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Study on Von Willebrand Disease and Hemophilia in Cuenca, Ecuador (VWD)

2013年7月2日 更新者:Jaime M. Moreno A., M.D., M.S., F.A.C.P.、Universidad del Azuay
  1. Hypothesis

    a. There are patients with von Willebrand Disease in Cuenca.

  2. Primary question

    a. How many women referred with a history of bleeding may have von Willebrand disease?

  3. Secondary

    1. Associations between the bleeding score and initial laboratory studies
    2. What are the differences on subgroups of enrolled patients with the bleeding score?
  4. Ancillary

    1. What is the clinical and socio-economic status of women with von Willebrand Disease in Cuenca?
    2. What is the clinical and socio-economic status of patients with Hemophilia in Cuenca?

研究概览

详细说明

The incidence of hemophilia A is 1 in 10,000 and the one of hemophilia B is 1 in 30,000 live born males. As the most frequent coagulopathy in the world, von Willebrand disease (vWD) can affect 1 in 1000 children of both genders. The prevalence of vWD is 1-2% and it may be as high as 5-15% among women with menorrhagia. So vWD can be present in 1 of every 100 to 500 individuals.

A world survey published that Ecuador, with a population of 14,790,608 people, has 238 patients with hemophilia, 45 people with von Willebrand disease (vWD) and 13 patients with other bleeding disorders including rare factor deficiencies and platelet disorders.

The Ecuadorian census of 2010 indicates that Cuenca district (canton) has 505,585 inhabitants. According to a local reference, Cuenca has no reports of vWD and it has registered 20-40 patients with hemophilia A and B. However Cuenca may host approximately 10,000 people with vWD because it affects both males and females. One plausible explanation for this lag is that the diagnostic suspicions of vWD had not been proven because of the lack of a special coagulation laboratory in Cuenca that would allow professionals to make a positive diagnosis.

This is the first clinical, demographic and socio-economic study of patients registered with hemophilia and of Cuenca women with possible vWD who are referred from dentists and physicians from public and private health centers. The instruments will be validated surveys and screening coagulation studies.

As far as we know Ecuador has not published studies on coagulopathies. Our aim is to initiate a process to eventually reach the goal to offer adequate diagnostic and therapeutic interventions to human victims of these diseases, within a program of service, teaching and research.

研究类型

观察性的

注册 (实际的)

81

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Azuay
      • Cuenca、Azuay、厄瓜多尔、0001
        • UAzuay
      • Cuenca、Azuay、厄瓜多尔、0001
        • Universidad del Azuay (UDA)

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 至 50年 (成人)

接受健康志愿者

有资格学习的性别

女性

取样方法

非概率样本

研究人群

Target population: all women from Cuenca district with a hemorrhage history.

Accessible population: Those women referred from professionals with an initial hemorrhage history, who comply with the inclusion criteria and who sign the informed consert form.

Sample population: First comers referred with a hemorrhage history until fulfilling the projected sample size. This non-probabilistic purposive sample will be used because it has been reported that it could represent the target population.

*2010 Ecuadorian census: 131.163 women ages 18 to 50 years, at Cuenca district.

描述

Inclusion Criteria:

  • Subjects living at urban and rural parishes from Cuenca district.
  • Subjects referred from professionals of public and private health services, who have filled the initial hemorrhage survey.
  • Must be referred women who sign the informed consent form.
  • Patients who answer the standardized bleeding score questionnaire (BS).
  • Patients who answer the quality of life questionnaire (SF-12).
  • Patients who answer the socio-economic survey.
  • Patients who accept to provide a venous blood sample for the initial laboratory tests.

Exclusion Criteria:

  • Women with organic or hormonal bleeding etiologies.
  • Patients taking medicines which may affect the coagulation cascade or the number or function of platelets.
  • Those women who otherwise do not comply with the inclusion criteria.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

队列和干预

团体/队列
von Willebrand women
Referred women who may have von Willebrand Disease

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Bleeding Score (BS)
大体时间:1 week

As an adequate bleeding history is fundamental, the Condensed MCMDM-1 Bleeding Questionnaire will be used. Its bleeding score (BS) has a sensitivity of 100%, specificity 87%, positive predictive value 0.2 and negative predictive value 1.0. There was a signifficant difference of BS between the subtypes of vWD: with type 3 >>type 2 >>type 1 vWD (Anova P <0.001).

AS the BS is an index of ordinal values, medians and the Mann-Whitney non-parametric ranksum test will be used, to study the bleeding score (BS) differences among subgroups of enrolled women.

1 week

次要结果测量

结果测量
措施说明
大体时间
Associations among BS and female subgroup characteristics and initial laboratory tests.
大体时间:1 week

As bleeding may tend to associate in subjects, i.e. epistaxis and menorrhagia, a logistic (log-linear) model will be used. As bleeding can also ocur independently, symptoms will be coded for an adjusted covariate analysis.

To study the relationships among the BS and the quantitative laboratory results, the BS will be divided in quintiles, and an adjusted multiple regression model will be used. Likelihood ratios (LR) for values of BS, with a prevalence of 5% and ROC curves will be applied. According to Tosetto et.al. laboratory data will be expressed in categorical and quantitative scales.

1 week

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:Jaime M. Moreno A., M.D., M.S.、Universidad del Azuay (UAzuay)
  • 学习椅:Jacinto Guillen G., Eng., M.S.、Universidad del Azuay (UAzuay)
  • 研究主任:Rodrigo Cueva M., Econ., M.S.、Universidad del Azuay (UAzuay)

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2013年3月1日

初级完成 (实际的)

2013年6月1日

研究完成 (实际的)

2013年6月1日

研究注册日期

首次提交

2012年4月30日

首先提交符合 QC 标准的

2012年4月30日

首次发布 (估计)

2012年5月2日

研究记录更新

最后更新发布 (估计)

2013年7月3日

上次提交的符合 QC 标准的更新

2013年7月2日

最后验证

2013年7月1日

更多信息

与本研究相关的术语

关键字

其他研究编号

  • 001 (NavyGHB)
  • UAzuay (其他赠款/资助编号:Universidad del Azuay, Cuenca, Ecuador)

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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