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Trial registered on ANZCTR
Registration number
ACTRN12617000382370
Ethics application status
Approved
Date submitted
9/03/2017
Date registered
14/03/2017
Date last updated
8/03/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Validation of head injury prognostic calculators
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Scientific title
Comparative study of two tools in determining severe head injury outcomes in an Australian setting: CRASH (Corticosteroid Randomisation after Significant Head injury) versus IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury)
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Secondary ID [1]
291406
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Nil known
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Universal Trial Number (UTN)
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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:
Severe traumatic brain injury (TBI)
302423
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Condition category
Condition code
Neurological
301990
301990
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0
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Other neurological disorders
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Injuries and Accidents
302031
302031
0
0
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Other injuries and accidents
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Intervention/exposure
Study type
Observational
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Patient registry
False
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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
CRASH (Corticosteroid Randomisation After Significant Head Injury)
-This prognostic model may be used as an aid to estimate mortality at 14 days and death and severe disability at six months in patients with traumatic brain injury (TBI). The predictions are based on the average outcome in adult patients with Glasgow coma score (GCS) of 14 or less, within 8 hours of injury, and can support clinical judgment.
-Duration of observation of each participant is 6 months (from admission to 6 months post admission)
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Intervention code [1]
297438
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Diagnosis / Prognosis
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Comparator / control treatment
IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in TBI)
-Based on extensive prognostic analysis, this prognostic model was developed for predicting 6 month outcomes in adult patients with moderate to severe head injury (Glasgow Coma Scale <=12) on admission. By entering patient admission details into the calculator, the models will provide an estimate of the expected outcome at 6 months.
-There are three models of increasing complexity (Core, Core + CT, Core + CT + Lab). These were developed and validated in collaboration with the CRASH trial collaborators on large numbers of individual patient data (the IMPACT database).
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Control group
Active
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Outcomes
Primary outcome [1]
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CRASH outcome: Risk of unfavourable outcome at 6 months (%)
-Assessed by plugging patient admission and CT data (e.g. age, Glasgow Coma Scale score on admission, presence of traumatic subarachnoid haemorrhage on CT) into calculator and pressing 'Calculate'
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Assessment method [1]
301413
0
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Timepoint [1]
301413
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6 months post admission
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Primary outcome [2]
301414
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IMPACT outcome: Core and Core + CT and Core + CT + Lab predicted probability of 6 month unfavourable outcome (%)
-All are assessed by plugging patient admission, CT and lab data (e.g. age, Glasgow Coma Scale score on admission, petechial hemorrhages on CT and blood glucose levels on admission) into calculator and pressing 'Calculate'
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Assessment method [2]
301414
0
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Timepoint [2]
301414
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6 months post admission
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Secondary outcome [1]
332563
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Glasgow Outcome Scale (GOS)
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Assessment method [1]
332563
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Timepoint [1]
332563
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6 months post admission
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Eligibility
Key inclusion criteria
The inclusion criteria consists of participants with severe head injury requiring intubation (i.e. Glasgow Coma Scale <8).
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Minimum age
18
Years
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Maximum age
85
Years
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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
The exclusion criteria consists of previously physically or mentally disabled participants (in order to maintain uniformity in outcome).
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Retrospective
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Statistical methods / analysis
-Statistical analysis of data shall assess discrimination using a 95% confidence interval, as well as the AUC (area under the curve).
-Adequate model discriminatory ability is represented by AUC greater or equal to 0.8, and model non-discriminatory ability is represented by AUC less than or equal to 0.5.
-The H-L goodness-of-fit test shall be used to assess calibration. It uses predicted probabilities to divide participants into deciles, followed by a computation of a x-squared from expected as well as observed frequencies.
-The x-squared distribution enables calculation of a p-value. A p-value of <0.05 is considered as significant.
-The Cox calibration analysis derives the slope and intercept from a logistical regression model. The degree of predictions variation is represented by the slope, being a coefficient of the predicted probability's logit. The slope equals 1 for an ideal model.
