- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT00614770
Narrow Band Imaging Colon Polyp Study
A Multicenter, Prospective, Randomized Controlled Trial for the Detection of Colon Polyps and Predicting Histology
In this study the investigators hypothesize that High Definition White Light colonoscopy and narrow band imaging (NBI) will detect a higher number of adenomas compared to standard definition white light colonoscopy. NBI will have a higher accuracy in predicting polyp histology compared to high definition colonoscopy and standard colonoscopy.
Specific Aim 1 - To compare the prevalence of adenomas detected by standard colonoscopy, high-definition white light colonoscopy and NBI.
Specific Aim 2 - To compare the number of adenoma detected per subject by standard colonoscopy, high-definition white light colonoscopy and NBI.
Specific Aim 3 - To compare the accuracy of predicting polyp histology between standard colonoscopy, high-definition white light colonoscopy and NBI by evaluating the surface mucosal and vascular patterns during the procedure.
Specific Aim 4 - To determine the inter-observer agreement between investigators for the recognition of various polyp patterns
Descripción general del estudio
Estado
Intervención / Tratamiento
Descripción detallada
This study is a multi-center randomized controlled trial that will be conducted at the Kansas City VA Medical Center, Kansas City, MO and The Barnes Jewish Hospital, St Louis, MO. Patients referred for screening and surveillance colonoscopy will be enrolled. They will be randomized to one of the following three groups: standard white light colonoscopy, high-definition white light colonoscopy or NBI.
All colonoscopies will be performed at the Kansas City VA Medical Center and The Barnes Jewish Hospital, St Louis, MO. Moderate sedation will be administered for the procedure with intravenous midazolam, demerol or fentanyl and Propofol. In patients randomized to the NBI arm, the colonoscope will be inserted to the cecum under white light and will switch to NBI mode at the time of withdrawal. After cecal intubation, the colonic mucosa will be carefully visualized during withdrawal of the scope with one of the three imaging modalities to which the patient has been randomized. No effort will be made to look for polyps during the insertion of the colonoscope. All polyps detected will be documented for their size, morphology (Polypoid: sessile, pedunculated or Non polypoid: superficially elevated, completely flat, depressed), and location. The surface of the polyp will be assessed during the procedure and the histology will be predicted real time by evaluating the surface mucosal and vascular patterns. The patterns would be classified into one of the four patterns described in our pilot study (tubular and gyrus patterns will be combined to tubulogyrus pattern). Any other patterns detected would be described and kept in the miscellaneous category. If a pattern is not identified on a polyp with either white light or NBI, it will be recorded as such and no attempts will be made to predict histology. Photo documentation of the surface patterns of the polyps will be performed. Polyps will then be removed either with a biopsy forcep or snare and sent for histopathological evaluation. Each polyp removed will have one or more corresponding picture of its surface patterns and these will be labeled accordingly. The total time spent in inspecting the colonic mucosa (excluding the time spent in removal of polyps or clearing the colon of liquid and solid debris) will be measured with a stop watch. Representative images of the various polyp patterns will be reviewed, discussed and standardized amongst all the investigators at both sites. In addition, images of all the polyp patterns will be printed and posted in the endoscopy suites at both hospitals.
The bowel preparation will be evaluated and graded as follow:
Excellent (score=1) - >90% mucosa seen, mostly liquid colonic contents, minimal suctioning needed for adequate visualization.
Good (score=2) - >90% of mucosa seen, mostly liquid colonic contents, significant suctioning needed for adequate visualization Fair (score=3) - > 90% mucosa seen, mixture of liquid and semisolid colonic contents, could be suctioned and/or washed Inadequate (score=4) - <90% mucosa seen, mixture of semisolid ands solid colonic contents, which could not be suctioned or washed
Patients with "Inadequate" (score = 4) bowel prep will be excluded.
Tipo de estudio
Inscripción (Actual)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
-
-
Missouri
-
Kansas City, Missouri, Estados Unidos, 64128
- Kansas City VA Medical Center
-
St. Louis, Missouri, Estados Unidos, 63110
- Barnes Jewish Hospital
-
-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion criteria:
- referral for screening or surveillance colonoscopy
- the ability to provide informed consent
Exclusion criteria:
- prior surgical resection of any portion of colon
- prior history of colon cancer
- history of inflammatory bowel disease
- use of anti-platelet agents or anticoagulants that precludes removal of polyps during the procedure
- poor general condition or any other reason to avoid prolonged procedure time
- history of polyposis syndrome or HNPCC
- inability to give informed consent.
- Inadequate bowel preparation
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Diagnóstico
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Experimental: 1
Standard White Light Colonoscopy
|
Standard White Light Colonoscopy one exam per patient High Definition White Light Colonoscopy one exam per patient |
Experimental: 2
High Definition White Light Colonoscopy
|
Standard White Light Colonoscopy one exam per patient High Definition White Light Colonoscopy one exam per patient |
Experimental: 3
Narrow Band Imaging Colonoscopy
|
Narrow Band Imaging Colonoscopy one exam per patient |
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
The prevalence of adenomas in the three arms of the study.
Periodo de tiempo: 2 years
|
Number of subjects with adenomas in the three arms of the study
|
2 years
|
Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
---|---|
Secondary outcome will be number of adenomas detected per subject in the three arms, the sensitivity, specificity, and accuracy of predicting polyp histology real time by the three imaging modalities.
Periodo de tiempo: 2 years
|
2 years
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Amit Rastogi, MD, Kansas City VA Medical Center
Publicaciones y enlaces útiles
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- AR0003
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
Ensayos clínicos sobre standard of care colonoscopy
-
RapidPulse, IncTerminadoAccidente cerebrovascular isquémico agudoDinamarca, Letonia, Pavo, Brasil, España
-
Kettering Health NetworkTerminadoPared Abdominal Herida Abierta | Herida que no cicatrizaEstados Unidos
-
DeRoyal Industries, Inc.Lincoln Memorial UniversityTerminadoSensibilización de la piel | Reacción de la piel a estímulos mecánicos, térmicos y de radiaciónEstados Unidos
-
Hospital Clínico Universitario de ValladolidReclutamientoEnfermedades Cerebrales | Enfermedades del Sistema Nervioso Central | Enfermedades del Sistema Nervioso | Dolor | Manifestaciones neurológicas | Trastornos de dolor de cabeza | Trastornos de Cefalea, SecundariaEspaña
-
University of StellenboschTerminado
-
University of StellenboschTerminadoVIH/SIDA | Tuberculosis - Tuberculosis | Terapia Antirretroviral, Altamente ActivaSudáfrica
-
Oregon Health and Science UniversityDesconocidoDelirio | Efectos secundarios y reacciones adversas relacionados con los medicamentos | Ancianos frágiles | Deterioro cognitivo relacionado con la edad | Úlcera por presión adquirida en el hospitalEstados Unidos
-
Ottawa Heart Institute Research CorporationActivo, no reclutando
-
Lawson Health Research InstituteDesconocidoPlanificación anticipada de la atenciónCanadá
-
Johns Hopkins UniversityAún no reclutando