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Evaluating the Use of an App in Pleural Disease: Algorithm-supported Clinical Decision Making Versus Usual Care (APPLAUS)

1. Juni 2026 aktualisiert von: Uffe Bodtger, Zealand University Hospital

Evaluating the Use of an App in Pleural Disease: Algorithm-supported Clinical Decision Making Versus Usual Care: a Multicentre, Stepped-wedge Cluster-randomised Controlled Trial to Reduce Number of Days in Hospital.

Pleural disease is a group of conditions that affect the membrane around the lungs. These conditions-fluid around the lungs, infections, cancer, and collapsed lung-are common and can cause serious illness. They often lead to long hospital stays, emergency admissions, and reduced quality of life. In Denmark and worldwide, the number of patients with pleural disease is rising, and the treatment is costly for the healthcare system.

How long patients stay in the hospital depends on the type of pleural disease. Some stay less than a week, while others remain for several weeks, especially if complications occur. Research shows that early diagnosis and treatment based on clinical guidelines can shorten hospital stays and improve outcomes.

In the UK, many hospitals have created dedicated pleural clinics run by specialists. These clinics help ensure that patients receive fast, consistent, and evidence based care, and they have reduced the number of days patients spend in hospital. In Denmark, however, such clinics are rare. A recent national survey showed that many Danish hospitals do not follow current pleural disease guidelines, and many lack clear pathways for diagnosing and treating these patients. As a result, patients may receive suboptimal care.

This project aims to close that gap. The goal is to develop an easy to use, guideline based decision tool that supports doctors in emergency, medical, and surgical departments. The tool will guide clinicians from the moment a patient arrives until discharge, helping them choose the right tests and treatments at the right time. By making expert knowledge accessible to non specialists, the project hopes to improve patient care, reduce complications, and shorten hospital stays.

Ultimately, the project seeks to ensure that all patients with pleural disease in Denmark receive fast, safe, and evidence based treatment-no matter where they are admitted.

Studienübersicht

Status

Anmeldung auf Einladung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

828

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • Dänemark
      • Aalborg, Dänemark, 9000
        • Aalborg University Hospital
      • Aarhus, Dänemark, 8200
        • Aarhus University Hospital
      • Amager, Dänemark, 2300
        • Amager Hospital
      • Esbjerg, Dänemark, 6700
        • Esbjerg Hospital
      • Hillerød, Dänemark, 3400
        • North Zealand Hospital, Hillerød
      • Hvidovre, Dänemark, 2650
        • Hvidovre Hospital
      • Kolding, Dänemark, 6000
        • Kolding Hospital
      • Køge, Dänemark, 4600
        • Zealand University Hospital, Køge
      • Odense, Dänemark, 5000
        • Odense University Hospital
      • Slagelse, Dänemark, 4200
        • Slagelse Hospital

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

One or more of the following, relevante ICD-10 codes for either spontaneous pneumothorax, pleural effusion or pleural infection.

Spontaneous pneumothorax:

  • DJ93
  • DJ930
  • DJ931
  • DJ938
  • DJ939

Pleural effusion:

  • DJ90
  • DJ909
  • DJ919
  • DJ91
  • DJ940
  • DJ948
  • DJ948A
  • DJ949
  • DC782

Pleural infection:

  • DJ86
  • DJ860
  • DJ860

Exclusion Criteria:

  • Traumatic pneumothorax (including iatrogenic pneumothorax)
  • Hemothorax

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Crossover-Aufgabe
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Aktiver Komparator: Usual care

Usual provided care for patients with spontaneous pneumothorax, pleural effusion or pleural infection.

