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Trial registered on ANZCTR
Registration number
ACTRN12616000459426
Ethics application status
Approved
Date submitted
3/04/2016
Date registered
7/04/2016
Date last updated
7/04/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Is opportunistic screening appropriate for identifying arrhythmias and establishing effective clinical pathways for Aboriginal Australians?
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Scientific title
Is opportunistic screening appropriate for identifying arrhythmias and establishing effective clinical pathways for Aboriginal Australians?
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Secondary ID [1]
288919
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None
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Universal Trial Number (UTN)
U1111-1181-5344
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Trial acronym
AAiECG
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
atrial fibrillation
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cardiovascular disease
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stroke
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Condition category
Condition code
Cardiovascular
298398
298398
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Public Health
298399
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0
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Other public health
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Opportunistic screening of Aboriginal people over 45 years using a portable ECG attached to a smart phone.
1. The screening will be undertaken by local Aboriginal health workers supervised by a Registered Nurse.
2. All health workers (known as screeners in the study) will receive one day of training of face to face training.
3. They will receive daily support from a Registered Nurse. All screeners will report patients with a non-normal result for follow up by the Registered Nurse.
4. All participants will be formally consented into the study by a local Aboriginal person and receive health literacy information as well as a participant information sheet. The health literacy will be in the form of a printed sheet in plain English and pictorial form. We are seeking advice of Aborignal health literacy experts in design, and the content will be approved by cardiologist Prof Ben Freedman. This resource is expected to be drafted for review by mid-April.
5. The screening will occur in the usual course of the workers duties in the Aboriginal Health Service, health clinic, pharmacy, home visit or community centre.
6. The screeners will undertake a 30 second screen by asking the patient to hold onto a small probe attached to a smart phone. The process is painless and quick, and a result appears on the smart phone App.
7. There are three possible results: normal; Atrial Fibrillation; or unreadable.
8. Anyone screened with result other than Normal will be referred for a 12-lead ECG to confirm the diagnosis and plan further assessment and treatment as indicated.
9. Each eligible patient will be screened once. Each screener will undertake 50 screens with eligible patients. There are 30 screeners in the study and each screener is supervised and supported by a Registered Nurse.
10. The host organisation will retain the device for use in their practice once the 50 screens have been included in the study.
11. Host organisations each have an investigator on the study and several members of the Investigators team are Aboriginal.
12. The Principal Investigator will have weekly teleconferences with the Registered Nurses about progress and issues.
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Intervention code [1]
294382
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Early detection / Screening
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Comparator / control treatment
No control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Estimate prevalence of Atrial Fibrillation in Aboriginal Australians using portable ECG results.
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Assessment method [1]
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Timepoint [1]
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At the end of the study
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Secondary outcome [1]
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Evaluate the effectiveness of opportunistic screening using an iECG for Australian Aboriginal people using semi structured interviews with Aboriginal health workers.
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Assessment method [1]
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Timepoint [1]
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At the end of the study.
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Eligibility
Key inclusion criteria
Aboriginality; aged 45 years or over; Australian
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Minimum age
45
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?
Yes
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Key exclusion criteria
non-Aboriginal people; people under 45 years
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (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
Single group
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Other design features
Mixed methods. In addition to opportunistic screening data, the study will conduct semi-structured interviews with screeners to determine effectiveness of the process in achieving the intended outcome.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Statistical analysis of screening data and thematic analysis of qualitative data. 1500 screens across three jurisdictions will enable an estimate of prevalence. No power calculation has been performed.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
20/05/2016
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Actual
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Date of last participant enrolment
Anticipated
22/12/2017
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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
1500
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,NT,WA
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Recruitment hospital [1]
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Brewarrina Multi Purpose Service - Brewarrina
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Recruitment hospital [2]
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Mungindi Hospital - Mungindi
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Recruitment postcode(s) [1]
13007
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2839 - Brewarrina
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Recruitment postcode(s) [2]
13008
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6530 - Geraldton
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Recruitment postcode(s) [3]
13009
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2360 - Inverell
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Recruitment postcode(s) [4]
13010
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2409 - Boggabilla
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Recruitment postcode(s) [5]
13011
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2406 - Mungindi
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Recruitment postcode(s) [6]
13012
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0870 - Alice Springs
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Recruitment postcode(s) [7]
13013
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2440 - Kempsey
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Recruitment postcode(s) [8]
13014
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2372 - Tenterfield
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Recruitment postcode(s) [9]
13015
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2370 - Glen Innes
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Recruitment postcode(s) [10]
13016
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2361 - Ashford
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Recruitment postcode(s) [11]
13017
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2369 - Tingha
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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Heart Research Institute
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Address [1]
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7 Eliza Street, Newtown NSW 2042
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Poche Centre for Indigenous Health, The University of Sydney
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Address
Rm 223 Edward Ford Building A27, The University of Sydney 2006 NSW
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Country
Australia
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Secondary sponsor category [1]
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Other
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Name [1]
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Heart Research Institute
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Address [1]
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3 Eliza St Newtown NSW 2042
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Country [1]
292069
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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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Aboriginal Health and Medical Research Council
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Ethics committee address [1]
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3/66 Wentworth Ave, Surry Hills NSW 2010
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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26/10/2015
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Approval date [1]
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17/12/2015
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Ethics approval number [1]
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1135/15
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Summary
Brief summary
Background: The leading cause of death for Aboriginal Australians is cardiovascular disease, including stroke and heart attack. Atrial Fibrillation is a precursor to stroke. There are no published studies about the prevalence of Atrial Fibrillation for Aboriginal people. The purpose of the study is twofold: to estimate prevalence of Atrial Fibrillation in Australian Aboriginal people and evaluate the effectiveness of opportunistic screening, and assessment and treatment pathways for Aboriginal people with Atrial Fibrillation or other arrhythmias. Methods: This is a mixed methods study which will screen 1500 Australian Aboriginal people living in New South Wales, Northern Territory or Western Australia to estimate prevalence of Atrial Fibrillation. This data will be analysed statistically to estimate prevalence. In addition, the study will conduct semi-structured interviews with Aboriginal workers who conduct the screens to evaluate qualitatively the effectiveness of opportunistic screening using an iECG to facilitate timely assessment and treatment for Aboriginal people over 45 years. Discussion: The study aims to determine the feasibility of the portable iECG device to diagnose abnormal heart rhythm in Aboriginal people and facilitate access to further assessment and treatment; estimate the prevalence of AF in Aboriginal people in Australia; improve health literacy in Aboriginal people and health workers; and help prevent the effects of untreated AF in Aboriginal people; including ischemic stroke and prevent early deaths or impairment.
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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
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Ms Kylie Gwynne
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Address
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Rm 223 Edward Ford Building A27 The University of Sydney 2006 NSW
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Country
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Australia
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Phone
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+61 2 9036 6494
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Fax
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+61 2 9351 3196
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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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Kylie Gwynne
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Address
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Rm 223 Edward Ford Building A27 The University of Sydney 2006 NSW
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Country
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Australia
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Phone
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+61 2 9036 6494
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Fax
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+61 2 9351 3196
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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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Ben Freedman
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Address
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Room 3114, 3E Charles Perkins Centre, University of Sydney 2006 NSW
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Country
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Australia
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Phone
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+61 411 591 633
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Fax
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+61 2 8212 9058
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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
Embase
Opportunistic screening to detect atrial fibrillation in Aboriginal adults in Australia.
2016
https://dx.doi.org/10.1136/bmjopen-2016-013576
N.B. These documents automatically identified may not have been verified by the study sponsor.
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