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- Essai clinique NCT00295659
An RCT to Evaluate Incidence, Cost and Clinical Outcomes Using 75 vs 100g. Screening Methods for Gestational Diabetes
What is the Optimal Method for Screening and Diagnosis of Gestational Diabetes? An RCT to Evaluate Incidence, Cost-Effectiveness and Clinical Outcomes Using Three Methods
Aperçu de l'étude
Statut
Les conditions
Description détaillée
Title: What is the optimal method for screening and diagnosis of gestational diabetes? A randomised clinical trial to evaluate incidence of GDM, cost-effectiveness and clinical outcomes using three methods.
Objectives: 1) To evaluate the incidence and cost-effectiveness of screening and diagnosis of GDM by comparing three different methods. 2) To evaluate the following by each method: population characteristics; gestational age at screening, diagnosis and initiation of treatment; and maternal and neonatal outcomes.
Rationale: There is no consensus on the best method to identify cases of GDM, numerous screening and diagnostic procedures are employed worldwide. Recently the Canadian Guidelines recommended a new set of values based on normative data, yet these data have not been validated against a large population and compared with diagnostic rates and outcomes head to head against the long accepted values of O'Sullivan and Mahan. In addition, the question of cost in a Canadian healthcare setting has never been addressed yet it is a significant societal concern. The results of this study would help clarify these issues using evidence-based methodology.
Outline: Pregnant women referred as outpatients for glucose testing for GDM will be given a study information sheet by obstetrics staff. At the time of booking the test they will be reminded of the study and to arrive fasting. On the day of glucose testing, the research assistant will invite patients to participate, obtain consent and perform randomisation into one three groups:
(1) 50g screen ± 100g 3h GTT; (2) 50g screen ± 75g 2h GTT; or (3) 75g 2h GTT. During the glucose test, study participants will also be asked information on health and costs incurred for the process of glucose testing. If the screen or GTT needs to be repeated at some time during the pregnancy, patients will remain in the same study arm as originally assigned. Interpretation of results by patient's caregivers and referral to the diabetes clinic as needed will continue as usual. Data will be analysed using appropriate bivariate and multivariate methods for GDM incidence, direct and indirect costs of glucose testing, and maternal and infant outcomes.
Significance to DM: This study will evaluate the diagnostic efficacy, cost-effectiveness and clinical outcomes of three methods. A one-step procedure may be better tolerated compared to a two-step approach with respect to number of visits, amount of drink and length of testing. Furthermore, diagnosis by a single test may avoid unnecessary delay in initiation of therapy and still identify those patients at risk for type 2 DM.
Type d'étude
Inscription
Contacts et emplacements
Lieux d'étude
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Quebec
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Montreal, Quebec, Canada, H3A 1A1
- Royal Victoria Hospital, McGill University Health Centre
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- all women presenting for glucose screening in pregnancy between January 2001 and June, 2004 at a tertiary care university hospital setting
Exclusion Criteria:
- insufficient knowledge of French or English; known diabetes; refusal to participate; error in protocol; not fasting when presenting for study test
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Sara J Meltzer, MD, FRCPC, McGill Unversity, Faculty of Medicine, Dept. of Medicine and Obstetrics and Gynecology
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- CDA 200665
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