
Maintenance treatment group
- See inclusion criteria 'intensive treatment group'
- But: instead of patients planned to start with intensive lymphatic therapy, patients of this group should have ended their intensive treatment phase at least 3 months ago (= currently receiving maintenance decongestive lymphatic therapy)
Exclusion Criteria:
- Pregnant participants
- Presence of chronic venous insufficiency C4, C5, C6; deep venous thrombosis; post-thrombotic syndrome
- Presence of skin infections of wounds at the level of the lower limbs at the moment of inclusion
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Intensive group
Patients with lower limb lymphoedema planned for intensive treatment
|
Patients will be evaluated twice with all evaluation methods selected by the international expert group (cfr.
aim 1) showing sufficient reliability and feasibility in the patient group with LLL from aim 1
|
Maintenance group
Patients with stable lower limb lymphoedema who are in the maintenance phase (at least 3 months)
|
Patients will be evaluated twice with all evaluation methods selected by the international expert group (cfr.
aim 1) showing sufficient reliability and feasibility in the patient group with LLL from aim 1
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sensitivity of measurement methods
Time Frame: 1 month
|
Sensitivity of measurement methods (resulting from aim 1:NCT05269264) in the evaluation of the treatment effect over time in patients with unilateral and bilateral LLL. Patients will be evaluated twice with 1 month in between. |
1 month
|
Specificity of measurement methods
Time Frame: 1 month
|
Specificity of measurement methods (resulting from aim 1:NCT05269264) in the evaluation of the treatment effect over time in patients with unilateral and bilateral LLL. Patients will be evaluated twice with 1 month in between. |
1 month
|
Diagnostic accuracy of measurement methods
Time Frame: 1 month
|
Diagnostic accuracy (in terms of area under the curve using a ROC curve, as well as sensitivity and specificity) of measurement methods (resulting from aim 1:NCT05269264) in the evaluation of the treatment effect over time in patients with unilateral and bilateral LLL. Patients will be evaluated twice with 1 month in between. |
1 month
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Lymphedema volume after 4 weeks of intensive DLT in patients with unilateral and bilateral LLL
Time Frame: 1 month
|
Evaluation of different outcome parameters in the patients from the 'intensive group' with unilateral LLL and patients with bilateral LLL: Lymphedema volume (foot, leg) |
1 month
|
Hardness of skin after 4 weeks of intensive DLT in patients with unilateral and bilateral LLL
Time Frame: 1 month
|
Evaluation of different outcome parameters in the patients from the 'intensive group' with unilateral LLL and patients with bilateral LLL: skin hardness test at the level of the foot, leg and midline region. Skin is palpated with thumb and index (and, if possible, compared to the contralateral side) Outcome: If skin is hardened; yes(1), otherwise; no(0) |
1 month
|
Piiting status after 4 weeks f intensive DLT in patients with unilateral and bilateral LLL
Time Frame: 1 month
|
Evaluation of different outcome parameters in the patients from the 'intensive group' with unilateral LLL and patients with bilateral LLL: Pitting test at the level of the foot, leg and midline region; The grading of edema is determined by pit depth (measured visually) and recovery time from grade 0-3. The scale is used to rate the severity and the scores are as follows: - Grade 0: No clinical edema- Grade 1: Slight pitting (up to 2 mm depth) - Grade 2: Moderate pitting (2-5 mm) - Grade 3: Noticeably deep pit (>5 mm) |
1 month
|
Skinfold thickness after 4 weeks of intensive DLT in patients with unilateral and bilateral LLL
Time Frame: 1 month
|
