Assess a Diagnostic Tool to Distinguish Between Bacterial and Viral Infection (OPPORTUNITY)
Prospective, Blinded Validation Study to Assess Accuracy of a Diagnostics for Distinguishing Between Bacterial and Viral Etiology in Pediatric Patients With Lower Respiratory Tract Infections and Fever Without Source
Aperçu de l'étude
Statut
Les conditions
Description détaillée
This is a prospective clinical validation study of a novel in-vitro diagnostic (IVD) assay that will enroll 830 pediatric patients. The study will be conducted in two stages: In stage A 50 patients will be enrolled with the aim of verifying proper protocol execution including proper collection of patient samples, accurate data retrieval and precise etiology determination. In stage B 780 patients will be enrolled with the aim of blinded validation of the host-response based diagnostics using a fresh independent cohort of patients. Patients enrolling into the study will be managed according to the current standard of care (GCP) and per standard institutional procedures. Participation in this study requires the collection of an additional blood sample and a nasal swab sampling.
The investigated assay requires the measurement of three host-related, blood-based, protein biomarkers that are being integrated using a logistic regression formula into a single score. Based on this score, each patient is classified into one of three categories: (i) bacterial immune response (i.e., pure bacterial infections and mixed bacterial and viral co-infection), (ii) viral immune response, and (iii) marginal immune response (inconclusive or non-infectious). It is estimated that 10-20% of the infected patients will have a marginal immune response. A composite reference standard will be used in order to determine the diagnosis of each patient. Specifically, all the clinical, radiological, microbiological and laboratory data of each patient, will be recorded in a dedicated eCRF. Based on this data, the diagnosis of each patient will be determined by a panel of three independent pediatricians. Each pediatrician will be blinded to the diagnosis of his peers and to the assay results. In the current study, unanimous agreement between the experts ("consensus agreement") will be considered as the true diagnosis for the purpose of computing the assay performance.
Type d'étude
Inscription (Réel)
Contacts et emplacements
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
The study population will include eligible subjects aged 1 to 60 months of age from both genders that attend the hospital or the emergency department (ED) due to a suspected LRTI, FWS or due to a non-infectious disease. These subjects are expected to fall into one of the following categories:
- Patients with an acute bacterial infection
- Patients with an acute viral infection
- Patients with an acute mixed co-infection (bacterial and viral)
- Patients with an undetermined disease etiology
- Patients with a non-infectious disease (control group; n=140) We estimate that approximately 75% of the patients will fall into categories number 1-3 (i.e., bacterial, viral or mixed infections).
La description
Inclusion Criteria:
Patients aged 1 to 60 months whose their legal guardian agrees to sign an informed consent will be eligible for inclusion.
The infectious disease group (n = 690) should also fulfill the following criteria:
- Peak temperature ≥ 38°C (100.4°F) (AND)
- Symptoms duration ≤ 6 days (AND)
- Clinical suspicion of LRTI (OR)
- Fever without a clear source where no localizing sign of infection are present at the emergency department
The non-infectious disease control group will include:
- Patients with a non-infectious disease (n = 140)
Exclusion Criteria:
Patients who will meet one or more of the following criteria will be excluded from the study:
- Another episode of febrile infection during the past 3 weeks
- Congenital immune deficiency (CID)
- A proven or suspected human immunodeficiency virus (HIV)-1, hepatitis B virus (HBV), or hepatitis C virus (HCV) infection
- Active malignancy
Current treatment with immune-suppressive or immune-modulating therapies including without limitations:
- Use of high dose steroids >1 mg/kg/day prednisone or equivalent in the past two weeks
- Monoclonal antibody administration
- Intravenous immunoglobulin (IVIG)
- Cyclosporine
- G/GM-CSF
- Anti-TNF agents
- Interferon (of all kinds)
Other severe illnesses that affect life expectancy and quality of life such as:
- Moderate to severe psychomotor retardation
- Thalassemia Major
- Moderate to severe congenital metabolic disorder
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
sensitivity / specificity diagnostic tool
Délai: one year
|
To determine the sensitivity and specificity of a host-response based diagnostics in differentiating between bacterial and viral etiology of pediatric patients aged 2 to 60 months with LRTI or FWS.
|
one year
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
sensitivity /specificity diagnostic tool
Délai: One year
|
To determine the sensitivity and specificity of a host-response based diagnostics in differentiating between infectious and non-infectious disease of pediatric patients aged 2 to 60 months.
|
One year
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
sensitivity / specificity diagnostic tool
Délai: One year
|
To determine the sensitivity and specificity of a host-response based diagnostics in differentiating between bacterial and viral etiology of pediatric patients aged 1 to 60 months with LRTI or FWS.
|
One year
|
Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Louis Bont, MD, UMC Utrecht
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
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 (Réel)
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
- MM-1003-BV
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