Monitoraggio remoto della gravidanza per migliorare l'accesso (REACTIVE)
Monitoraggio remoto della gravidanza per migliorare l'accesso: la sperimentazione REACTIVE
The goal of this clinical trial is to determine the effectiveness of remote nonstress test (NST) compared to in-clinic NSTs in improving fetal testing completion rates. Participants will be randomized to either in-clinic NSTs or use of an FDA-approved remote monitoring belt for their pregnancy monitoring.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Effettivo)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, Stati Uniti, 19104
- University of Pennsylvania
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Bambino
- Adulto
- Adulto più anziano
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Singleton pregnancy
- Gestational age between 30 weeks 0 days and 35 weeks 6 days
- Pregnant patients who have clinical indication for fetal surveillance with NSTs (based on UPHS Health System clinical guidelines for antenatal monitoring)
- Able to provide written consent
- English speaking
Exclusion Criteria:
- Multiple gestations
- Maternal pre-gravid BMI greater than 45kg/m2
- Presence of an implanted pacemaker or defibrillator
- Active abdominal skin infection
- A known amniotic fluid index (AFI) less than 5cm or greater than 25cm on the most recent ultrasound (if available) prior to randomization
- Delivery is planned within 2 weeks of potential randomization
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Diagnostico
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: NST remoto
|
INVU monitoring belt used for remote NSTs |
|
Comparatore attivo: NST in clinica - Standard di cura
|
In-clinic NSTs - standard of care |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Fetal Testing Completion Rate
Lasso di tempo: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Percentage of recommended antenatal testing sessions successfully completed, defined as a clinically interpreted test performed. Calculated for each participant as: number of NST visits completed divided by number of NST visits expected × 100. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
|
Fetal Testing Completion Rate in Black Versus Non-Black Subjects
Lasso di tempo: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Comparison between Black and non-Black subjects' percentage of recommended antenatal testing sessions that were successfully completed as defined as a clinically interpreted test was performed. Calculated as the number of NST visits completed divided by the number of NST visits expected per participant × 100. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Fetal Monitoring Outcomes: Number of Visits to the Antenatal Testing Unit
Lasso di tempo: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Count of visits to the office for in-person monitoring |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
|
Fetal Monitoring Outcomes: Percentage of Non-Stress Test Sessions Requiring Provider-Recommended Prolonged Monitoring
Lasso di tempo: From randomization until delivery.
|
For each participant, the percentage of all NST sessions requiring prolonged monitoring (>40 minutes) was calculated. The median participant-level percentage is reported. |
From randomization until delivery.
|
|
Fetal Monitoring Outcomes: Average Duration of Non-Stress Test Monitoring Sessions
Lasso di tempo: From randomization until delivery.
|
Mean duration of NST monitoring sessions across all NSTs completed by each participant from randomization to delivery. Participant-level means were calculated and summarized by study arm. |
From randomization until delivery.
|
|
Fetal Monitoring Outcomes: Non-reactive NST Rate
Lasso di tempo: From randomization until delivery
|
Percentage of NSTs that were non-reactive among all NSTs completed for each participant. |
From randomization until delivery
|
|
Fetal Monitoring Outcomes: Percentage of NSTs Resulting in Biophysical Profile Evaluation
Lasso di tempo: From randomization until delivery.
|
Percentage of completed NSTs followed by biophysical profile assessment. |
From randomization until delivery.
|
|
Fetal Monitoring Outcomes: Number of Participants With ≥1 Obstetrical Triage Visit
Lasso di tempo: From randomization to delivery
|
Number of Participants With ≥1 Obstetrical Triage Visit |
From randomization to delivery
|
|
Fetal Monitoring Outcomes: Number of Participants Who Had Any Triage Visit Directly Related to a Fetal Monitoring Visit
Lasso di tempo: From randomization to delivery
|
Number of participants who underwent at least one obstetrical triage evaluation directly related to a fetal monitoring visit, during the study period from randomization until delivery. |
From randomization to delivery
|
|
Fetal Monitoring Outcomes: Number of Participants Recommended for Delivery Based on Findings on Fetal Monitoring Result
Lasso di tempo: From randomization to delivery
|
Count of the number of subjects in each arm who receive a recommendation for delivery based on the findings of the fetal monitoring results. |
From randomization to delivery
|
|
Fetal Monitoring Outcomes: Percentage of NSTs Not Completed Within the Prescribed Window
Lasso di tempo: from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
Percentage of NSTs which occur outside of prescribed window, for example, if a weekly testing regimen is prescribed, an appointment 8 or more days following the last one would count as 1 missed calendar window. |
from 32 weeks gestational age to delivery, average of 10 weeks after enrollment.
