- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06411574
Body Surface Gastric Mapping vs Gastric Emptying Scintigraphy on Clinical Management in Gastroparesis
Comparing the Impact of Body Surface Gastric Mapping and Gastric Emptying Scintigraphy on Clinical Management in Suspected Gastroparesis
Gastroparesis is a chronic and debilitating gastric disease associated with poor quality of life, psychological distress, frequent hospitalisations, and high healthcare utilization and associated costs. It is defined by persistent upper gastrointestinal symptoms and delayed gastric emptying with no mechanical gastric outlet obstruction. Gastric emptying scintigraphy (GES) is the current gold standard for diagnosing gastroparesis but its clinical utility is currently being questioned. Current management strategies have often been found to be ineffective, largely due to an incomplete understanding of the disease's pathophysiology. There is a critical need for more advanced diagnostic testing that can better diagnose patients and guide personalized targeted therapy.
Body surface gastric mapping (BSGM) using Gastric Alimetry (Alimetry Ltd., New Zealand) is a new FDA-cleared medical device to assess gastric function by non-invasively assessing gastric motility using simultaneous high-resolution electrogastrography and symptom profiling. BSGM has demonstrated clinical utility in the assessment of gastric function through patient phenotyping in a variety of cohorts, including patients with nausea and vomiting disorders, diabetes, delayed gastric emptying, and post-gastric surgery. Previous research revealed that the detection of gastric motility abnormality rates through patient phenotyping were higher using Gastric Alimetry compared to GES (43% vs 23%). Clinical application of these phenotypes has also aided in changing management decisions, which reduced healthcare utilization and associated costs. However, how GES and BSGM test results differentially influence clinical management in patients is uncertain.
This exploratory pilot study proposes a two-arm, prospective trial to assess whether BSGM-guided care could change clinical outcomes compared to the standard of care (GES) in patients with suspected gastroparesis. The trial consists of two phases. Phase 1 involves participants separately undertaking a GES and BSGM test. Based on these results, the referring clinician will devise management plans for treatment using a standardized form: 1) unblinded to one test (GES or BSGM) but blinded to the other test; and 2) unblinded to both tests (GES + BSGM). They will be asked to recommend any changes to interventions (medications, diet, endoscopic/surgical referral or other) and additional testing. In phase 2, those in Phase 1 will undergo BSGM-guided care based on their combined management plan (GES + BSGM) and followed up over a 12 month period. A separate set of participants will be recruited to undergo standard of care (GES only) in parallel with Phase 1 participants. After 12 months, those on the standard of care arm will be crossed over to BSGM-guided care, undergo a BSGM test, treated according to the new management plan, and followed up over 6 months. Questionnaires will assess symptoms, quality of life, health psychology, sleep, and work impact.
If validated, this may change clinical practice by reducing the need for invasive or radioactive-based procedures to diagnose these patients and facilitating a more targeted treatment approach.
Study Overview
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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New South Wales
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Campbelltown, New South Wales, Australia, 2560
- Western Sydney University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged over 18 years old
- Meeting Rome IV Criteria for Functional Dyspepsia and/or Chronic Nausea and Vomiting Syndrome
- Referred for gastric emptying scintigraphy
- Normal gastroscopy
- Negative or treated H. Pylori status
Exclusion Criteria:
- Pregnant or breast-feeding
- Inability to perform a BSGM test according to Indications for Use: history of severe skin allergies or sensitivity to cosmetics or lotions; chronically damaged or vulnerable epigastric skin (fragile skin, wounds, inflammation); unable to remain in a relaxed reclined position for the test duration.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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No Intervention: Standard of care
Only the GES test result will be used to guide treatment as part of standard of care.
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Experimental: BSGM-guided care
Both the GES and BSGM test results will be used to guide treatment.
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The Gastric Alimetry™ System is intended to record, store, view and process gastric myoelectrical activity as an aid in the diagnosis of various gastric disorders.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Phase 1: Change in Clinical Management Decisions Based on the Combined Test Results Compared to the Single Test Result.
Time Frame: After unblinding to first test (week 1) and after unblinding to second test (week 2)
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In phase 1, the change in clinical management decisions from the single test result to the combined test results was assessed. For each arm, the proportion of patients with a management change is reported as a percentage. In the first plan (either unblinded to BSGM or GES first), a management change was defined as any addition, removal or modification within a category (eg, switching from 1 prokinetic to another) compared to the initial management plan. In the second plan (unblinded to both test results), a change due to the combined test results was defined as any addition, removal or modification within the same category compared to the first plan. The categories were: medication, diet, psychology-based interventions, surgery referral, other intervention and additional testing. |
After unblinding to first test (week 1) and after unblinding to second test (week 2)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Phase 1: Change to a Single Clinical Diagnosis Due to the Combined Test Results From Baseline.
