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Trial registered on ANZCTR
Registration number
ACTRN12611001261909
Ethics application status
Approved
Date submitted
30/11/2011
Date registered
8/12/2011
Date last updated
8/12/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Stochastic Targeted Glycemic Control in the Intensive Care Unit Pilot Trials
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Scientific title
Insulin and Nutrition Dosing Using a Stochastic Targeting Model-Based System for Improved Control of Blood Glucose Levels in Intensive Care Patients
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Secondary ID [1]
273485
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Stress-induced Hyperglycaemia
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Condition category
Condition code
Metabolic and Endocrine
279541
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0
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Other metabolic disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
STAR is a system that uses an algorithm and computer model to provide equivalent or tighter control of glucose levels. Target glycemic levels will be chosen by the clinical staff dependent on patient characteristics, the most common target range is 4.4-8.0 mmol/L. The algorithm will determine all insulin doses and enteral nutrition given to achieve that target with safety from hypoglycemia. STAR clinical trials will run until 30 June 2012 and will occur whenever there is an eligible patient in the ICU from whom consent has been obtained.
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Intervention code [1]
283803
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Treatment: Other
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Comparator / control treatment
Retrospective data (of blood glucose, insulin and nutrition) from SPRINT (the current tight glycaemic control protocol in use in Christchurch hospital). The data was gathered from August 2005-May 2007.
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Control group
Historical
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Outcomes
Primary outcome [1]
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Time in target glycaemic control bands (e.g. 4 to 7 mmol/L)
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Assessment method [1]
286041
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Timepoint [1]
286041
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As a percentage of total time on STAR for each patient throughout their time on STAR. Blood glucose (BG) measurements are taken 1-3 hourly.
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Primary outcome [2]
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Numbers of patients who experience hypoglycaemia (BG < 2.2 mmol/L) and numbers or percentage of measurements lower than 4.0 mmol/L.
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Assessment method [2]
286042
0
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Timepoint [2]
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Data taken from each patients time on STAR. Blood glucose (BG) measurements are taken 1-3 hourly.
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Secondary outcome [1]
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Measures of glycaemic variability (standard deviation, variation over time)
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Assessment method [1]
295030
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Timepoint [1]
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Blood glucose (BG) measurements are taken 1-3 hourly for each patient.
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Eligibility
Key inclusion criteria
1 In-patient in Intensive Care.
2 Blood glucose >8 mmol/L, same as with SPRINT.
3 In-situ arterial line.
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1 Moribund or not expected to survive >72 hours
2 No arterial line present
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
All patients will be in-patients in intensive care and will be identified by investigators according to the entry criteria. The intensive care clinicians will approach the patient or if the patient cannot consent him/herself a family/whanau/representative will be approached. All contact will be made within the Department of Intensive Care.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
N/A
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
11/01/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Christchurch
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Canterbury Dept of Mechanical Engineering
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Address [1]
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Dept of Mechanical Engineering
University of Canterbury
Private Bag 4800
Christchurch
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Country [1]
284277
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Geoffrey M Shaw
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Address
Department of Intensive Care Medicine
Christchurch Hospital
2 Riccarton Avenue
Private Bag 4710, Christchurch
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Country
New Zealand
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Secondary sponsor category [1]
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Individual
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Name [1]
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Prof. J. Geoffrey Chase
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Address [1]
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Dept of Mechanical Engineering
University of Canterbury
Private Bag 4800
Christchurch
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Country [1]
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New Zealand
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Secondary sponsor category [2]
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Individual
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Name [2]
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Dr Aaron Le Compte
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Address [2]
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Dept of Mechanical Engineering
University of Canterbury
Private Bag 4800
Christchurch
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Country [2]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Upper South A Regional Ethics Committee
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Ethics committee address [1]
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c/- Ministry of Health Montgomery Watson Building 6 Hazeldean Rd Christchurch 8023
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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07/10/2010
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Ethics approval number [1]
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URA/10/09/069
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Summary
Brief summary
Critically ill patients often experience stress-induced hyperglycaemia (high blood sugar levels) and insulin resistance, resulting in increased infection, cardiac events and death. The Christchurch ICU currently controls glucose levels using a system called SPRINT, a paper-based protocol that has provided world leading control and reduced mortality 25-40% in patients who stay 3 days or longer in the ICU. It has also reduced costs by over $1000 per patient treated. However, SPRINT does not allow clinicians to make changes or provide more patient-specific care, when necessary. STAR is a system that uses an algorithm and computer model to provide equivalent or tighter control of glucose levels with greater clinical flexibility and less nursing effort through reduced need for measurements or/and intervention. It also improves safety from low glucose levels (hypoglycaemia) using a statistical model to provide a guaranteed risk of hypoglycemia of 0.1%. STAR pilot trials will be supervised by medical personnel and run for as long as a patient requires glycemic control during their ICU stay. Target glycemic levels will be chosen by the clinical staff. The algorithm will determine all insulin doses and enteral nutrition given to achieve that target with guaranteed safety from hypoglycemia.
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Trial website
N/A
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr. Geoffrey M Shaw
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Address
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Department of Intensive Care Medicine
Christchurch Hospital
2 Riccarton Avenue
Private Bag 4710, Christchurch
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Country
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New Zealand
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Phone
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+64 3 364 1077
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Fax
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+64 3 364 0099
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Geoffrey M Shaw
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Address
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Department of Intensive Care Medicine
Christchurch Hospital
2 Riccarton Avenue
Private Bag 4710, Christchurch
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Country
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New Zealand
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Phone
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+64 3 364 1077
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Fax
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+64 3 364 0099
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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