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Trial registered on ANZCTR
Registration number
ACTRN12620000518965
Ethics application status
Approved
Date submitted
18/02/2020
Date registered
27/04/2020
Date last updated
27/04/2020
Date data sharing statement initially provided
27/04/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
Feasibility of thin disposable endoscopes for screening and surveillance of gastro-oesophageal varices performed in outpatient liver clinic
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Scientific title
Feasibility of thin disposable endoscopes for screening and surveillance of gastro-oesophageal varices performed in outpatient liver clinic
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Secondary ID [1]
300585
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
This is a follow-up to study ACTRN12616001103459
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Health condition
Health condition(s) or problem(s) studied:
Gastro-oesophageal varices
316321
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Condition category
Condition code
Oral and Gastrointestinal
314588
314588
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients with liver cirrhosis who are scheduled to attend RAH Liver Clinic will be screened 4 weeks prior to their attendance. Patients who are due for their surveillance gastroscopy for gastro-esophagal varices will be identified by their treating physician and will be sent a signed letter of invitation. Patients who are interested in participating will be able to contact the researchers using an opt-in form and reply paid envelope. If no response is received following the initial letter, a single follow-up phone call will be made to confirm the patient’s decision for opt-in or opt-out. A follow-up phone call will be made 24-48 hours prior to the scheduled appointment to confirm whether the patient is agreeable to study participation. Subjects who agree to participate in the study will be asked to fast six hours prior to their attendance at the Outpatient department. Once the subjects are seen by the caring physician and the need for surveillance gastroscopy is confirmed, the subjects will be consented and un-sedated disposable ultra-thin gastroscopy will be performed in a dedicated room in the Liver clinic by an endoscopist.
Procedure: The duration of the procedure is approximately 5-10 minutes. All subjects will be asked to complete the visual analogue scale for pain and State-trait Anxiety Inventory (STAI Y-1) score prior to commencement of the unsedated gastroscopy, which will be performed under laryngeal/pharyngeal local anaesthesia with lignocaine gargle or spray (10 minutes prior). On endoscopic examination, the following will be documented:
1. Number and location of varices: upper, middle or lower oesophagus or stomach.
2. Size of varices: classified according to Baveno I consensus, small varices < 5mm, large varices >5mm. [13]
3. Presence of red colour signs / red wale signs
4. Tolerability: to be assessed by pain visual analogue scale and State-trait Anxiety Inventory (STAI Y-1) form
5. Adverse events (3-min vital signs will be recorded).
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Intervention code [1]
316891
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Early detection / Screening
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Intervention code [2]
317118
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Feasibility will be assessed by successful intubation of:
-the oesophagus
Assessed via audit of video recording.
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Assessment method [1]
322917
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Timepoint [1]
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Within 24 hours of procedure.
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Primary outcome [2]
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Feasibility will be assessed by successful intubation of:
-the duodenum
Assessed via audit of video recording.
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Assessment method [2]
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Timepoint [2]
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Within 24 hours of procedure.
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Secondary outcome [1]
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tolerability
Assessed via visual analogue scale for pain and State-trait Anxiety Inventory (STAI Y-1) score.
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Assessment method [1]
380239
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Timepoint [1]
380239
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Within 48 hours following procedure
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Secondary outcome [2]
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adverse events/complication - Adverse events related to possible gastroscope trauma
after the endoscopies, including sore throat, hematemesis, melena or blood passed per rectum, and abdominal pain.
Assessed via participant self-reported and checking medical records.
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Assessment method [2]
381226
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Timepoint [2]
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Within 48 hours following procedure.
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Eligibility
Key inclusion criteria
1. Male or female subject aged 18 – 90 years
2. Cirrhosis (of any aetiology) as documented by histology, or chronic liver disease with the presence of portal hypertension (eg. ascites, gastro-oesophageal varices) or complications of cirrhosis (eg. hepatic encephalopathy)
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Minimum age
18
Years
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Maximum age
90
Years
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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. Pregnant and/or breastfeeding mothers
2. As this a diagnostic study only, patients who will likely need endoscopic intervention including secondary prophylaxis with variceal banding are excluded
a. Presence of active gastrointestinal bleeding
b. History of recent variceal bleed within 7 days
3. Unable to give written informed consent
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Study design
Purpose of the study
Diagnosis
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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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
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Actual
23/04/2018
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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
24
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
305007
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Hospital
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Name [1]
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Royal Adelaide Hospital
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Address [1]
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Department of Gastroenterology
Royal Adelaide Hospital
Port Road Adelaide SA 5000
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Country [1]
305007
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Australia
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Primary sponsor type
Hospital
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Name
GI and Pancreatic Researchs Group, Royal Adelaide Hospital
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Address
Department of Gastroenterology
Royal Adelaide Hospital
Port Road Adelaide SA 5000
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Country
Australia
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Secondary sponsor category [1]
305364
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None
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Name [1]
305364
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Address [1]
305364
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Country [1]
305364
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305404
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Royal Adelaide Hospital Research Ethics Committee
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Ethics committee address [1]
305404
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CALHN Research Office RAH Clinical Trial Centre Level 3, Royal Adelaide Hospital Port Road ADELAIDE SA 5000
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Ethics committee country [1]
305404
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Australia
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Date submitted for ethics approval [1]
305404
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Approval date [1]
305404
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22/02/2018
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Ethics approval number [1]
305404
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Summary
Brief summary
Patients with liver cirrhosis are at risk of having varices (dilated vessels) in their oesophagus and stomach. These varices can bleed and bleeding is associated with serious complications. It is recommended that all patients have their oesophagus examined with an endoscopy (flexible telescope / camera) to detect these varices. Currently these endoscopies are performed in the Gastrointestinal Investigation Unit using sedation (medication to make you drowsy). The purpose of this study is to evaluate the feasibility of performing this procedure in the outpatient clinic, using a new endoscope. The newer scope is very thin, disposable and can be used in a consultation room. The thinness of the scope allows the examination to be performed without sedation, using only local anaesthesia with lignocaine gargle or spray. The scope has already been shown to be as effective in the detection of large varices as standard endoscopy; this study aims to assess the viability of its use in the outpatient setting.
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Trial website
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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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A/Prof Nam Q Nguyen
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Address
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Department of Gastroenterology
Royal Adelaide Hospital
Port Road Adelaide SA 5000
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Country
100262
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Australia
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Phone
100262
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+61 8 70742189
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Fax
100262
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Email
100262
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[email protected]
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Contact person for public queries
Name
100263
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Romina Safaeian
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Address
100263
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Department of Gastroenterology
Royal Adelaide Hospital
Port Road Adelaide SA 5000
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Country
100263
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Australia
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Phone
100263
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+61 8 70742189
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Fax
100263
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Email
100263
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[email protected]
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Contact person for scientific queries
Name
100264
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Romina Safaeian
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Address
100264
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Department of Gastroenterology
Royal Adelaide Hospital
Port Road Adelaide SA 5000
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Country
100264
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Australia
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Phone
100264
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+61 8 70742189
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Fax
100264
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Email
100264
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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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