-The intercept, on the other hand, measures overall calibration by indicating systematically if predictions are too high or too low, and is zero in an ideal model.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
31/03/2017
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Actual
1/01/2011
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Date of last participant enrolment
Anticipated
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Actual
31/12/2016
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Date of last data collection
Anticipated
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Actual
31/12/2017
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Sample size
Target
200
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Accrual to date
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Final
256
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
7646
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Princess Alexandra Hospital - Woolloongabba
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Recruitment postcode(s) [1]
15557
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4102 - Woolloongabba
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Funding & Sponsors
Funding source category [1]
295879
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Hospital
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Name [1]
295879
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Princess Alexandra Hospital
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Address [1]
295879
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Dept of Neurosurgery, Princess Alexandra Hospital,
199 Ipswich Rd,
WOOLLOONGABBA,
QLD 4102
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Country [1]
295879
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Australia
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Primary sponsor type
Individual
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Name
Dr Ananthababu Pattavilakom Sadasivan
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Address
Dept of Neurosurgery, Princess Alexandra Hospital,
199 Ipswich Rd,
WOOLLOONGABBA,
QLD 4102
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Country
Australia
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Secondary sponsor category [1]
294740
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None
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Name [1]
294740
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N/A
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Address [1]
294740
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N/A
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Country [1]
294740
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297158
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Metro South Human Research Ethics Committee
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Ethics committee address [1]
297158
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Metro South Hospital and Health Service, Level 7 TRI, 37 Kent Street, WOOLLOONGABBA QLD 4102
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Ethics committee country [1]
297158
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Australia
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Date submitted for ethics approval [1]
297158
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Approval date [1]
297158
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19/09/2016
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Ethics approval number [1]
297158
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HREC/16/QPAH/462- SSA/16/QPAH/463
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Summary
Brief summary
Head injury is common, affecting Australians at a rate of 107 per 100,000 people. Its outcome varies from complete recovery to disability. Two recognised tools predict these outcomes, based on presentation: CRASH (Corticosteroid Randomisation after Significant Head injury) and IMPACT (International Mission for Prognosis and analysis of Clinical Trials in TBI (Traumatic Brain Injury)). Clinical studies independently validated them. One reported study compared them within a non-Australian community. Study Aim: To compare CRASH’s efficacy against IMPACT in predicting severe head injury outcomes. Research design: -Recruiting severe head injury patients admitted to Princess Alexandra Hospital as participants. -Collect symptom details from first admission and after six months. -Calculate participants’ CRASH and IMPACT scores and compare with actual outcomes. Reviewing participants after six months provides information relating initial presentation to recovery. The results would identify whether CRASH or IMPACT better predicts outcomes. This knowledge may influence future patient care and research.
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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
73174
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Miss Harini Ravi
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Address
73174
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Dept of Neurosurgery, Princess Alexandra Hospital,
199 Ipswich Rd,
WOOLLOONGABBA,
QLD 4102
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Country
73174
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Australia
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Phone
73174
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+61411824152
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Fax
73174
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Email
73174
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[email protected]
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Contact person for public queries
Name
73175
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Ananthababu Pattavilakom Sadasivan
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Address
73175
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Dept of Neurosurgery, Princess Alexandra Hospital,
199 Ipswich Rd,
WOOLLOONGABBA,
QLD 4102
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Country
73175
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Australia
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Phone
73175
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+61411824152
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Fax
73175
0
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Email
73175
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[email protected]
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Contact person for scientific queries
Name
73176
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Ananthababu Pattavilakom Sadasivan
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Address
73176
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Department of Neurosurgery, Princess Alexandra Hospital,
199 Ipswich Rd,
WOOLLOONGABBA,
QLD 4102
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Country
73176
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Australia
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Phone
73176
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+61411536689
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Fax
73176
0
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Email
73176
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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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