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Remote Monitoring of Cancer Patients With Suspected Covid-19 (RECAP)

2021年2月9日 更新者：The Christie NHS Foundation Trust

Remote Monitoring of Cancer Patients Presenting With Symptoms Suggestive of Covid-19 - Pilot Phase.

Since emerging in December 2019, coronavirus disease 2019 (Covid-19) has developed into an unprecedented global pandemic. The causative pathogen, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has the potential to cause a wide range of clinical syndromes, from fever, dyspnoea and cough to respiratory failure and cardiac injury necessitating critical care support. A number of patients have a more indolent clinical course and can be safely managed in the community.

Characterising the clinical course of Covid-19 infection in the oncology population and distinguishing this from other acute oncology presentations which can mimic Covid-19 is a key unmet research need. Current standard of care for monitoring patients at high risk of chemotherapy associated neutropenic sepsis involves asking them to contact their cancer centre when they feel unwell or develop a fever. No standard of care for monitoring ambulatory Covid-19 patients has yet been established. We hypothesise that using wearable biosensors to detect patients who exhibit 'red flags' for sepsis or deterioration due to Covid-19 may allow earlier assessment and intervention. There is no current evidence for wearable biosensors in ambulatory patients receiving chemotherapy, and there is no existing research into this proposed use of biosensors in patients with suspected or confirmed Covid-19 infection.

In order to justify performing a randomised controlled study comparing standard of care with biosensor driven monitoring it is important to establish the tolerability and validity of these devices. We aim to collect patient reported outcome measures (PROMs) on tolerability and assess the reliability of data transmission to a central data collection server. We will also perform an initial analysis of physiological data and correlation with clinical events

調査の概要

状態

募集

条件

介入・治療

詳細な説明

This is a pilot, single arm, open label feasibility study. This is a single centre trial based in a large tertiary cancer centre which treats patients across all solid and haematological malignancies. Patients will be recruited from all disease groups.

Patients who present with symptoms suspicious for Covid-19 who the admitting clinicians deems appropriate for outpatient management will be considered for this study.

Patients who are enrolled will undergo continuous physiological monitoring for up to three weeks. This includes continuous monitoring of heart rate, respiratory rate, temperature, activity levels (by accelerometer measurement) and twice daily pulse oximetry. The physiological data will not be reviewed in real time by clinicians and therefore will not be used to alter patients' standard care. The pulse oximetry data will be visible to patients who will be given clear guidelines to follow with regards to contacting the cancer centre hotline should values deviate from baseline.

In the pilot phase of RECAP 10-30 patients will each be monitored for up to 3 weeks and the following endpoints will be addressed:

Physiological trends and interactions predictive of clinical deterioration due to COVID-19 (Co-primary endpoint) Reliability of biosensor data collection/transmission using digital technology from patients self-isolating at home (Co-primary endpoint) Acceptability and tolerability of wearable biosensors and continuous monitoring If the pilot phase is successful we will move to a phase II study in a larger number of patients where the objective will be to refine a physiological signature predictive of clinical deterioration in COVID-19 patients so that early hospitalisation and relevant medical interventions can be arranged.

研究の種類

介入

入学 (予想される)

30

段階

  • フェーズ 1

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

  • イギリス
    • Greater Manchester
      • Manchester、Greater Manchester、イギリス、M204BX
        • 募集
        • The Christie Nhs Foundation Trust
        • コンタクト：

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  1. Participants are capable of giving informed consent
  2. Male or female aged 18 or over

  3. Diagnosis of any solid tumour or haematological malignancy meeting one of the following criteria:

    • Current malignant diagnosis
    • Received anti-cancer treatment within the last two years
  4. Emergency presentation to hospital with symptoms consistent with Covid-19 deemed to meet the criteria for Covid-19 testing by admitting clinician.
  5. Deemed by the admitting clinician to be suitable for outpatient management of suspected Covid-19.
  6. Stable oxygen saturations of 95% or higher at time of emergency presentation.
  7. Able to complete tolerability questionnaire.
  8. Able and willing to comply with twice daily pulse oximetry monitoring as outlined in section 6 of the protocol.
  9. ECOG-PS <4
  10. Life expectancy of greater than three months as assessed by screening investigator from review of electronic patient record.

