- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00241826
Prospective Investigation of Pulmonary Embolism Diagnosis III
Prospective Investigation of Pulmonary Embolism Diagnosis III (PIOPED III)
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
BACKGROUND:
Prospective Investigation of Pulmonary Embolism Diagnosis III (PIOPED III) follows PIOPED I and PIOPED II. PIOPED I was a multicenter trial supported between 1983 and 1989 to evaluate the sensitivity and specificity of two major, widely used technologies, radionuclear imaging (ventilation-perfusion scanning) and pulmonary angiography, for the diagnosis of PE. PIOPED II was a multicenter trial conducted between 2000 and 2005 to determine the value of contrast-enhanced spiral computed tomography (spiral CT) for the diagnosis of acute PE.
In PIOPED II, among 7,284 patients with suspected acute PE, 18.6% had an elevated creatinine, 3.9% were allergic to iodinated contrast material, and 4.7% of women were pregnant. One or more of these relative contraindications to an imaging procedure that would expose the patient to ionizing radiation or iodinated contrast material was present in 24.4% of patients with suspected acute PE. Although patients with relative contraindications often take the risk of CT or digital subtraction angiography (DSA) because of the importance of having a definitive diagnosis, such patients could benefit from safer diagnostic testing with Gd-MRA/MRV if it is shown to be sufficiently accurate.
The purpose of this investigation is to determine the extent to which Gd-MRA/MRV can serve as a diagnostic test in patients with clinically suspected PE and thereby eliminate the need for iodinated contrast material or ionizing radiation in patients who have a relative contraindication to one of them. This is important because 24% of patients with suspected acute PE have a relative contraindication to diagnostic procedures that involve ionizing radiation or iodinated contrast material.
DESIGN NARRATIVE:
PIOPED III is a multicenter prospective investigation designed to determine the diagnostic accuracy of Gd-MRA of the pulmonary arteries in combination with MRV of the veins of the thighs in patients with clinically suspected acute PE. The diagnostic accuracy of Gd-MRA alone and in combination with MRV will be expressed as sensitivity, specificity, and likelihood ratio for positive and negative tests. The study design is a prospective study of consecutive patients incorporating standardized inclusion/exclusion criteria, complete ascertainment of patient characteristics and outcomes, uniform diagnostic criteria, and unbiased paired central readings of imaging studies. Over a period of 2 years, 1,256 patients with suspected acute PE will be recruited at clinical centers. Composite reference standards will be used to diagnose venous thromboembolism (VTE) and exclude PE. It is expected that 314 patients will have acute VTE and they will undergo Gd-MRA/MRV. It is expected that 942 patients will be shown not to have PE. From among this group, 314 patients will be randomly selected for the index test, Gd-MRA/MRV.
Studientyp
Einschreibung (Voraussichtlich)
Kontakte und Standorte
Studienorte
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Alberta
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Calgary, Alberta, Kanada, T2N 2T9
- Foothills Hospital
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-
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Georgia
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Atlanta, Georgia, Vereinigte Staaten, 30308
- Emory University
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Maryland
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Bethesda, Maryland, Vereinigte Staaten, 20892
- Divison of Lung Diseases, NHLBI
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Rockville, Maryland, Vereinigte Staaten, 20852
- Data Coordinating Center
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Massachusetts
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Boston, Massachusetts, Vereinigte Staaten, 02114
- Massachusetts General Hospital
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Michigan
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Ann Arbor, Michigan, Vereinigte Staaten, 48109
- University of Michigan Medical Center
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Pontiac, Michigan, Vereinigte Staaten, 48341
- St. Joseph Mercy-Oakland
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Missouri
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St. Louis, Missouri, Vereinigte Staaten, 63110
- Washington University Medical Center
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New York
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New York, New York, Vereinigte Staaten, 10016
- NYU Medical Center
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Probenahmeverfahren
Studienpopulation
Beschreibung
Inclusion Criteria:
- Acute PE of diagnostic concern
- Informed consent
- Willing to undergo Gd-MRA/MRV
Exclusion Criteria:
- Any implanted ferromagnetic foreign body, including a ferromagnetic cerebral aneurysm clip or implanted electrical device/pump
- Dependency on a continuous connection to an external electrical device/pump (e.g., pacemaker, internal defibrillator, cochlear implant, nerve or bone stimulator implant, ICU appliance) and cardiac pacing wires
- Severe claustrophobia
- Severe shaking
- Inability to lie still for 30 minutes
- Pregnancy and nursing mothers
- Serum creatinine levels within range of normal at local center
- Sickle cell anemia, other hemoglobinopathies, and other hemolytic anemias
- Critical illness, shock or hypotension, hemodynamic instability, ventilatory support, chronic anticoagulation, inferior vena cava filter
- Documented episodes of ventricular fibrillation or sustained ventricular tachycardia within the past 24 hours
- Myocardial infarction within the past month
- History of allergy to gadolinium-containing contrast agents or to iodinated contrast media
- Current symptomatic asthma
- Clinical evidence of venous thrombosis of the upper extremity
- Prisoners
- Institutionalized or mentally handicapped patients
- Too large to fit in MRI unit
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Beobachtungsmodelle: Kohorte
- Zeitperspektiven: Interessent
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
---|---|
Diagnosis or exclusion of pulmonary embolism in agreement with a reference standard
Zeitfenster: Measured within 36 to 48 hours of study entry
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Measured within 36 to 48 hours of study entry
|
Mitarbeiter und Ermittler
Sponsor
Ermittler
- Hauptermittler: Sarah Fowler, PhD, George Washington University
- Hauptermittler: Charles Hales, MD, Massachusetts General Hospital
- Hauptermittler: Russell Hull, MBBS, MSc, University of Calgary
- Hauptermittler: Kenneth Leeper, Jr., MD, Emory University
- Hauptermittler: David Naidich, MD, NYU Langone Health
- Hauptermittler: Daniel Sak, Do, St. Joseph Mercy Oakland
- Studienstuhl: Paul D. Stein, MD, St. Joseph Mercy Oakland
- Hauptermittler: John Weg, MD, University of Michigan at Ann Arbor
- Hauptermittler: Pamela Woodard, MD, Washington University School of Medicine
Publikationen und hilfreiche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- 329
- U01HL077155 (US NIH Stipendium/Vertrag)
- U01HL077149 (US NIH Stipendium/Vertrag)
- U01HL077150 (US NIH Stipendium/Vertrag)
- U01HL077151 (US NIH Stipendium/Vertrag)
- U01HL077153 (US NIH Stipendium/Vertrag)
- U01HL077154 (US NIH Stipendium/Vertrag)
- U01HL077358 (US NIH Stipendium/Vertrag)
- U01HL081593 (US NIH Stipendium/Vertrag)
- U01HL081594 (US NIH Stipendium/Vertrag)
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