Vzdálené sledování těhotenství pro zlepšení přístupu (REACTIVE)
Vzdálené sledování těhotenství pro zlepšení přístupu: Zkouška REACTIVE
The goal of this clinical trial is to determine the effectiveness of remote nonstress test (NST) compared to in-clinic NSTs in improving fetal testing completion rates. Participants will be randomized to either in-clinic NSTs or use of an FDA-approved remote monitoring belt for their pregnancy monitoring.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Typ studie
Typ studie
Zápis (Aktuální)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
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Pennsylvania
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Philadelphia, Pennsylvania, Spojené státy, 19104
- University of Pennsylvania
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dítě
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Singleton pregnancy
- Gestational age between 30 weeks 0 days and 35 weeks 6 days
- Pregnant patients who have clinical indication for fetal surveillance with NSTs (based on UPHS Health System clinical guidelines for antenatal monitoring)
- Able to provide written consent
- English speaking
Exclusion Criteria:
- Multiple gestations
- Maternal pre-gravid BMI greater than 45kg/m2
- Presence of an implanted pacemaker or defibrillator
- Active abdominal skin infection
- A known amniotic fluid index (AFI) less than 5cm or greater than 25cm on the most recent ultrasound (if available) prior to randomization
- Delivery is planned within 2 weeks of potential randomization
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Diagnostický
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
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Experimentální: Vzdálená NST
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INVU monitoring belt used for remote NSTs |
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Aktivní komparátor: In-clinic NST - Standard of Care
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In-clinic NSTs - standard of care |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Fetal Testing Completion Rate
Časové okno: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
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Percentage of recommended antenatal testing sessions successfully completed, defined as a clinically interpreted test performed. Calculated for each participant as: number of NST visits completed divided by number of NST visits expected × 100. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
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Fetal Testing Completion Rate in Black Versus Non-Black Subjects
Časové okno: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
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Comparison between Black and non-Black subjects' percentage of recommended antenatal testing sessions that were successfully completed as defined as a clinically interpreted test was performed. Calculated as the number of NST visits completed divided by the number of NST visits expected per participant × 100. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Fetal Monitoring Outcomes: Number of Visits to the Antenatal Testing Unit
Časové okno: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
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Count of visits to the office for in-person monitoring |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
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Fetal Monitoring Outcomes: Percentage of Non-Stress Test Sessions Requiring Provider-Recommended Prolonged Monitoring
Časové okno: From randomization until delivery.
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For each participant, the percentage of all NST sessions requiring prolonged monitoring (>40 minutes) was calculated. The median participant-level percentage is reported. |
From randomization until delivery.
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Fetal Monitoring Outcomes: Average Duration of Non-Stress Test Monitoring Sessions
Časové okno: From randomization until delivery.
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Mean duration of NST monitoring sessions across all NSTs completed by each participant from randomization to delivery. Participant-level means were calculated and summarized by study arm. |
From randomization until delivery.
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Fetal Monitoring Outcomes: Non-reactive NST Rate
Časové okno: From randomization until delivery
|
Percentage of NSTs that were non-reactive among all NSTs completed for each participant. |
From randomization until delivery
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Fetal Monitoring Outcomes: Percentage of NSTs Resulting in Biophysical Profile Evaluation
Časové okno: From randomization until delivery.
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Percentage of completed NSTs followed by biophysical profile assessment. |
From randomization until delivery.
