Hb Scope: A Multi-Center Validation Trial

Hemodialysis Clinical Trial

Official title:

Hb Scope: A Multi-Center Validation Trial

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05852184
• Other study ID #: T-CMUH-29745
• Status: Recruiting
• Start date: July 1, 2023
• Est. completion date: April 30, 2024

Study information

• Verified date: March 2024
• Source: China Medical University Hospital
• Contact: Chin-Chi Kuo, MD, PhD
• Phone: +886422052121
• Email: fenderkuo[@]gmail.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The global prevalence of end-stage renal disease (ESRD) was estimated ranging 5.3 to 9.7 million patients in 2017 and is a major healthcare cost driver in both developed and developing economies. The majority of patients with ESRD, approximately 90%, received in-center maintenance hemodialysis (HD). Although HD patients are under the close supervision of a nephrologist, they are vulnerable to anemia and substantial hemoglobin (Hb) variability, which are controversially associated with poor clinical outcomes, such as all-cause mortality. The contemporary narrow target hemoglobin level recommended in the KDIGO and KDOQI guidelines, despite the ongoing debates, poses a crucial challenge in maintaining the optimal hemoglobin level in HD patients.

The Big Data Center at China Medical University Hospital (CMUH) has developed a tool, Hb Scope APP, that can use the color of the HD tubing to predict real-time Hb levels by leveraging the smartphone's camera capacity and machine learning (ML) technology. The performance of the Hb Scope ML algorithm in predicting Hb > 10 g/dL can reach an accuracy of 0.93 and an AUROC of 0.99 in the testing dataset. This opens an opportunity to establish a vibrant digital ecosystem for automatic anemia management.

Innovative ML tools must be appropriately regulated before these algorithms are adopted into clinical practice. Therefore, in the current validation study, we propose to do a multicenter validation trial for validating whether the Hb predicted by Hb Scope APP can achieve an area under the receiver operating curve (AUROC) of at least 0.80 in the adult HD populations from CMUH, Asia University Hospital (AUH) in Taiwan, and SEHA Kidney Care (SKC)-Central in the United Arab Emirates.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 504
• Est. completion date: April 30, 2024
• Est. primary completion date: January 31, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 20 Years to 90 Years

Eligibility

Inclusion Criteria:

• Patients receiving regular maintenance HD in the three participating sites; AND

• Aged 20-90 years old; AND

• Received regular HD through an arteriovenous (AV) fistula or AV graft access; AND

• Use the Fresenius HD machine 4008/4008S and 5008/5008S.

Exclusion Criteria:

• Do not have last Hb level from labs within 1 month prior; OR

• Do not receive blood drawn for the true Hb level or do not have the true Hb level on the date of image taking by Hb Scope APP; OR

• Do not agree to participate.

Related Conditions & MeSH terms

• Hemodialysis
• Hemoglobin

Intervention

Other:
• Hb Scope APP
The study intervention is the Hb Scope APP, a camera-based real-time Hb estimation tool using a data collection function and a machine learning-based algorithm to analyze the image of HD tubing and output the estimated Hb value. Our proposed Hb Scope APP can provide a non-invasive and real-time estimation of Hb level for detecting the alarming Hb status (i.e., <=10 g/dL) during every HD session. The software is for information management purposes only and is not intended for diagnostic use.

Locations

Country	Name	City	State
Taiwan	Asia University Hospital	Taichung
Taiwan	China Medical University Hospital	Taichung
United Arab Emirates	SHEA Kidney Care	Abu Dhabi

Sponsors (4)

Lead Sponsor	Collaborator
China Medical University Hospital	Asia University Hospital, National Science and Technology Council, SEHA Kidney Care

Countries where clinical trial is conducted

Taiwan,  United Arab Emirates, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Agreement between the lab-derived and the Hb Scope-derived Hb level at the dichotomous cutoff of > 10 g/dL.	The targeted area under the receiver operating curve (AUROC) is 0.80.	2 months
Secondary	Agreement between the lab-derived and the Hb Scope-derived Hb level at the dichotomous cutoff of < 8 g/dL.	The targeted area under the receiver operating curve (AUROC) is 0.80.	2 months
Secondary	Agreement between the lab-derived and the Hb Scope-derived Hb level at the dichotomous cutoff of > 12 g/dL.	The targeted area under the receiver operating curve (AUROC) is 0.80.	2 months
Secondary	Consistency between the lab-derived and Hb Scope-derived Hb continuous value.	The targeted correlation coefficient is 0.70.	2 months