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Standard Medical Care or Urgent Chest X-ray in Diagnosing Lung Cancer in Smokers With Chest Symptoms Who Are Older Than 60 Years

23. august 2013 oppdatert av: Wales Cancer Trials Unit

A Pilot Clinical Trial Looking at the Effect on Lung Cancer Diagnosis of Giving a CXR to Smokers Aged Over 60 With Chest Symptoms

RATIONALE: Diagnostic procedures, such as an urgent chest x-ray, may help in planning cancer treatment. It is not yet known whether standard medical care is more effective than an urgent x-ray in diagnosing lung cancer in smokers with chest symptoms who are older than 60 years.

PURPOSE: This randomized clinical trial is studying standard medical care to see how well it works compared with an urgent chest x-ray in diagnosing lung cancer in smokers with chest symptoms who are older than 60 years.

Studieoversikt

Status

Ukjent

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

OBJECTIVES:

Primary

  • To determine the prevalence of extra-NICE symptoms in patients consulting in UK general practice.
  • To determine the proportion of patients who agree to participate in the trial.
  • To determine the proportion of patients who are diagnosed with lung cancer and the best sources of routine data for capturing lung cancers.

Secondary

  • To determine the best way to train general practitioners to identify and recruit eligible patients into the trial.
  • To determine the most effective method of presenting the trial (and randomization) to patients.
  • To determine the barriers to recruitment and how to overcome those barriers.
  • To determine the best tools to use to measure anxiety/depression that may be caused by unnecessary chest-x-rays or no chest x-rays.
  • To determine the best measures of resource use to facilitate health economic analysis of the cost-effectiveness of 'extra-NICE'.
  • To determine the stage at diagnosis, performance status, and the proportion of patients receiving radical treatments in those diagnosed with lung cancer.

OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.

  • Arm A: Patients are managed as per the National Institute for Health and Clinical Excellence (NICE) guidelines.
  • Arm B: Patients are referred for an urgent chest x-ray according to extra-NICE guidelines.

General practitioners from South East Wales are surveyed to assess their level of interest in the proposed full trial. For the feasibility study, 20 South East Wales general practices and 6 South Yorkshire general practices are selected. General practitioners are trained to recruit all patients who fulfill the extra-NICE criteria as well as those who do not.

Patients complete questionnaires (HADS, EQ-5D, and ICECAP[O]) at baseline and at 2 months to measure quality of life and health economic analysis of the cost-effectiveness of extra-NICE guidelines.

Peer Reviewed and Funded or Endorsed by Cancer Research UK.

Studietype

Intervensjonell

Registrering (Forventet)

386

Fase

  • Ikke aktuelt

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

60 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

DISEASE CHARACTERISTICS:

  • Patients over 60 seeing a participating General Practitioner

  • Currently smokes 10 or more pack years, meeting at least one of the following criteria:

    • New or altered cough of any duration reported to primary care
    • Increased breathlessness or wheezing (with or without purulent sputum)

  • Do not qualify for an urgent referral for a chest x-ray under the National Institute for Health and Clinical Excellence (NICE) guidelines (i.e., hemoptysis or unexplained or persistent [lasting > 3 weeks] signs or symptoms), including having any of the following:

    • Cough
    • Chest/shoulder pain
    • Dyspnea
    • Weight loss
    • Chest signs
    • Hoarseness
    • Finger clubbing
    • Features suggestive of metastasis from a lung cancer (e.g., in the brain, bone, liver, or skin)
    • Cervical/supraclavicular lymphadenopathy

PATIENT CHARACTERISTICS:

  • Not specified

PRIOR CONCURRENT THERAPY:

  • No chest x-ray within in past 3 months
  • No need for a chest x-ray within the next 3 weeks for reasons other than those listed under Disease Characteristics

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Diagnostisk
  • Tildeling: Randomisert
  • Masking: Ingen (Open Label)

Hva måler studien?

Primære resultatmål

Resultatmål
Prevalence of extra-NICE symptoms in patients consulting in UK general practice
Proportion of patients who agree to participate in the trial
Proportion of patients who are diagnosed with lung cancer and the best sources of routine data for capturing lung cancers

Sekundære resultatmål

Resultatmål
Best way to train general practitioners to identify and recruit eligible patients into the trial
Most effective method of presenting the trial (and randomization) to patients
Barriers to recruitment and how to overcome those barriers
Best tools to use to measure anxiety/depression that may be caused by unnecessary chest-x-rays or no chest x-rays
Best measures of resource use to facilitate health economic analysis of the cost-effectiveness of 'extra-NICE'
Stage at diagnosis, performance status, and the proportion of patients receiving radical treatments in those diagnosed with lung cancer
False-positive and false-negative rates for chest x-rays

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Wales Cancer Trials Unit

Etterforskere

  • Hovedetterforsker: Richard Neal, MD, North Wales Clinical School

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. juni 2011

Primær fullføring (Forventet)

1. juni 2013

Datoer for studieregistrering

Først innsendt

27. april 2011

Først innsendt som oppfylte QC-kriteriene

27. april 2011

Først lagt ut (Anslag)

28. april 2011

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

26. august 2013

Siste oppdatering sendt inn som oppfylte QC-kriteriene

23. august 2013

Sist bekreftet

1. april 2011

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CDR0000699222
  • WCTU-EL-CID
  • EU-21112
  • CRUK-C8350/A12199

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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