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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05682027
Other study ID # Diaphragm 001
Secondary ID
Status Completed
Phase
First received
Last updated
Start date September 5, 2023
Est. completion date March 21, 2024

Study information

Verified date June 2024
Source Isala
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The diaphragm is the main muscle for inspiration and vital for ventilation. Multiple diagnostic modalities can be performed in the work-up of suspected diaphragm dysfunction. Fluoroscopy has traditionally been the method of choice in diagnosing diaphragm paralysis and is still widely used in clinical practice, while alternative non-invasive and accessible methods have been available. Superiority of ultrasound over fluoroscopy for the diagnosis of diaphragm dysfunction has been suggested. The primary objective of this study is to investigate the construct validity of ultrasound in diaphragm paralysis.


Description:

To study the sensitivity of ultrasound in diaphragm dysfunction we propose a prospective, operator-blinded, two-center, observational study. Participants will be evaluated for diaphragm dysfunction with fluoroscopy and pulmonary function testing as in standard of care. Additionally, ultrasound will be performed. Construct validity The primary objective of this study is to investigate the construct validity of ultrasound in diaphragm paralysis. Validity is defined as the degree to which an instrument truly measure the construct(s) it purports to measure. In general, three different types of validity can be distinguished: content validity, criterion validity, and construct validity. Since evaluation with gold standard testing is invasive, as explained in the introduction, criterion validity testing not a feasible option. Therefore, in this study, we use construct validity to provide evidence of validity. Construct validity is defined as the degree to which the scores of an instrument (here: ultrasound) are consistent with scores of other instruments (here: pulmonary function tests, fluoroscopy). Construct validation is often considered less powerful, however, with strong theories and specific and challenging hypothesis, it is possible to acquire substantial evidence. Therefore, specific definitions of 'diaphragm paresis' and 'diaphragm paralysis' regarding diagnostic modalities are established in this protocol before the start of the study


Recruitment information / eligibility

Status Completed
Enrollment 36
Est. completion date March 21, 2024
Est. primary completion date March 21, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - 18 years or older - Suspicion of diaphragm dysfunction based on medical history and/or physical examination; as determined by the treating physician. Exclusion Criteria: - Inability for fluoroscopy (e.g. severely limited mobility, or unable to follow vocal instructions). - Inability for diaphragm imaging (e.g. mechanical ventilation, or unable to follow vocal instructions). - Those not able or unwilling to give written informed consent. - Pregnant women

Study Design


Related Conditions & MeSH terms


Intervention

Diagnostic Test:
ultrasound of the diaphragm
Parameters measured during ultrasound: Thickening fraction; End-expiratory thickness, and; Diaphragm excursion.

Locations

Country Name City State
Netherlands UCMG Groningen
Netherlands Isala Klinieken Zwolle Overijssel

Sponsors (1)

Lead Sponsor Collaborator
Isala

Country where clinical trial is conducted

Netherlands, 

Outcome

Type Measure Description Time frame Safety issue
Primary Concordance of diaphragm paralysis as determined by ultrasound compared with the construct for diaphragm paralysis based on traditional measurements Parameters:
Paralysis (ultrasound): Qualitative (visual): Paradoxal movement OR Quantitative: Diaphragm Excursion(DE) < 0cm (negative).
Paralysis (reference): (Physical examination suggestive of diaphragm dysfunction (i.e. paradoxal abdominal movement) OR Decrease in vital capacity of >15% when suspine) AND Paradoxal movement during fluoroscopy.
From referall till completion of diagnostic tests.
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