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Trial registered on ANZCTR
Registration number
ACTRN12614000018617
Ethics application status
Approved
Date submitted
29/12/2013
Date registered
7/01/2014
Date last updated
7/01/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
A randomised controlled study evaluating the use of water during a colonoscopy in patients to facilitate the performance of the colonoscopic procedure
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Scientific title
A randomised controlled study evaluating the use of water during a colonoscopy in patients to facilitate the performance of the colonoscopic procedure
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Secondary ID [1]
283814
0
nil known
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Universal Trial Number (UTN)
U1111-1151-5922
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Screening intervention for colorectal cancer prevention.
290793
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Investigation for patients with lower gastrointestinal symptoms such as rectal bleeding, altered bowel habit and abdominal pain
290794
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Condition category
Condition code
Oral and Gastrointestinal
291161
291161
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Cancer
291203
291203
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0
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Bowel - Back passage (rectum) or large bowel (colon)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The use of room temperature water as an adjunctive method for distension of colon lumen during colonoscopy. Approximately 300ml of sterile water will be instilled into the colon during the colonoscopy procedure. The addition of water will take approximately 2-3 minutes to the overall time of the procedure. Additional gas insufflation (the normal standard of care) will also be used in addition to the water to achieve adequate colon distension to facilitate the procedure.
Patients will be randomised to either the water assisted group or the standard of care. patients will be blinded to which arm they have been allocated to, but the operator will be unblinded. Standard parameters will be monitored and recorded during the procedure in both arms to assess the effect/difference between the two groups
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Intervention code [1]
288505
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Treatment: Surgery
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Comparator / control treatment
Standard method of air/gas insufflation during the colonoscopy procedure
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Control group
Active
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Outcomes
Primary outcome [1]
291150
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Time to caecal intubation
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Assessment method [1]
291150
0
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Timepoint [1]
291150
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When the caecal pole is reached
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Primary outcome [2]
291151
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Patient analgesic scores. Pain will be assessed by using a visual analog scale of 1-10 (Wong-Baker Faces Pain rating scale)
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Assessment method [2]
291151
0
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Timepoint [2]
291151
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At conclusion of procedure and if further analgesia is requested by the patient during the procedure.
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Primary outcome [3]
291193
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Sedation requirements. The required quantity of midazolam and fentanyl will be collated and recorded at the conclusion of the procedure. Any extra analgesia during the course of the procedure will be noted in addition to the induction analgesia.
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Assessment method [3]
291193
0
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Timepoint [3]
291193
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At conclusion of the procedure
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Secondary outcome [1]
306147
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Patient satisfaction scores. A 7 point Likert scale is used ( 1- very unsatisfied, 7 - very satisfied) to assess this outcome.
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Assessment method [1]
306147
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Timepoint [1]
306147
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At conclusion of procedure/ in recovery
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Secondary outcome [2]
306212
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Polyp detection. This outcome will be assessed by the documentation and removal of the polyp during the procedure. If retrieved, the polyp will be sent to pathology for histological analysis - this will also be noted and amended to the database once received (usually at day 5-7)
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Assessment method [2]
306212
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Timepoint [2]
306212
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At conclusion of procedure
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Eligibility
Key inclusion criteria
Age over 18 years of age.
Appropriate clinical indication for a colonoscopy
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Minimum age
18
Years
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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
Previous colonic surgery
Haemodynamic instability
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised sequence generation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Noninferiority study design.
Anticipate that water assisted colonoscopy will allow a 25% improvement in caecal intubation time (6 minutes compared to the standard accepted 8 minutes).
Allowing for an 80% power and a significance of 5%, this will require 251 patients in each arm.
Intention to treat analysis. It is assumed that both groups will follow a normal distribution. Categorical outcomes will be assessed with chi-square tests and continuous data will be analysed through t-tests.
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
9/07/2012
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Actual
8/08/2012
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Date of last participant enrolment
Anticipated
28/03/2014
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
410
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5704
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Canada
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State/province [1]
5704
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Ontario
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Funding & Sponsors
Funding source category [1]
288481
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Hospital
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Name [1]
288481
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Division of Gastroenterology, St Michael's Hospital
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Address [1]
288481
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St. Michael's Hospital
30 Bond Street
Toronto, Ontario
M5B 1W8, Canada
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Country [1]
288481
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Canada
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Primary sponsor type
Hospital
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Name
Division of Gastroenterology, St Michael's Hospital
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Address
Level 16
Cardinal Carter Wing
St. Michael's Hospital
30 Bond Street
Toronto, Ontario
M5B 1W8, Canada
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Country
Canada
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Secondary sponsor category [1]
287180
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None
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Name [1]
287180
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Address [1]
287180
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Country [1]
287180
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290344
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Research Ethics Board St Michael's Hospital
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Ethics committee address [1]
290344
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St. Michael's Hospital 30 Bond Street Toronto, Ontario M5B 1W8, Canada
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Ethics committee country [1]
290344
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Canada
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Date submitted for ethics approval [1]
290344
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Approval date [1]
290344
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08/11/2010
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Ethics approval number [1]
290344
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Summary
Brief summary
CRC is the second leading cause of cancer death, and accounts for approximately 9% of cancer deaths overall. Approximately one in three people who develop CRC die of this disease. Colonoscopy is considered the gold standard for screening but requires time, sedation and patients may experience some discomfort during the procedure. The standard method of colonoscopy uses air to inflate the colon in order for the lumen to be visualized and the instrument to be safely passed to the caecum/terminal ileum. Water assisted colonoscopy has been described to reduce caecal intubation time as well as analgesia requirements. However this technique has not been studied in a wide variety of patients nor in patients typical of a population appropriate for colorectal cancer screening. We aim to investigate the benefit of water assisted colonoscopy to reduce the time of intubation and thereby also allow a reduction in the sedation requirements and overall improve patient experience. We anticipate this will result in reduced procedural times and expense and hence allow more screening to be conducted without adversely affecting patient experience. It is speculated that water may decrease friction and lead to a reduction in intubation time and less cramping from air. To investigate the benefit of water assisted colonoscopy to reduce the time of intubation and thereby also allow a reduction in the sedation requirements and overall improve patient experience
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
45158
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Dr Michael Swan
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Address
45158
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Department of Gastroenterology
Monash Health
246 Clayton Road
Clayton 3168
Victoria
Australia
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Country
45158
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Australia
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Phone
45158
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+61 3 95435311
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Fax
45158
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+61 3 95433805
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Email
45158
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[email protected]
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Contact person for public queries
Name
45159
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Maria Cirocco
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Address
45159
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St. Michael's Hospital
30 Bond Street
Toronto, Ontario
M5B 1W8, Canada
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Country
45159
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Canada
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Phone
45159
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+1 4163604000
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Fax
45159
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Email
45159
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[email protected]
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Contact person for scientific queries
Name
45160
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Michael Swan
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Address
45160
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Department of Gastroenterology
Monash Health
246 Clayton Road
Clayton 3168
Victoria
Australia
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Country
45160
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Australia
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Phone
45160
0
+61 3 95435311
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Fax
45160
0
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Email
45160
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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
No additional documents have been identified.
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