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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06303986
Other study ID # NAS-002
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date March 18, 2024
Est. completion date June 30, 2024

Study information

Verified date March 2024
Source Rekovar Inc.
Contact Neema Onbirbak, BS
Phone 9493741604
Email neema.onbirbak@rekovar.com
Is FDA regulated No
Health authority
Study type Observational [Patient Registry]

Clinical Trial Summary

Substance abuse during pregnancy is on the rise through both prescribed and illicit use of controlled substances, which has increased neonatal abstinence syndrome (NAS). The prevalence of opioid use during pregnancy has increased by 333% from 2013 to 2014 and continues to rise. Approximately 1 in 3 women were prescribed opioids during pregnancy from 2008 to 2012. In the US, NAS was diagnosed every 25 minutes in 2014. By 2019, it became every 15 minutes. Although there are medication-based interventions for the treatment of NAS, used in up to 80% of opioid-exposed infants, these treatments carry risks of toxicity and drug interactions. Despite the steep medical costs and the risks of treatment, current tools to assess the severity of NAS are subjective and suffer from examiner bias, resulting in poorer clinical outcomes, such as longer lengths of stay in the Neonatal Intensive Care Unit (NICU), for these babies. Studies have shown that continuous vital sign monitoring improves outcomes and decreases the length of stay in general practice. Preliminary machine learning models have been able to predict pharmacological treatment for Neonatal Opioid Withdrawal Syndrome (NOWS). This project will collect physiological and behavioral data of NAS patients to develop an AI algorithm and establish the advantages of continuous monitoring in NAS. The AI algorithm, processed by machine learning, will help predict NAS symptoms, automate scoring, and provide healthcare personnel with predictive analytics to guide suggested treatments.


Description:

The current diagnostic and assessment framework for NAS heavily relies on subjective methods, primarily the Finnegan Neonatal Abstinence Score (FNAS). FNAS helps providers evaluate pharmacological and non-pharmacological treatments and monitor the progress of infants with NAS. The Eat Sleep Console (ESC) approach has been implemented in some hospitals to emphasize non-pharmacological interventions as the primary method of managing and treating NAS. Despite the high prevalence of NAS and the significant resources allocated to its management, the healthcare system continues to grapple with an unmet clinical need for standardized diagnostic and treatment protocols. The reliance on subjective assessments contributes to this challenge, as FNASS and ESC introduce variability in care that can affect outcomes. Developing objective, reliable tools for assessing NAS severity and guiding treatment decisions remains a critical need in neonatal care, promising to enhance the efficiency and effectiveness of interventions for these vulnerable patients. Recent studies have underscored the lack of consistency in diagnosing and treating NAS, revealing a broad spectrum of practices across different pediatric healthcare settings. This problematic inconsistency leads to varied patient outcomes and a lack of clarity on best practices. This multicenter study will collect data that will be used to develop an AI-based tool that can automate scoring with predictive analytics. Additionally, the investigators aim to establish the advantages of continuous monitoring in NAS that should lead to decreased length of stay in the NICU and improved patient outcomes.


Recruitment information / eligibility

Status Recruiting
Enrollment 60
Est. completion date June 30, 2024
Est. primary completion date June 30, 2024
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group N/A to 4 Weeks
Eligibility Inclusion Criteria: - The subject selection criteria per site will be 80% term neonates affected by neonatal abstinence syndrome (NAS) and 20% term neonates without any health complications. - The eligible screening process for the NAS neonates in the study will include neonates affected by NAS, newborn infants diagnosed with NAS, infants with confirmed history of prenatal exposure to opioids or other drugs that can cause NAS, and infants who meet specific diagnostic criteria for NAS based on standardized clinical assessments. - The eligible screening process for neonates without any health complications include newborn infants without any known health complications or medical conditions, infants with a normal physical examination and absence of clinical signs or symptoms suggestive of NAS or other health issues. - Given the simple nature of the study, wards of the courts will also be enrolled upon evaluating the appropriateness, identifying an advocate if required, and providing an approved consent for the ward subject. Exclusion Criteria: - The investigators are NOT purposefully excluding or including any gender or race in our studies.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Neomonki
The Neomonki is a monitoring kit for hospital use in neonates with Neonatal Abstinence Syndrome (NAS).

Locations

Country Name City State
United States University of New Mexico Albuquerque New Mexico
United States John Hopkins University Baltimore Maryland

Sponsors (5)

Lead Sponsor Collaborator
Rekovar Inc. Children's Hospital Los Angeles, Children's Hospital of Orange County, Johns Hopkins University, University of New Mexico

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Training/validation data collection Physiological data collected to be used for training and validation of AI model development in-house to help monitor and treat NAS. 1.5 years
Secondary Continuous Monitoring This endpoint will be used to compare the validity of the scoring data collected continuously from the device to intermittent scoring from healthcare providers. 1.5 years
See also
  Status Clinical Trial Phase
Completed NCT01965704 - Can Ondansetron Prevent Neonatal Abstinence Syndrome (NAS) in Babies Born to Narcotic-dependent Women Phase 2
Completed NCT03890562 - Assessing the Effects of Auricular Acupressure on Newborns With NAS N/A
Completed NCT01958476 - Improving Outcomes in Neonatal Abstinence Syndrome Phase 3
Active, not recruiting NCT01734551 - NAS Treatment - Opiate Versus Non-Opiate Phase 4
Completed NCT00496951 - Vagal Tone and Neonatal Abstinence Syndrome N/A
Completed NCT02851303 - Morphine Versus Methadone for Opiate Exposed Infants With Neonatal Abstinence Syndrome Phase 4
Recruiting NCT05226624 - The Alberta Neonatal Abstinence Syndrome Mother-Baby Care ImprovEmeNT Program N/A
Completed NCT03670160 - Clonidine Versus Phenobarbital as Adjunctive Therapy for Neonatal Abstinence Syndrome Phase 2
Not yet recruiting NCT04611659 - Averting NAS Among Opioid-Using Young Women Receiving MAT Using Buprenorphine N/A
Completed NCT01452789 - Blinded Trial of Buprenorphine or Morphine in the Treatment of the Neonatal Abstinence Syndrome Phase 3
Completed NCT04588519 - tAN to Mitigate Withdrawal Behaviors in Neonates N/A
Completed NCT02797990 - Conflict Between Maternal Autonomy and Child Health in Substance-use N/A
Completed NCT02801331 - Efficacy and Outcomes of a Non-Pharmacological Intervention for Neonatal Abstinence Syndrome N/A
Terminated NCT03246243 - Quantitative Assessment of Sucking for Early Diagnosis of Brain Injury in Infants at High Risk
Completed NCT03567603 - Sound Processing Changes in Babies With Opioid Exposure
Active, not recruiting NCT03725332 - The PATH Home Trial: A Comparative Effectiveness Study of Peripartum Opioid Use Disorder in Rural Kentucky N/A
Recruiting NCT04983563 - Actigraphy and Neonatal Abstinence Syndrome of Hospitalized Newborn in Intensive Care Units N/A
Completed NCT04298853 - Optimal Morphine Dosing Schedule for Neonatal Abstinence Syndrome Phase 4
Completed NCT02182973 - Donor Human Milk in Neonatal Abstinence Syndrome
Completed NCT02810782 - How to Treat Opiate Withdrawal in Neonates Phase 3

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