Cancer Clinical Trial
Official title:
Post Market Evaluation of Aer-O-Scope Visualization
This will be a prospective multi-center, multi-national comparative non-blinded clinical investigation. Each subject will undergo back-to-back tandem colonoscopies with the Aer-O-Scope Colonoscope System and a conventional colonoscope since this is a tandem colonoscopy study, each subject will serve as their own control. The 1st procedure will be randomized, half to Aer-O-Scope Colonoscope System and half to conventional colonoscope. The same investigator will perform both procedures on each subject. All pathologies found will be either removed or tattooed. Unmarked pathologies found on second pass will represent those missed during the 1st pass, thus making the subject and the control one and the same. Tattooed pathologies that can be removed endoscopically will be removed in an additional colonoscopy. This may occur if a large polyp cannot be removed for any reason with the Aer-O-Scope, but can be removed with conventional colonoscopy.
Subjects will be randomized in blocks of twenty (20) for either Aer-O-Scope or conventional
colonoscopy as the first procedure. Physicians will be notified of the procedural order
immediately prior to first colonoscopy. Up to the first ten (10) cases for each physician
(system operation training cases) will all begin with the Aer-O-Scope colonoscopy as the
first procedure.
The primary endpoint of AMR was chosen as this measure appears to be related to the
performance of colonoscopy and reduction in colorectal cancer incidence. During the course of
the last decade, several major visualizations studies have been performed and it has become
common practice to use the "second-pass" method for measuring colonoscopy visualization
methods, iii, iv. In the "second-pass" method, during the course of the first colonoscopy,
all visualized lesions are removed (or tattooed in the event that they cannot be removed for
any reason.). Any unmarked abnormalities discovered during the second pass colonoscopy are
considered to be missed pathologies for the first pass colonoscopy.
All endpoints related to timing will be measured using a stopwatch and overall time stamp
from the Aer-O-Scope or conventional colonoscope. Time to perform therapeutic interventions
with Aer-O-Scope as well as a description of said interventions will also be recorded. The
same instruments will be used to measure all procedures and will be calibrated as dictated by
the manufacturer.
All equipment used during the course of this clinical investigation will undergo calibration
and testing as per the manufacturing instructions. The Aer-O-Scope Colonoscope System has an
automated calibration system and diagnostic test that run daily. Conventional colonoscopes
will be maintained as per hospital/manufacturer protocol.
Recruited subjects who are withdrawn as a result of poor bowel prep or any other medical
determination leading to the inability to undergo colonoscopy and/or tandem colonoscopy will
be replaced. A poor prep is defined as having a score of score of 0 or 1 in the Boston Bowel
Preparation Scale (BBPS). The BBPS scores are as follows:
0 = Unprepared colon segment with mucosa not seen due to solid stool that cannot be cleared.
1. = Portion of mucosa of the colon segment seen, but other areas of the colon segment not
well seen due to staining, residual stool and/or opaque liquid.
2. = Minor amount of residual staining, small fragments of stool and/or opaque liquid, but
mucosa of colon segment seen well.
3. = Entire mucosa of colon segment seen well with no residual staining, small fragments of
stool or opaque liquid.
Any subject withdrawn as a result of physician discretion due to concomitant medical issues
will be withdrawn prior to the actual colonoscopic procedures. Patients with a large polyp
(>20mm) removed during the first pass with a conventional colonoscope will be withdrawn.
Patients who receive treatment during the first pass with clips (no other option available)
will be withdrawn.
Coagulation therapy should be performed either with Argon Plasma Coagulation (APC) or another
cautery tool or contact thermal device as per clinical protocol. For the purpose of this
clinical investigation, clips should not be used unless there is no alternative. Patients
treated with clips prior to their final pass colonoscopy, will be withdrawn from the
investigation.
Physicians may also withdraw any patient due to medical causes if deemed appropriate,
including patients that have undergone at least one (1) procedure.
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