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Trial registered on ANZCTR
Registration number
ACTRN12611001259932
Ethics application status
Approved
Date submitted
4/12/2011
Date registered
7/12/2011
Date last updated
9/03/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Evaluation of the Innovance Immunoturbidimetric D-Dimer Assay for the Diagnosis of Disseminated Intravascular Coagulopathy (DIC) in different clinical settings
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Scientific title
Evaluation of the Innovance Immunoturbidimetric D-Dimer Assay for the Diagnosis of Disseminated Intravascular Coagulopathy (DIC) in different clinical settings
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Secondary ID [1]
273530
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None
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Universal Trial Number (UTN)
NONE
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Trial acronym
DIC
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Disseminated Intravascular Coagulopathy (DIC)
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Condition category
Condition code
Blood
279516
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0
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Clotting disorders
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The study is aiming to evaluate the diagnostic performance of a new D-dimer immunoturbidimetric assay Innovance and compare it with the diagnostic score of the International Society on Thrombosis and Haemostasis (ISTH) for disseminated intravascular coagulation (DIC) in different clinical scenarios in patients who are suffering from infection/sepsis, malignancy or trauma/surgery cases with a consequence of a massive bleeding setting.
INNOVANCE D-dimer assay uses a monoclonal antibody (8D3) specific for epitopes contained on the crosslinked D-domains of fibrin derivatives. It measures the end fibrin degradtaion product and hence correlates to the degree of DIC.
The trial observation period is 6 months.
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Intervention code [1]
283843
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Not applicable
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Comparator / control treatment
Age and sex matched inpatients from medical and surgical wards for whom coagulation testing was ordered as a part of their routine care and who hadno suspected DIC were also analysed for the same parameters and served as control group in the same time period of the study.
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Control group
Historical
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Outcomes
Primary outcome [1]
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To evaluate the diagnostic performance of the new d-dimer immunoturbidimetric assay Innovance as a part of the diagnostic scoring system of the ISTH for DIC in different clinical scenarios that are associated with DIC.
Tools: Clinical criteria for DIC together with abnormal coagulation profile and other laboratory tests in line with the ISTH-scoring system of diagnosis of DIC. In addition to serial testing of D-Dimer value (Innovance).
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Assessment method [1]
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Timepoint [1]
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The data will be assessed by the end of study.
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Secondary outcome [1]
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Assess patients with suspected DIC who presented at the LGH with different clinical scenarios according to the underlying diseases e.g. Surgery, trauma, infection/sepsis and cancer in correlation with Innovance D-Dimer.
Tools: By using different cut-off values of Innovance D-Dimer in different clinical scenarios.
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Assessment method [1]
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Timepoint [1]
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The data will be assessed by the end of study.
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Eligibility
Key inclusion criteria
Patients with suspected DIC who presented at the LGH in the Oncology ward, ICU, Surgery and Emergency Departments were recruited for the trial. These patients had a clinical condition associated with DIC and were clinically suspected to have DIC together with abnormal coagulation profile and other laboratory tests in line with the ISTH-scoring system of diagnosis of DIC.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients without DIC according to the ISTH criteria.