|
|
Obstetrics Outcomes: Gestational Age at Delivery
Lasso di tempo: time of delivery
|
gestational age at time of delivery |
time of delivery
|
|
Obstetrics Outcomes: Number of Participants With Preterm Delivery
Lasso di tempo: time of delivery
|
preterm delivery is defined as less than 37 weeks gestational age |
time of delivery
|
|
Obstetrics Outcomes: Mode of Delivery
Lasso di tempo: time of delivery
|
categorized as vaginal or cesarean |
time of delivery
|
|
Obstetrics Outcomes: Number of Participants With an Indication for Labor Induction
Lasso di tempo: time of labor induction
|
in subjects who have labor induction, indication for inducing labor |
time of labor induction
|
|
Obstetrics Outcomes: Number of Participants With an Indication for Cesarean Section
Lasso di tempo: time of delivery
|
in subjects who have a cesarean section delivery, indication for cesarean section |
time of delivery
|
|
Obstetrics Outcomes: Number of Participants With Composite Neonatal Morbidity
Lasso di tempo: from delivery to 6 weeks post-delivery
|
Number of participants whose neonate experienced at least one component of the composite neonatal morbidity outcome, defined as severe respiratory distress, neonatal resuscitation outside the delivery room, or neonatal death. |
from delivery to 6 weeks post-delivery
|
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Obstetrics Outcomes: Neonatal Cord Blood pH
Lasso di tempo: time of delivery
|
time of delivery
|
|
|
Obstetrics Outcomes: Apgar Scores
Lasso di tempo: one and five minutes after delivery
|
Apgar score at 1 and 5 minutes after delivery. Scores range from 0 to 10, with higher scores indicating better neonatal condition |
one and five minutes after delivery
|
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Obstetrics Outcomes: Number of Participants With an Admission to the Neonatal Intensive Care Unit
Lasso di tempo: from delivery to 6 weeks post-delivery
|
from delivery to 6 weeks post-delivery
|
|
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Obstetrics Outcomes: Number of Participants Who Had an Admission to the Neonatal Intensive Care Unit for Greater Than 48 Hours
Lasso di tempo: from delivery to 6 weeks post-delivery
|
from delivery to 6 weeks post-delivery
|
|
|
Obstetrics Outcomes: Maternal Length of Hospital Stay
Lasso di tempo: Delivery hospitalization
|
Length of maternal hospitalization associated with the delivery admission, measured from hospital admission for delivery through maternal discharge. |
Delivery hospitalization
|
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Obstetrics Outcomes: Neonatal Length of Hospital Stay
Lasso di tempo: Birth hospitalization
|
Length of neonatal hospitalization from birth through hospital discharge. |
Birth hospitalization
|
|
Cost-effectiveness Outcomes: Productivity Loss Due to Antenatal Testing and Monitoring
Lasso di tempo: From randomization until delivery (approximately 10 weeks on average)
|
Productivity loss was assessed by summing the number of days of work missed reported by participants across the two study productivity assessments. The reported value represents the total number of work days missed during the study period for each participant. |
From randomization until delivery (approximately 10 weeks on average)
|
|
Cost-effectiveness Outcomes: Total Societal Perspective Cost
Lasso di tempo: Randomization through delivery
|
Total societal perspective cost per participant, calculated as the sum of direct healthcare costs, informal healthcare costs, and productivity costs incurred from randomization through delivery. Costs are reported in U.S. dollars (USD). The societal perspective includes costs related to antenatal testing, delivery hospitalization, neonatal care, triage visits, antepartum admissions, productivity losses, caregiving, and transportation. |
Randomization through delivery
|
|
Implementation Outcomes: Theory-informed Acceptability Questionnaire
Lasso di tempo: at time of delivery
|
Participant acceptability of the assigned fetal monitoring strategy was assessed using an 8-item Theory-Informed Acceptability Questionnaire (TFA). Total scores range from 8 to 40, with higher scores indicating greater acceptability of the monitoring approach. |
at time of delivery
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
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Inizio studio (Effettivo)
Inizio studio
Completamento primario (Effettivo)
Completamento primario
Completamento dello studio (Effettivo)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- 852291
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