Evaluation of different outcome parameters in the patients from the 'intensive group' with unilateral LLL and patients with bilateral LLL: Skinfold test at the level of the foot, leg and midline region: Skin and subcutaneous tissue is lifted between thumb and index(and, if possible, compared to the contralateral side) Outcome:If skinfold is increased; yes(1), otherwise; no(0) |
1 month
|
Extracellullar fluid after 4 weeks of intensive DLT in patients with unilateral and bilateral LLL
Time Frame: 1 month
|
Evaluation of different outcome parameters (ECW ratio, total body water, body water left/right leg, ICW total/left/right, ECW total/left/right, phase angle total/left/right, impedance at 5 kHz) in the patients from the 'intensive group' with unilateral LLL and patients with bilateral LLL: Extracellular fluid |
1 month
|
Problems in functioning after 4 weeks of intensive DLT in patients with unilateral and bilateral LLL
Time Frame: 1 month
|
Disease-specific QoL (i.e. problems in functioning will be evaluated with the Lymph-ICF-LL. The Lymph-ICF-LL is a descriptive, evaluative tool containing 28 questions about impairments in function, activity limitations, and participation restrictions in patients with lower limb lymphedema. The questionnaire has 5 domains: physical function, mental function, general tasks/household activities, mobility activities, and life domains/social life. |
1 month
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Tessa De Vrieze, Dr., KU Leuven
Study record dates
Study Major Dates
Study Start (Estimated)
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
- s66033-aim4
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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 Lower Limb Lymphedema
-
StendoCompletedPrimary Lower Limb Lymphedema | Secondary Lower Limb LymphedemaFrance
-
Lymphatica Medtech SATerminatedLymphedema of Upper Limb | Lymphedema, Secondary | Lymphedema, Lower Limb | Lymphedema of Leg | Lymphedema ArmSwitzerland
-
KU LeuvenUniversitaire Ziekenhuizen KU Leuven; Nij Smellinghe Hospital DrachtenRecruitingLower Limb LymphedemaBelgium, Netherlands
-
Universitaire Ziekenhuizen KU LeuvenKU LeuvenRecruiting
-
Rowan UniversityCompletedLymphedema, Lower LimbUnited States
-
University Hospital, MontpellierCompletedLymphedema | Lower Limb LymphedemaFrance
-
Maastricht University Medical CenterRadboud University Medical Center; Erasmus Medical CenterRecruitingLymphedema of Upper Limb | Lymphedema, Secondary | Lymphedema, Lower Limb | Lymphedema of Leg | Lymphedema ArmNetherlands
-
Ankara City Hospital BilkentRecruitingGynecologic Cancer | Lymphedema | Lymphedema, Lower LimbTurkey
-
National Cheng Kung UniversityNot yet recruitingGynecological Cancer | Lower Limb Lymphedema
-
University of OttawaMcGill University; Horizon Health Network; University of New Brunswick; New Brunswick...UnknownLymphedema of Upper Limb | Mastectomy Related Lymphedema | Lymphedema of Lower Extremity
Clinical Trials on 2 clinical evaluations with 1 month in between
-
University of Milano BicoccaCompleted
-
Federico II UniversityCompleted
-
Fundacio d'Investigacio en Atencio Primaria Jordi...CompletedType 2 Diabetes | Cardiovascular Risk Factor | GenderSpain
-
Nottingham University Hospitals NHS TrustActive, not recruitingAdvanced Chronic Liver DiseaseUnited Kingdom
-
Centre Hospitalier Universitaire de NīmesCompletedErectile DysfunctionFrance
-
Steno Diabetes Center CopenhagenActive, not recruitingHyperglycemia | Cardiovascular Diseases | Hypoglycemia | Diabetes | Sudden Cardiac DeathDenmark
-
Hospices Civils de LyonCompletedOral Glucose Tolerance Test and Post Partum Diagnosis of Diabetes Mellitus, Type 2 (DT2 Post-Partum)Gestational DiabetesFrance
-
Mohamed Ashraf AbdallahRecruitingSkillful Neglect Vs Repair For Subscapularis Tear Associated With Posterosuperior Cuff Tears Repair.Subscapularis Muscle StrainEgypt
-
Chang Gung Memorial HospitalRecruitingYoung Children With Motor DisabilitiesTaiwan
-
University Hospital, GenevaUniversity Medical Center Groningen; The Ottawa HospitalUnknownDeep Vein Thrombosis | D-dimerCanada, Switzerland, France