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Trial registered on ANZCTR
Registration number
ACTRN12623000705684
Ethics application status
Approved
Date submitted
5/06/2023
Date registered
30/06/2023
Date last updated
28/08/2024
Date data sharing statement initially provided
30/06/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Web-based cognitive rehabilitation intervention for cancer-related cognitive impairment in patients with lymphoma
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Scientific title
Web-based cognitive rehabilitation intervention for cancer-related cognitive impairment following chemotherapy for aggressive lymphoma: a randomised pilot trial.
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Secondary ID [1]
309829
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Nil Known
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Universal Trial Number (UTN)
N/A
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Trial acronym
N/A
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Linked study record
N/A
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Health condition
Health condition(s) or problem(s) studied:
lymphoma
330256
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Cancer related cognitive impairment
330257
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Condition category
Condition code
Cancer
327120
327120
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0
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Neurological
327121
327121
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
After the baseline assessment, participants will be randomised 1:1 to either the intervention or usual care. Randomisation will be performed using a computer-generated block allocation sequence and will be carried out by a member of the research team not involved in the assessment of participants.
Intervention group. Responding to Cognitive Concerns (eReCog) is a web-based cognitive rehabilitation program, based on the principles of cognitive behavioural therapy. The interactive program offers adult cancer survivors psychoeducation on cognitive dysfunction associated with cancer and cancer treatment, skills training for improving memory and attention, relaxation training, discussion questions and optional weekly homework tasks. Modules take approximately 30 to 60 minutes, and participants are expected to complete one module per week over four weeks.
Module topics are (1) aging, health, cancer and cognitive functioning, (2) memory, (3) attention, and (4) emotions, fatigue and cognition. Each module has a fixed number of pages, which participants progress through consecutively until reaching the end of the module. There is a tracking bar indicating the total number of pages in the module that allows participants to monitor their progress. Participants will be sent weekly reminder emails if a task is not completed. Online facilitation of the program will be carried out by a Research Assistant, who is not involved in the assessment of participants.
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Intervention code [1]
326263
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Rehabilitation
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Comparator / control treatment
Usual care: At baseline, participants in both study arms will receive a factsheet produced by Cancer Council ‘Understanding Changes in Thinking and Memory: A guide for people affected by cancer’. On completion of the study, participants assigned to usual care will be given a list of brain training websites they may wish to try.
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Control group
Active
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Outcomes
Primary outcome [1]
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This trial’s primary outcome is to determine the feasibility of recruitment and appraise reasons for ineligibility. This will be assessed as a composite outcome. This will be assessed via the project operation database
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Assessment method [1]
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Timepoint [1]
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Upon conclusion of the study
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Secondary outcome [1]
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Adherence to the eReCog intervention assessed using data collected from the backend server.
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Assessment method [1]
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Timepoint [1]
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Upon conclusion of study
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Secondary outcome [2]
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Usability of eReCog assessed via the mHealth App Usability Questionnaire patient reported outcome measure (PROM)
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Assessment method [2]
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Timepoint [2]
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Five to six weeks post-baseline (one to two weeks post-intervention for participants randomised to the intervention arm, T2).
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Secondary outcome [3]
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Compliance with study measures at follow-up assessed using data collected from the project operation database.
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Assessment method [3]
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Timepoint [3]
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Upon conclusion of the study
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Secondary outcome [4]
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Retention of participants at follow-up assessed using data collected from the project operation database.
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Assessment method [4]
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Timepoint [4]
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Upon completion of study
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Secondary outcome [5]
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Intrinsic motivation to perform the rehabilitation intervention assessed using the Intrinsic Motivation Inventory PROM.
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Assessment method [5]
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Timepoint [5]
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Five to six weeks post-baseline (one to two weeks post-intervention for participants randomised to the intervention arm, T2).
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Secondary outcome [6]
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Objective assessment of cognitive functioning will be assessed via the Stroop colour and word scale
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Assessment method [6]
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Timepoint [6]
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Baseline and five to six weeks weeks post-baseline (one to two weeks post-intervention for participants randomised to the intervention arm, T2).
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Secondary outcome [7]
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Objective assessment of cognitive functioning will be assessed via the Trail Making A & B scale
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Assessment method [7]
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Timepoint [7]
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Baseline and five to six weeks weeks post-baseline (one to two weeks post-intervention for participants randomised to the intervention arm, T2).
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Secondary outcome [8]
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Objective assessment of cognitive functioning will be assessed via the Hopkins Verbal Learning Test
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Assessment method [8]
423128
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Timepoint [8]
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Baseline and five to six weeks weeks post-baseline (one to two weeks post-intervention for participants randomised to the intervention arm, T2).
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Secondary outcome [9]
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Objective assessment of cognitive functioning will be assessed via the Controlled Oral Word Association Test
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Assessment method [9]
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Timepoint [9]
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Baseline and five to six weeks weeks post-baseline (one to two weeks post-intervention for participants randomised to the intervention arm, T2).
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Secondary outcome [10]
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Objective assessment of cognitive functioning will be assessed via the Digit Span scale
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Assessment method [10]
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Timepoint [10]
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Baseline and five to six weeks weeks post-baseline (one to two weeks post-intervention for participants randomised to the intervention arm, T2).
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Secondary outcome [11]
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Subjective assessment of cognitive functioning will be assessed via the PROMIS Cognitive Function-Short form 8a PROM
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Assessment method [11]
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Timepoint [11]
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Baseline and five to six weeks weeks post-baseline (one to two weeks post-intervention for participants randomised to the intervention arm, T2).
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Eligibility
Key inclusion criteria
• Aged 18 years of age or older
• Perceived reduction in cognitive functioning based on responses to a single-item Cognitive Change Score
• Completed chemotherapy for aggressive lymphoma within the past five years and are in remission.
