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Assess a Diagnostic Tool to Distinguish Between Bacterial and Viral Infection (OPPORTUNITY)

2017년 11월 27일 업데이트: Louis Bont, UMC Utrecht

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

In the past 70 years antibiotics have served as the first line of defense against infectious diseases. However, antibiotics are only effective against bacterial infections and are not the solution for infections caused by viruses such as common colds or flu. Despite their contribution to healthcare, antibiotics are currently recognized as the most misused drugs in the world with global overuse estimated at 40%-70%, mostly due to the ineffectiveness of current diagnostic solutions to distinguish between bacterial and viral infections. Antibiotics misuse often causes preventable adverse events that impact patient care and lead to the emergence of antibiotic-resistant bacteria, one of the major threats to global health today. To address these challenges, MeMed has been developing the ImmunoDx™, a novel technology that relies on the best available detection system for differentiating between viruses and bacteria - the body's own immune system. The ImmunoDx™ technology employs a simple blood test that provides the physician, within two-hours, the information he needs to decide whether to treat the patient with antibiotics or not. This technology has been tested on over 1000 patients of different ages and diseases and was found to be highly accurate and safe. The current study is a non-interventional study and the participants do not receive any investigational drug nor any experimental examination or procedure. Therefore, the collected data in this study will not affect the diagnosis, prognosis, or treatment of the participants. Participation includes the collection of a teaspoon of blood and collection of a specimen using a nasal swab. These procedures are common in the clinical practice and are widely performed and possess no significant risk. By participating in the study, the subjects impact the development of the ImmunoDx™ technology, which is expected to enable a future faster and more accurate diagnosis of infectious diseases as well as more appropriate prescription of antibiotics. This will open the way to improve treatment decisions in millions of patients around the world.

연구 개요

상태

완전한

상세 설명

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.

연구 유형

관찰

등록 (실제)

777

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

      • Utrecht, 네덜란드, 3584 EA
        • UMC Utrecht, Wilhelmina Kinderziekenhuis
      • Hadera, 이스라엘
        • Pediatrics Department, Hillel Yaffe Medical center (HYMC),
      • Haifa, 이스라엘
        • Pediatric Emergency Department (ED), Bnei Zion Medical Center (BZMC),

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

1개월 (어린이)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

샘플링 방법

확률 샘플

연구 인구

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:

  1. Patients with an acute bacterial infection
  2. Patients with an acute viral infection
  3. Patients with an acute mixed co-infection (bacterial and viral)
  4. Patients with an undetermined disease etiology
  5. 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).

설명

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:

  1. Use of high dose steroids >1 mg/kg/day prednisone or equivalent in the past two weeks
  2. Monoclonal antibody administration
  3. Intravenous immunoglobulin (IVIG)
  4. Cyclosporine
  5. G/GM-CSF
  6. Anti-TNF agents
  7. 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

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
sensitivity / specificity diagnostic tool
기간: 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

2차 결과 측정

결과 측정
측정값 설명
기간
sensitivity /specificity diagnostic tool
기간: 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

기타 결과 측정

결과 측정
측정값 설명
기간
sensitivity / specificity diagnostic tool
기간: 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

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

수사관

  • 수석 연구원: Louis Bont, MD, UMC Utrecht

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2013년 10월 1일

기본 완료 (실제)

2016년 8월 1일

연구 완료 (실제)

2016년 11월 1일

연구 등록 날짜

최초 제출

2013년 8월 22일

QC 기준을 충족하는 최초 제출

2013년 8월 22일

처음 게시됨 (추정)

2013년 8월 29일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2017년 11월 28일

QC 기준을 충족하는 마지막 업데이트 제출

2017년 11월 27일

마지막으로 확인됨

2017년 11월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • MM-1003-BV

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