Time Frame: After unblinding to first test (week 1) and after unblinding to second test (week 2)
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In phase 1, a change in diagnosis was defined as either an addition of a diagnosis or a shift to a different one compared to baseline (confirmation of an existing diagnosis was not considered a change).
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After unblinding to first test (week 1) and after unblinding to second test (week 2)
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Phase 1: Change in Clinician Certainty Based on the Combined Test Results Compared to a Single Test Result
Time Frame: After unblinding to first test (week 1) and after unblinding to second test (week 2)
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In phase 1, Clinicians rated diagnostic and management plan certainty using a Likert scale (0-10; 0 = uncertain, 10 = certain) firstly after reviewing the initial allocated test (GES or BSGM) and formulating the first management plan with a single test result, and again after reviewing the second test and formulating the second management plan with the combined test results.
The change in the certainty score from the single test result to the combined test results was assessed.
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After unblinding to first test (week 1) and after unblinding to second test (week 2)
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Vincent Ho, MBBS, FRACP, FACP, PhD, Western Sydney University
Publications and helpful links
General Publications
- Gharibans AA, Calder S, Varghese C, Waite S, Schamberg G, Daker C, Du P, Alighaleh S, Carson D, Woodhead J, Farrugia G, Windsor JA, Andrews CN, O'Grady G. Gastric dysfunction in patients with chronic nausea and vomiting syndromes defined by a noninvasive gastric mapping device. Sci Transl Med. 2022 Sep 21;14(663):eabq3544. doi: 10.1126/scitranslmed.abq3544. Epub 2022 Sep 21.
- Wang WJ, Foong D, Calder S, Schamberg G, Varghese C, Tack J, Xu W, Daker C, Carson D, Waite S, Hayes T, Du P, Abell TL, Parkman HP, Huang IH, Fernandes V, Andrews CN, Gharibans AA, Ho V, O'Grady G. Gastric Alimetry Expands Patient Phenotyping in Gastroduodenal Disorders Compared with Gastric Emptying Scintigraphy. Am J Gastroenterol. 2024 Feb 1;119(2):331-341. doi: 10.14309/ajg.0000000000002528. Epub 2023 Oct 30.
- Varghese C, Schamberg G, Calder S, Waite S, Carson D, Foong D, Wang WJ, Ho V, Woodhead J, Daker C, Xu W, Du P, Abell TL, Parkman HP, Tack J, Andrews CN, O'Grady G, Gharibans AA. Normative Values for Body Surface Gastric Mapping Evaluations of Gastric Motility Using Gastric Alimetry: Spectral Analysis. Am J Gastroenterol. 2023 Jun 1;118(6):1047-1057. doi: 10.14309/ajg.0000000000002077. Epub 2022 Dec 20.
- Varghese C, Daker C, Lim A, Sebaratnam G, Xu W, Kean B, Cederwall C. Gastric Alimetry in the Management of Chronic Gastroduodenal Disorders: Impact to Diagnosis and Health Care Utilization. Clin Transl Gastroenterol. 2023 Nov 1;14(11):e00626. doi: 10.14309/ctg.0000000000000626.
- Varghese C, Xu W, Daker C, Bissett IP, Cederwall C. Clinical utility of Gastric Alimetry® in the management of intestinal failure patients with possible underlying gut motility disorders. Clinical Nutrition Open Science [Internet]. 2023 Oct 1;51:15-25. Available from: https://www.sciencedirect.com/science/article/pii/S2667268523000359.
- Xu W, Wang T, Foong D, Schamberg G, Evennett N, Beban G, Gharibans A, Calder S, Daker C, Ho V, O'Grady G. Characterization of gastric dysfunction after fundoplication using body surface gastric mapping. J Gastrointest Surg. 2024 Mar;28(3):236-245. doi: 10.1016/j.gassur.2023.12.023. Epub 2024 Jan 23.
- Xu W, Gharibans AA, Calder S, Schamberg G, Walters A, Jang J, Varghese C, Carson D, Daker C, Waite S, Andrews CN, Cundy T, O'Grady G. Defining and Phenotyping Gastric Abnormalities in Long-Term Type 1 Diabetes Using a Novel Body Surface Gastric Mapping Device. Gastro Hep Adv. 2023 Aug 18;2(8):1120-1132. doi: 10.1016/j.gastha.2023.08.005. eCollection 2023.
- Abraham R, Foong D, Ho V. Combined Gastric Alimetry and Gastric Emptying Scintigraphy Testing Increases Clinician Certainty in the Diagnosis and Management of Suspected Gastroparesis. J Neurogastroenterol Motil. 2026 Jan 30;32(1):61-70. doi: 10.5056/jnm25094. Epub 2025 Nov 20.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
- WS-GMSC-001
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.
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