• Have access to a laptop or desktop computer with internet.
• Have an active email account.
• Able to read and comprehend English instructions.
• Eastern Cooperative Oncology Group (ECOG) performance <2
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Minimum age
18
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
• Central nervous system (CNS) lymphoma
• Prior cranial radiotherapy
• Prior CAR T -cell therapy or allograft
• An expected life expectancy <12 months
• Medical conditions that compromise compliance or lead to prolonged hospitalisation
• Documented history of/or current substance abuse
• Concurrent poorly controlled psychiatric illness
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
After the baseline assessment, participants will be randomised 1:1 to either the intervention or usual care. Randomisation will be performed using a computer-generated block allocation sequence and will be carried out by a member of the research team not involved in the assessment of participants.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants will be randomised 1:1 to either the intervention or usual care. Randomisation will be performed using a computer-generated block allocation sequence and will be carried out by a member of the research team not involved in the assessment of participants.
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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
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Statistical analysis
Analysis will include all available data and be performed in R (reference index version 4.2.1 or higher). Neuropsychological tests and PROMs will be scored according to author guidelines. Values for missing tests and measures will not be imputed.
Missing data
Counts and percentages will be used to summarise missing data, including missing items and forms on neuropsychological tests and patient-reported outcome measures, at baseline and follow-up.
Sample characteristics
Descriptive statistics (counts and percentages, means and standard deviations, or medians and interquartile ranges, as appropriate) will be used to summarise demographic and clinical characteristics by study arm.
Feasibility outcomes
Recruitment data will be summarised using a rate and 95% confidence interval using the Poisson distribution. Adherence, retention, usability, intrinsic motivation, and compliance with study measures data will be summarised using a proportion and 95% confidence interval using the Wilson method.
Potential efficacy
Descriptive statistics (means and standard deviations) will be used to summarise test/(sub)scale scores at each assessment by study arm. Differences in (sub)scale scores at follow-up will be summarised using a mean and 95% confidence interval. If appropriate, analysis of covariance will be used to estimate differences between study arms adjusting for participants’ baseline scores.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
3/07/2023
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Actual
31/07/2023
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Date of last participant enrolment
Anticipated
1/07/2024
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Actual
12/06/2024
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Date of last data collection
Anticipated
2/12/2024
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Actual
9/08/2024
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Sample size
Target
38
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Accrual to date
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Final
38
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
24866
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment postcode(s) [1]
40514
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3000 - Melbourne
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Funding & Sponsors
Funding source category [1]
314014
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University
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Name [1]
314014
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Deakin University
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Address [1]
314014
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221 Burwood Highway
Burwood, 3125
Victoria
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Country [1]
314014
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Australia
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Primary sponsor type
Hospital
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Name
Peter MacCallum Cancer Centre
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Address
305 Grattan st
Melbourne 3000
Victoria
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Country
Australia
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Secondary sponsor category [1]
315904
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None
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Name [1]
315904
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Address [1]
315904
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Country [1]
315904
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
313151
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Peter MacCallum Cancer Centre Human Research Ethics Committee
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Ethics committee address [1]
313151
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305 Grattan St Melbourne 3000 Victoria
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Ethics committee country [1]
313151
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Australia
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Date submitted for ethics approval [1]
313151
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08/05/2023
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Approval date [1]
313151
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07/06/2023
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Ethics approval number [1]
313151
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Summary
Brief summary
This study is investigating the feasibility of a web-based cognitive rehabilitation program called Cognitive Concerns(eReCog) to address cancer-related cognitive impairment. Who is it for? You may be eligible for this study if you are an adult who has completed chemotherapy for aggressive lymphoma within the past five years and are in remission, and have perceived reductions in cognitive functioning. Study details Participants will be randomly assigned to either the intervention or control group. Those in the intervention group will receive access to an online program containing 4 modules on strategies to address cognitive dysfunction, which are estimated to take 30-60 minutes each. Those in the control group will receive a factsheet on cancer-related cognitive impairment and a list of suggested brain training websites. Participants will be asked to complete measures on the usability of the program and changes in their cognition. It is hoped that information from this study will inform a future, larger trial to test the effectiveness of a novel intervention to improve cognitive outcomes and quality of life in cancer patients following treatment.
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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 Michael Dickinson
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Address
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Peter MacCallum Cancer Centre
305 Grattan St
Melbourne 3000
Victoria
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Country
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Australia
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Phone
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+61417916969
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Fax
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Email
127170
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[email protected]
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Contact person for public queries
Name
127171
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Priscilla Gates
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Address
127171
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Peter MacCallum Cancer Centre
305 Grattan St
Melbourne 3000
Victoria
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Country
127171
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Australia
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Phone
127171
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+61417916969
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Fax
127171
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Email
127171
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[email protected]
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Contact person for scientific queries
Name
127172
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Priscilla Gates
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Address
127172
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Peter MacCallum Cancer Centre
305 Grattan St
Melbourne 3000
Victoria
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Country
127172
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Australia
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Phone
127172
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+61417916969
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Fax
127172
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Email
127172
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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)?
Yes
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What data in particular will be shared?
On completion of study, de-identified individual participant data of published results only will be will be made available upon request.
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When will data be available (start and end dates)?
Data collection will complete in December 2024. On completion of study and after publication of findings de-identified data will be made available upon request. No end date is determined.
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Available to whom?
De-identified data will be made available to researchers who provide a methodologically sound proposal on case-by-case basis at the discretion of Primary Investigator
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Available for what types of analyses?
Subject to approvals by Principal Investigator
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How or where can data be obtained?
Access subject to approvals by Principal Investigator/Study contact Priscilla Gates:
[email protected]
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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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