Exclusion Criteria:

  1. Patients hospitalized for more than 24 hours at initial presentation with symptoms consistent with Covid-19.
  2. Pregnant patients.
  3. Patients unable to give informed consent.
  4. Presence of ulceration or pre-existing skin rash at site of device application (left precordium and axillae). If only one axilla affected this is not an exclusion criterion if patient is happy to apply temperature sensor to the other axilla.
  5. Radiotherapy to the left chest wall either during or within the six months preceding the study. Plans for subsequent radiotherapy to commence after study completion are not an exclusion criterion. If only one axilla is within the planned radiotherapy field and patient is happy to apply temperature sensor to the other axilla this is not an exclusion criteria.
  6. History of allergy or contact dermatitis to medical adhesives e.g sticking plasters, ECG electrodes.
  7. Patients with pacemakers, implantable defibrillators or neurostimulators.
  8. Patients who are currently receiving treatment as part of a clinical study or have had their end of treatment visit for another clinical study less than 30 days prior to the study enrollment visit.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：他の
  • 割り当て：なし
  • 介入モデル：単一グループの割り当て
  • マスキング：なし（オープンラベル）

武器と介入

参加者グループ / アーム
介入・治療
実験的：Ambulatory monitoring
Participants will be asked to wear the sensors (heart rate, respiratory rate, temperature, and pulse oximetry) for three weeks. Data will be collected from the devices but will only be reviewed retrospectively and will not be used to alter participants care.
デバイス：Patient Status Engine
Wearable sensors

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Device Tolerability (Attrition)
時間枠：Three weeks
Percentage of patients who choose to stop wearing the devices before they have completed the study
Three weeks
Correlation of physiological data with clinical events
時間枠：Over three weeks of patients wearing devices
Correlation of sensor collected data with clinical episodes of infection. Sensor collected data includes heart rate, respiratory rate and temperature.
Over three weeks of patients wearing devices

二次結果の測定

結果測定
メジャーの説明
時間枠
Device Tolerability (Questionnaire)
時間枠：Questionnaire at three weeks
Percentage of participants who answer 'agree' or 'strongly agree' on a five point Likert scale to the statement 'I would be happy to wear the sensors again for the next three weeks'. This statement is included in the questionnaires completed after three weeks of wearing the device.
Questionnaire at three weeks
Device Tolerability (Semi-structured interviews)
時間枠：One to four weeks after completion of wearing the device
Device tolerability as assessed by semi-structured interviews.
One to four weeks after completion of wearing the device
Reliability of data transmission
時間枠：Over three weeks of patients wearing devices
Reliable data transmission to central hospital system expressed as a percentage of total data points collected out of target data points collected.
Over three weeks of patients wearing devices

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

The Christie NHS Foundation Trust

捜査官

  • 主任研究者：John Radford、The University of Manchester

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2020年10月12日

一次修了 (予想される)

2021年4月1日

研究の完了 (予想される)

2021年4月1日

試験登録日

最初に提出

2020年5月20日

QC基準を満たした最初の提出物

2020年5月20日

最初の投稿 (実際)

2020年5月21日

学習記録の更新

投稿された最後の更新 (実際)

2021年2月11日

QC基準を満たした最後の更新が送信されました

2021年2月9日

最終確認日

2021年2月1日

詳しくは

本研究に関する用語

追加の関連 MeSH 用語

その他の研究ID番号

  • CFTSp186

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

The physiological data represents a rich clinical data resource which has the potential to be valuable in other contexts to answer future unanticipated questions. We therefore propose storing this pseudoanonymised data in a Data Bank with a lifespan initially of five years with potential for extension if appropriate ethical approval is gained. This Data Bank could then be used, under ethical approval for other research in order to maximise the potential utility of the data.

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

米国で製造され、米国から輸出された製品。

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

COVIDの臨床試験

Patient Status Engineの臨床試験

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