Deep Vein Thrombosis Clinical Trial
Official title:
Point-of-care Ultrasound in Finland
Verified date | September 2021 |
Source | Kuopio University Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study has two aims. 1. Deep venous thrombosis (DVT) is a common suspected medical condition. If it cannot be excluded clinically and using D-dimer, ultrasound examination is required. An option for traditional radiologist-performed ultrasound is a 2-point compression ultrasound (2-CUS). The safety of this technique is proven. However there does not exist any data on costs comparing traditional and 2-CUS pathways in primary health care. This study will evaluate the total cost of both pathways by conducting a cost-minimization analysis. It will also study the effect of a simple ultrasound education on the referrals to hospital due to suspected DVT. Hypothesis 1: Short education in ultrasound will reduce significantly referrals to hospital and save resources. 2. Length of stay (LOS) in emergency department (ED) is related to increased mortality, morbidity, prolonged hospital stay and probably patient satisfaction. LOS of patients with a point-of-care ultrasound (POCUS) performed by an emergency physician (EP) will be compared to those that have a radiology performed ultrasound examination. Further examination and accuracy of POCUS will be noted. Hypothesis 2: POCUS can shorten LOS significantly in selected clinical conditions
Status | Completed |
Enrollment | 220 |
Est. completion date | December 31, 2019 |
Est. primary completion date | December 31, 2019 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Emergency department patient - A suspected medical condition, that can be confirmed or excluded by basic POCUS exam, including: free fluid in pleura, pericardium or intraperitoneal space, abdominal aorta aneurysm, gallbladder stones, urine retention, deep venous thrombosis in lower limb, pneumothorax, early pregnancy with non-specified location (confirming intrauterine pregnancy), hydronephrosis. - Emergency medicine specialist or resident decides to perform a POCUS exam Exclusion Criteria: - age under 18 - not able to give informed consent in Finnish |
Country | Name | City | State |
---|---|---|---|
Finland | Central Finland central hospital | Jyväskylä | |
Finland | Kuopio university hospital | Kuopio | |
Finland | Saarikka Primary Care Public Utility | Saarijärvi | |
Finland | Tampere university hospital | Tampere |
Lead Sponsor | Collaborator |
---|---|
Ossi Hannula | University of Eastern Finland |
Finland,
Alrajab S, Youssef AM, Akkus NI, Caldito G. Pleural ultrasonography versus chest radiography for the diagnosis of pneumothorax: review of the literature and meta-analysis. Crit Care. 2013 Sep 23;17(5):R208. doi: 10.1186/cc13016. Review. — View Citation
Bernstein SL, Aronsky D, Duseja R, Epstein S, Handel D, Hwang U, McCarthy M, John McConnell K, Pines JM, Rathlev N, Schafermeyer R, Zwemer F, Schull M, Asplin BR; Society for Academic Emergency Medicine, Emergency Department Crowding Task Force. The effect of emergency department crowding on clinically oriented outcomes. Acad Emerg Med. 2009 Jan;16(1):1-10. doi: 10.1111/j.1553-2712.2008.00295.x. Epub 2008 Nov 8. Review. — View Citation
Birdwell BG, Raskob GE, Whitsett TL, Durica SS, Comp PC, George JN, Tytle TL, McKee PA. The clinical validity of normal compression ultrasonography in outpatients suspected of having deep venous thrombosis. Ann Intern Med. 1998 Jan 1;128(1):1-7. — View Citation
Park YH, Jung RB, Lee YG, Hong CK, Ahn JH, Shin TY, Kim YS, Ha YR. Does the use of bedside ultrasonography reduce emergency department length of stay for patients with renal colic?: a pilot study. Clin Exp Emerg Med. 2016 Dec 30;3(4):197-203. doi: 10.15441/ceem.15.109. eCollection 2016 Dec. — View Citation
Ross M, Brown M, McLaughlin K, Atkinson P, Thompson J, Powelson S, Clark S, Lang E. Emergency physician-performed ultrasound to diagnose cholelithiasis: a systematic review. Acad Emerg Med. 2011 Mar;18(3):227-35. doi: 10.1111/j.1553-2712.2011.01012.x. Review. — View Citation