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Fetal Monitoring Outcomes: Number of Participants With ≥1 Obstetrical Triage Visit
Časové okno: From randomization to delivery
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Number of Participants With ≥1 Obstetrical Triage Visit |
From randomization to delivery
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Fetal Monitoring Outcomes: Number of Participants Who Had Any Triage Visit Directly Related to a Fetal Monitoring Visit
Časové okno: From randomization to delivery
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Number of participants who underwent at least one obstetrical triage evaluation directly related to a fetal monitoring visit, during the study period from randomization until delivery. |
From randomization to delivery
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Fetal Monitoring Outcomes: Number of Participants Recommended for Delivery Based on Findings on Fetal Monitoring Result
Časové okno: From randomization to delivery
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Count of the number of subjects in each arm who receive a recommendation for delivery based on the findings of the fetal monitoring results. |
From randomization to delivery
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Fetal Monitoring Outcomes: Percentage of NSTs Not Completed Within the Prescribed Window
Časové okno: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
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Percentage of NSTs which occur outside of prescribed window, for example, if a weekly testing regimen is prescribed, an appointment 8 or more days following the last one would count as 1 missed calendar window. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
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Obstetrics Outcomes: Gestational Age at Delivery
Časové okno: time of delivery
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gestational age at time of delivery |
time of delivery
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Obstetrics Outcomes: Number of Participants With Preterm Delivery
Časové okno: time of delivery
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preterm delivery is defined as less than 37 weeks gestational age |
time of delivery
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Obstetrics Outcomes: Mode of Delivery
Časové okno: time of delivery
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categorized as vaginal or cesarean |
time of delivery
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Obstetrics Outcomes: Number of Participants With an Indication for Labor Induction
Časové okno: time of labor induction
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in subjects who have labor induction, indication for inducing labor |
time of labor induction
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Obstetrics Outcomes: Number of Participants With an Indication for Cesarean Section
Časové okno: time of delivery
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in subjects who have a cesarean section delivery, indication for cesarean section |
time of delivery
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Obstetrics Outcomes: Number of Participants With Composite Neonatal Morbidity
Časové okno: from delivery to 6 weeks post-delivery
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Number of participants whose neonate experienced at least one component of the composite neonatal morbidity outcome, defined as severe respiratory distress, neonatal resuscitation outside the delivery room, or neonatal death. |
from delivery to 6 weeks post-delivery
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Obstetrics Outcomes: Neonatal Cord Blood pH
Časové okno: time of delivery
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time of delivery
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Obstetrics Outcomes: Apgar Scores
Časové okno: one and five minutes after delivery
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Apgar score at 1 and 5 minutes after delivery. Scores range from 0 to 10, with higher scores indicating better neonatal condition |
one and five minutes after delivery
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Obstetrics Outcomes: Number of Participants With an Admission to the Neonatal Intensive Care Unit
Časové okno: from delivery to 6 weeks post-delivery
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from delivery to 6 weeks post-delivery
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Obstetrics Outcomes: Number of Participants Who Had an Admission to the Neonatal Intensive Care Unit for Greater Than 48 Hours
Časové okno: from delivery to 6 weeks post-delivery
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from delivery to 6 weeks post-delivery
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Obstetrics Outcomes: Maternal Length of Hospital Stay
Časové okno: Delivery hospitalization
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Length of maternal hospitalization associated with the delivery admission, measured from hospital admission for delivery through maternal discharge. |
Delivery hospitalization
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Obstetrics Outcomes: Neonatal Length of Hospital Stay
Časové okno: Birth hospitalization
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Length of neonatal hospitalization from birth through hospital discharge. |
Birth hospitalization
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Cost-effectiveness Outcomes: Productivity Loss Due to Antenatal Testing and Monitoring
Časové okno: From randomization until delivery (approximately 10 weeks on average)
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Productivity loss was assessed by summing the number of days of work missed reported by participants across the two study productivity assessments. The reported value represents the total number of work days missed during the study period for each participant. |
From randomization until delivery (approximately 10 weeks on average)
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Cost-effectiveness Outcomes: Total Societal Perspective Cost
Časové okno: Randomization through delivery
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Total societal perspective cost per participant, calculated as the sum of direct healthcare costs, informal healthcare costs, and productivity costs incurred from randomization through delivery. Costs are reported in U.S. dollars (USD). The societal perspective includes costs related to antenatal testing, delivery hospitalization, neonatal care, triage visits, antepartum admissions, productivity losses, caregiving, and transportation. |
Randomization through delivery
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Implementation Outcomes: Theory-informed Acceptability Questionnaire
Časové okno: at time of delivery
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Participant acceptability of the assigned fetal monitoring strategy was assessed using an 8-item Theory-Informed Acceptability Questionnaire (TFA). Total scores range from 8 to 40, with higher scores indicating greater acceptability of the monitoring approach. |
at time of delivery
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Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Aktuální)
Primární dokončení
Dokončení studie (Aktuální)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
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