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Case control
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Timing
Both
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
15/12/2008
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Actual
1/01/2010
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Date of last participant enrolment
Anticipated
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Actual
31/01/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
90
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Accrual to date
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Final
68
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Recruitment in Australia
Recruitment state(s)
TAS
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Launceston General Hospital
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Address [1]
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Address: Charles street
Launceston, Tasmania 7250
Country: Australia
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Country [1]
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Australia
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Funding source category [2]
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Charities/Societies/Foundations
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Name [2]
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Clifford Craig Medical Trust Fund
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Address [2]
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Level 5
Launceston General Hospital
Charles street
Launceston, Tasmania 7250
Australia
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Country [2]
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Australia
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Primary sponsor type
Hospital
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Name
Pathology Dept. Launceston General Hospital, Launceston, Tasmania, Australia
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Address
Pathology Department
Launceston General Hospital
Charles Street
Launceston
Tasmania 7250
Australia
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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School of Human Life Sciences, University of Tasmania
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Address [1]
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Charles street
Launceston, Tasmania 7250
Australia
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Tasmanian Human Research Ethics Committee
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Ethics committee address [1]
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University of Tasmania Private Bag 01 Hobart, Tas 7001 Australia
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
286283
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Approval date [1]
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15/12/2008
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Ethics approval number [1]
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H0010328
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Summary
Brief summary
Disseminated intravascular coagulation (DIC) remains a clinical challenge and a major cause of morbidity and mortality n different clinical situations. DIC is a clinical diagnosis supported by laboratory data but with no universally accepted diagnostic algorithm. However, the International Society on Thrombosis and Haemostasis (ISTH) recently proposed a DIC scoring system based on 4 laboratory parameters and the presence of a predisposing condition. Increase of a fibrin-related marker, such as D-dimer, represents a key element of the ISTH algorithm, which also scores elevations in the prothrombin time (PT) and reductions in the platelet count and fibrinogen concentration. A sensitive immunoturbidimetric D-dimer assay would probably provide an excellent sensitivity and negative predictive value for the diagnosis of DIC. The Innovance D-dimer assay is a new class of automated D-dimer test that is based on immunoturbidimetric techniques with a promising performance in terms of high sensitivity and specificity. Little is known about the performance of Innovance in the context of patient evaluation for suspected DIC in different clinical settings as proposed in this trial. Therefore, we are evaluating both the analytic and clinical performance of the Innovance (Dade Behring, Marbburg, Germany) immunoturbidimetric D-dimer assay in hospitalized patients not suspected of having DIC, and in patients who have had D-dimer assays ordered for suspected DIC. Because the measurement of D-dimer has not been harmonized among marketed assays, cutoff values for scoring D-dimer elevations in the ISTH algorithm (see table 1 and 2) need to be assay-specific. By using receiver operating characteristic (ROC) curve analysis, we will identify a prospective cutoff that maximizes sensitivity and specificity of the Innovance D-dimer assay. We are hoping by establishment of a cutoff value to compare the diagnostic performance of the Innovance D-dimer assay in the context of the ISTH scoring system. Furthermore, DIC is a serious complication of infection/sepsis, malignancy and in the acutely bleeding patient and it carries a considerable mortality rate, and once established it is difficult to reverse. Therefore it is crucial to establish a simple coagulation test like D-Dimer assay in order to predict the ocurrence of DIC.
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Trial website
None
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Trial related presentations / publications
Khalafallah A, Jarvis C, Morse M, Albarzan AM, Stewart P, Bates G, Hayes R, Robertson I, Seaton D, Brain T. Evaluation of the innovance d-dimer assay for the diagnosis of disseminated intravascular coagulopathy in different clinical settings. Clin Appl Thromb Hemost. 2014 Jan;20(1):91-7. doi: 10.1177/1076029612454936. Epub 2012 Aug 1. PMID: 22859588 http://www.ncbi.nlm.nih.gov/pubmed/22859588 http://cat.sagepub.com/content/20/1/91.full.pdf+html
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Public notes
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Contacts
Principal investigator
Name
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Prof Professor Alhossain Khalafallah
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Address
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Launceston General Hospital
Charles Street
TAS 7250
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Country
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Australia
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Phone
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+61367776777
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Alhossain A. Khalafallah
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Address
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Launceston General Hospital
Charles Street, Launceston, TAS 7250
Australia
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Country
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Australia
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Phone
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+61373487111
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Fax
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+61373487695
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Email
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[email protected]
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Contact person for scientific queries
Name
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Alhossain A. Khalafallah
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Address
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Launceston General Hospital
Charles Street, Launceston, TAS 7250
Australia
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Country
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Australia
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Phone
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+61373487111
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Fax
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+61373487695
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Evaluation of the Innovance d-Dimer Assay for the Diagnosis of Disseminated Intravascular Coagulopathy in Different Clinical Settings
2012
https://doi.org/10.1177/1076029612454936
N.B. These documents automatically identified may not have been verified by the study sponsor.
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