Rubano E, Mehta N, Caputo W, Paladino L, Sinert R. Systematic review: emergency department bedside ultrasonography for diagnosing suspected abdominal aortic aneurysm. Acad Emerg Med. 2013 Feb;20(2):128-38. doi: 10.1111/acem.12080. Review. — View Citation
Stein JC, Wang R, Adler N, Boscardin J, Jacoby VL, Won G, Goldstein R, Kohn MA. Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis. Ann Emerg Med. 2010 Dec;56(6):674-83. doi: 10.1016/j.annemergmed.2010.06.563. Epub 2010 Sep 15. — View Citation
Ten Cate-Hoek AJ, Toll DB, Büller HR, Hoes AW, Moons KG, Oudega R, Stoffers HE, van der Velde EF, van Weert HC, Prins MH, Joore MA. Cost-effectiveness of ruling out deep venous thrombosis in primary care versus care as usual. J Thromb Haemost. 2009 Dec;7(12):2042-9. doi: 10.1111/j.1538-7836.2009.03627.x. Epub 2009 Sep 28. — View Citation
Wilson SP, Connolly K, Lahham S, Subeh M, Fischetti C, Chiem A, Aspen A, Anderson C, Fox JC. Point-of-care ultrasound versus radiology department pelvic ultrasound on emergency department length of stay. World J Emerg Med. 2016;7(3):178-82. doi: 10.5847/wjem.j.1920-8642.2016.03.003. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Length of stay in emergency department | time between registration in emergency department and "finished from doctor" sign. | Duration of a single emergency department visit. Up to 48 hours. | |
Secondary | Need for follow-up radiologist performed imaging | If radiologist performed ultrasound exam is required, is it performed the same day, during same hospital day or later by appointment. Does the POCUS examination lead to other imaging modality while skipping radiologist performed ultrasound exam. | 6 months | |
Secondary | Accuracy of POCUS exam findings | POCUS findings are compared to any follow-up imaging by radiologist, surgery results or autopsy results when possible | 6 months |
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT05003843 -
BOLT: Study of the Indigo® Aspiration System When Used in Patients With Deep Vein Thrombosis
|
N/A | |
Recruiting |
NCT03937947 -
Traumatic Brain Injury Associated Radiological DVT Incidence and Significance Study
|
||
Withdrawn |
NCT04136561 -
Novel Strategy to Encourage Early Removal of Central Venous Catheters
|
N/A | |
Completed |
NCT03420625 -
Blood Flow Stimulation in the Lower Limbs by Application of Different External Devices
|
N/A | |
Recruiting |
NCT02507180 -
Safely Ruling Out Deep Vein Thrombosis in Pregnancy With the LEFt Clinical Decision Rule and D-Dimer
|
||
Completed |
NCT02555111 -
Xarelto Versus no Treatment for the Prevention of Recurrent Thrombosis in Patients With Chronic Portal Vein Thrombosis.
|
Phase 3 | |
Completed |
NCT01975090 -
The SENTRY Clinical Study
|
N/A | |
Terminated |
NCT02469376 -
Evaluation of a New Imagingtechnologie for Thrombosis
|
Phase 1 | |
Completed |
NCT02037607 -
Incidence of Venous Thromboembolism in Children Undergoing Elective Neurosurgical Procedures
|
N/A | |
Not yet recruiting |
NCT01357941 -
Need for Antepartum Thromboprophylaxis in Pregnant Women With One Prior Episode of Venous Thromboembolism (VTE)
|
N/A | |
Completed |
NCT00720915 -
D-dimer to Select Patients With First Unprovoked Venous Thromboembolism Who Can Have Anticoagulants Stopped at 3 Months
|
N/A | |
Completed |
NCT00773448 -
Screening for Occult Malignancy in Patients With Idiopathic Venous Thromboembolism
|
N/A | |
Completed |
NCT00771303 -
Ruling Out Pulmonary Embolism During Pregnancy:a Multicenter Outcome Study
|
||
Completed |
NCT00244725 -
Odiparcil For The Prevention Of Venous Thromboembolism
|
Phase 2 | |
Completed |
NCT00264277 -
D-dimer to Establish Duration of Anticoagulation After Venous Thromboembolism
|
Phase 4 | |
Completed |
NCT00365950 -
3 Months' Versus 6 Months' Anticoagulation in Patients With DVT and/or PE
|
Phase 4 | |
Completed |
NCT00182403 -
Fixed Dose Heparin Study
|
Phase 3 | |
Completed |
NCT03682419 -
Evaluation of Precision and Accuracy of INR Measurements in a Point of Care Device (OPTIMAL)
|
N/A | |
Not yet recruiting |
NCT04981327 -
The API-CALF Study: Apixaban to Treat Calf Vein Thrombosis
|
Phase 3 | |
Recruiting |
NCT03240120 -
A Study of Dabigatran Etexilate as Primary Treatment of Malignancy Associated Venous Thromboembolism
|
Phase 3 |