- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT02538406
The Utility of Time Segmental Withdrawal During Screening Colonoscopy for Increasing Adenoma Detection Rate.
26 oktober 2020 bijgewerkt door: Mohamed Othman, Baylor College of Medicine
The Utility of Time Segmental Withdrawal During Screening Colonoscopy for Increasing Adenoma Detection Rate. A Randomized Controlled Clinical Trial.
Colonoscopy( examining the colon with a flexible tube and a camera ) is usually done for screening purposes to find any precancerous lesions (polyps) at an early stage.
During the colonoscopy the doctor will advance the colonoscope to the end of your colon and start examining the colon for any polyps.
"Withdrawal time" is the period of time the doctor spends examining the colon.
Doctors usually spend six minutes examining the colon after they reach the end of the colon.
Studies have showed that spending more withdrawal time detects more lesions.
The proposal to dedicating half of the withdrawal time during colonoscopy in examining the right side will increase the detection of polyps in the right side of the colon.
There will be no other changes in the procedural aspect of the colonoscopy.
Studie Overzicht
Toestand
Beëindigd
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Screening colonoscopy is an essential diagnostic tool in the early detection of precancerous colonic lesions, preventing the progression of these lesions to cancer.
Population-based and case control studies found a 50% reduction in colo-rectal cancer (CRC) incidence and up to a one-third reduction in mortality from CRC after screening colonoscopy.
The effectiveness of colonoscopy in preventing colon cancer is dependent on the adenoma detection rate (ADR) during the procedure.
Studies have demonstrated that withdrawal times of 6 minutes or more had higher rates of detection of any neoplasia.
In 2006 joint task force of the American College of Gastroenterology and American Society for Gastrointestinal Endoscopy changed the recommendation to indicate that average withdrawal time should exceed 6 minutes in normal colonoscopies in which no polypectomies or biopsies were performed.
Based on this recommendation, the 6-minute benchmark is the current standard of care.
Longer mean withdrawal times are associated with increasing adenoma detection, mainly of small or right-sided adenomas and proximal serrated adenomas, presumably due to longer inspection of the right colon.
However, it also have been showed withdrawal time using 6 minutes as the threshold is not a strong predictor of the likelihood of finding a polyp during colonoscopy and should not be used as a quality indicator.
New CRC diagnosis within 3 years of negative screening colonoscopy can be as high as 6%.
Right-sided lesions, flat polyps, and variability in endoscopist quality measures are all potential reasons why interval cancers develop.
A recent observational study was published showing increase in ADR after implementation of a protocol of careful inspection during a minimum of 8 minutes was established.
The investigators hypothesized that if colonoscopists would spend at least half of the time of the withdrawal time in the right side of the colon (referred as segmented protocol), ADR can increase mainly due to the detection of lesions in the right side, which could have been missed otherwise.
The investigators are conducting a single center randomized trial investigating the utility of timed segmental withdrawal of at least 3 minutes each in both right and left side of the colon respectively, compared to the regular 6 minutes total withdrawal time regardless of where the time was spent in the colon.
Studietype
Observationeel
Inschrijving (Werkelijk)
232
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
-
-
Texas
-
Houston, Texas, Verenigde Staten, 77030
- Baylor College of Medicine
-
-
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar tot 80 jaar (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Bemonsteringsmethode
Kanssteekproef
Studie Bevolking
Study participants will be recruited from patients ages 18-80 scheduled for a screening colonoscopy at Baylor College of Medicine.
Informed consent will be obtained from the patients during their Gastroenterology clinic visit if the procedure scheduled by gastroenterologist or during their pre-procedure assessment appointment if they were referred by a primary care doctor.
Participation in the study will be voluntary.
We use the split prep protocol in preparation for colonoscopy in all patients undergoing colonoscopy in our unit.
Beschrijving
Inclusion Criteria:
- Adult patients (18-80 years) who are undergoing colonoscopy for screening or surveillance purposes.
Exclusion Criteria:
- Patients with a prior history of colonic surgeries
- Patient with Crohns colitis or ulcerative colitis
- Patient with prior history of colon cancer
- Patient with poor bowel preparation
- Pregnant women
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Observatiemodellen: Cohort
- Tijdsperspectieven: Prospectief
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
---|---|
non segmental withdrawal
A standard of care colonoscopy will be done on the patient without extra time on the right side of the colon.
|
|
Segmental withdrawal
A standard of care colonoscopy will be done on the patient , however the time spent in the right side of the colon will be more than half of the normal colonoscopy procedure (i.e. more than 3 minutes)
|
Interventional group will have at least 3 minutes dedicated to the right side of the colon during segmental withdrawal.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Increase in detection rate of adenomas in the right side of the colon
Tijdsspanne: 30 minutes
|
To determine if timed segmental withdrawal protocol can increase the adenoma detection rate in the right side of the colon compared to non segmental withdrawal.
|
30 minutes
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Sessile Serrated lesion detection rate
Tijdsspanne: 30 minutes
|
Compare sessile serrated lesion detection rate between patients undergoing a screening colonoscopy with segmental withdrawal protocol and non-segmental withdrawal protocol.
|
30 minutes
|
Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Onderzoekers
- Hoofdonderzoeker: Mohamed O. Othman, MD, Baylor College of Medicine
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start
1 augustus 2015
Primaire voltooiing (Verwacht)
1 juni 2020
Studie voltooiing (Werkelijk)
2 april 2020
Studieregistratiedata
Eerst ingediend
31 augustus 2015
Eerst ingediend dat voldeed aan de QC-criteria
1 september 2015
Eerst geplaatst (Schatting)
2 september 2015
Updates van studierecords
Laatste update geplaatst (Werkelijk)
28 oktober 2020
Laatste update ingediend die voldeed aan QC-criteria
26 oktober 2020
Laatst geverifieerd
1 oktober 2020
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- H-37320
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .
Klinische onderzoeken op Adenomateuze poliep van colon
-
Universitätsmedizin MannheimBeëindigdColo-colon anastomosen | Ileo-colon anastomosenDuitsland
-
University Hospitals Cleveland Medical CenterApollo Endosurgery, Inc.VoltooidColon Kwaadaardige Tumor | Colon Goedaardige tumorVerenigde Staten
-
Sahlgrenska University Hospital, SwedenWerving
-
IRCCS San RaffaeleOnbekendColon poliep | Colon laesieItalië
-
Uppsala UniversityVoltooid
-
Uppsala UniversityLandstinget i VärmlandVoltooid
-
Princess Alexandra Hospital, Brisbane, AustraliaWerving
-
Imperial College LondonVoltooidColon Ziekten | Colon poliep | Koloniale neoplasmata | Darmkanker | Colon Adenocarcinoom | Colon adenoom | Coloncarcinoom | Colon dysplasie | Colon hyperplastische poliepVerenigd Koninkrijk
-
Norwegian Department of Health and Social AffairsUniversity of Oslo; Oslo University Hospital; Beth Israel Deaconess Medical Center en andere medewerkersOnbekendColon poliep | Adenoom colon | Colon adenoom
-
Istituto Clinico HumanitasVoltooidColon Adenoom | Colon poliep | Colon laesieItalië
Klinische onderzoeken op Segmental withdrawal
-
Benjamin MedoffNational Institutes of Health (NIH); U.S. Army Medical Research and Development...Werving
-
Andrew D. Luster, M.D.,Ph.D.National Institute of Allergy and Infectious Diseases (NIAID)VoltooidAstma | AllergieënVerenigde Staten
-
Andrew D. Luster, M.D.,Ph.D.National Institute of Allergy and Infectious Diseases (NIAID)Voltooid