All clusters begin in this condition before transitioning to the intervention as part of the stepped-wedge schedule.
Sonstiges: Usual care
Care supported by a clinical decision-support tool delivered via a smartphone app.
Experimental: Clinical decision-making support tool
Care supported by the clinical decision-making app. Clusters transition to this condition at predefined time points according to the stepped-wedge design.
Verhalten: Clinical decision-making support tool
Care for patients with spontaneous pneumothorax, pleural effusion or pleural infection when supported by a clinical decision-support tool, in the form of a smartphone app.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Length of hospital stay (days)
Zeitfenster: From hospital admission through hospital discharge (up to 90 days)
Number of days from hospital admission to hospital discharge.
From hospital admission through hospital discharge (up to 90 days)

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Correct pneumothorax subtype classification
Zeitfenster: During index hospital admission (up to 90 days after admission)
Whether the pneumothorax subtype was correctly classified during the index hospital admission according to predefined diagnostic criteria (yes/no).
During index hospital admission (up to 90 days after admission)
Number of participants receiving each initial pneumothorax management strategy
Zeitfenster: Within 24 hours from hospital admission
Number of participants managed with either conservative care, needle aspiration, chest tube insertion, or ambulatory device insertion
Within 24 hours from hospital admission
Chest tube size
Zeitfenster: Periprocedural.
Diameter of chest tube used for treatment of spontaneous pneumothorax, reported in French units (Fr).
Periprocedural.
Number of participants with persistent air leak (>7 days)
Zeitfenster: From chest tube insertion until resolution of air leak or up to 90 days
Number of participants with ongoing air leak through the chest drainage system for more than 7 days after chest tube insertion (yes/no)
From chest tube insertion until resolution of air leak or up to 90 days
Number of participants undergoing high-resolution computed tomography (HRCT)
Zeitfenster: During index hospital admission
Number of participants who underwent high-resolution computed tomography (HRCT) during hospital admission or within 90 days after discharge, recorded as yes/no
During index hospital admission
Number of participants receiving complete recommended diagnostic work-up for unilateral pleural effusion
Zeitfenster: At end of index hospital admission (up to 90 days).
Assessment of whether recommended blood tests (full blood count, C-reactive protein, renal function tests, liver function tests, and albumin) and pleural fluid analyses (pH or glucose, LDH, leukocyte differential count, microbiology culture and sensitivity analysis, and cytology) were performed in participants with unilateral pleural effusion.
At end of index hospital admission (up to 90 days).
Chest tube size
Zeitfenster: Periprocedural
Chest tube size (French gauge, Fr) used for pleural effusion drainage
Periprocedural
Definitive cause for pleural effusion
Zeitfenster: During hospital admission or within 90 days after discharge.
Was a definitive cause for the cause of pleural effusion established.
During hospital admission or within 90 days after discharge.
Definitive pleural procedure
Zeitfenster: During hospital admission or within 90 days after discharge.
Definitive pleural procedure within 90 days of admission due to pleural effusion.
During hospital admission or within 90 days after discharge.
Number of participants receiving complete recommended diagnostic work-up for suspected pleural infection
Zeitfenster: Up to 90 days
Assessment of whether recommended blood tests (full blood count, C-reactive protein, renal function tests, liver function tests, and albumin) and pleural fluid analyses (pH or glucose, LDH, leukocyte differential count, microbiology culture and sensitivity analysis, and cytology) were performed in participants with suspected pleural infection.
Up to 90 days
Chest tube diameter of chest tubes used for pleural infection.
Zeitfenster: Periprocedural.
Diameter of chest tube used for drainage of pleural infection, reported in French units (Fr).
Periprocedural.
Number of participants receiving intrapleural enzyme therapy (IET) for pleural infection.
Zeitfenster: Up to 90 days.
Assessment of whether intrapleural enzyme therapy (IET) was administered in participants with pleural infection despite chest tube drainage.
Up to 90 days.
Length of antibiotic treatment
Zeitfenster: During hospital admission or within 90 days after discharge.
Total length of antibiotic treatment (both intravenously and orally) for pleural infection.
During hospital admission or within 90 days after discharge.

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Zealand University Hospital

Ermittler

  • Hauptermittler: Casper Jensen, MD, Lungemedicinsk Forskningsenhed (PLUZ), Institut for Regional Sundhedsforskning, Syddansk Universitet

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. April 2026

Primärer Abschluss (Geschätzt)

15. Oktober 2026

Studienabschluss (Geschätzt)

15. Oktober 2026

Studienanmeldedaten

Zuerst eingereicht

20. März 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

1. Juni 2026

Zuerst gepostet (Tatsächlich)

4. Juni 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

4. Juni 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

1. Juni 2026

Zuletzt verifiziert

1. Mai 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • p-2024-17577

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .

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