Hypercholesterolemia Clinical Trial
Official title:
Internet-Based Cholesterol Assessment Trial
The purpose of this trial is to find out if a special website might help people discover if
they have high cholesterol and then enable them to manage their cholesterol more
appropriately. The primary aim of this trial is to determine the effects on consumers' use
of cholesterol lowering therapy of an online service that provides automated, individually
tailored, advice about eligibility for cholesterol lowering treatment. The primary null
hypothesis being tested is that the service will result in no change in the use of
cholesterol lowering treatments by consumers that use the service.
The secondary aim of the trial is to see if it is possible to improve the cholesterol
management of the friends or relatives of consumers that use the I-CAT service. The
corresponding secondary null hypothesis being tested is that the I-CAT service will result
in no change in the use of cholesterol lowering treatments by the friends or relatives of
the consumers that use the service.
The Internet-based Cholesterol Assessment Trial (I-CAT) is a masked, randomised, controlled
trial that will include at least 3,700 consumers followed for between 8 and 16 weeks. All
consumers that participate in the study will ultimately be offered the I-CAT service, which
provides individually tailored information about the management of cholesterol-related risk
via an interactive website. However, by offering the service immediately to one group
(intervention) and delaying it by 8 weeks in the other group (control) it will be possible
to precisely and reliably determine the effects of the I-CAT service on consumers and their
use of cholesterol lowering interventions.
There will be two types of individuals involved in the study: 'index cases' and 'friends or
relatives' of the index cases. The index cases will be randomised to intervention or control
and will comprise the study participants on which the main outcome analyses will be based.
Friends and relatives of the index case will only be involved insomuch as they will be asked
to visit the site by the index case as part of the evaluation of the effectiveness of the
intervention.
Index cases will comprise mainly individuals already known to be at high risk of a
cholesterol-related disease event - for example individuals with established vascular
disease, individuals with multiple risk factors and individuals already using
cholesterol-lowering therapy. Index cases will be recruited using advertising materials
placed at a range of sites including hospital in patient services, hospital out patient
services, general practices, pharmacies, pathology services and the Internet.
All individuals that provide informed consent (index cases and friends or relatives) will be
asked to answer as many questions as possible from the XX questions in the baseline
questionnaire. The questionnaire will seek information about the individual's cardiovascular
disease history, their risk factors, their cholesterol levels, their use of any medications
or other strategies to reduce their cholesterol-related cardiovascular risk and any family
history of cardiovascular disease or high cholesterol levels.
Once baseline data collection is complete index cases will be randomised to either
intervention or control. Randomisation will be done automatically in real time by a central
computerised service. The intervention group will receive immediate feedback from the I-CAT
service. The control group will receive general information about cholesterol-related
disease risk derived from existing materials prepared by the National Heart Foundation of
Australia. Hyperlinks to a range of relevant websites will be provided.
In addition, after returning to the website at 8 weeks and providing follow-up information,
all control group participants will receive the same tailored feedback from the I-CAT
service as was given to the intervention group participants at randomisation. In this way,
all study participants will ultimately receive the same advice but by providing one group
with immediate advice and one group with delayed advice it will be possible to precisely and
reliably determine the value of the I-CAT service to consumers.
All primary analyses will be of comparisons between the index cases in the intervention
group and the index cases in the control group conducted according to the principle of
intention-to-treat. For each outcome the analyses will compare the proportions of index
cases reporting the outcome (or the mean values for each outcome) between randomised groups.
Comparisons of proportions will be done using Chi-square tests and comparisons between means
will be done using t-tests.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind
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