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Trial registered on ANZCTR
Registration number
ACTRN12617001237370
Ethics application status
Approved
Date submitted
11/07/2017
Date registered
24/08/2017
Date last updated
31/05/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Utility of Whole Blood Point of Care Beta human Chorionic Gonadotrophin (BhCG) Testing using Urine Pregnancy Assay
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Scientific title
Utility of Whole Blood Point of Care BhCG Testing on Urine Pregnancy Assay - a comparison of time taken to obtain results from whole blood point of care BhCG testing versus lab serum BhCG and urine point of care BhCG testing in female patients presenting to the Emergency Department who require pregnancy status checked
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Secondary ID [1]
291838
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Nil known
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Universal Trial Number (UTN)
U1111-1196-2179
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Trial acronym
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Linked study record
Universal Trial Number (UTN) U1111-1194-3181 - the studies are linked, and will be run concurrently.
ACTRN registration number: ACTRN12617000656336
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Health condition
Health condition(s) or problem(s) studied:
pregnancy
303084
0
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Condition category
Condition code
Reproductive Health and Childbirth
302542
302542
0
0
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Normal pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Comparison of time taken to obtain results from urine and whole blood testing using point of care B-hCG testing cartridges, and blood samples sent to the lab for serum testing.
Blood drawn from the patient will be sent to the lab for testing as per our usual practice. The time taken to obtain a result since the patient's presentation to the Emergency Department will be calculated. Three drops from that sample drawn will be tested using the bedside BhCG test cartridge, and the time taken to obtain a result from that since the patient's presentation will be calculated. When the patient is able to provide a urine sample, the urine will be tested using the bedside BhCG test cartridge, and the time taken to obtain a result from that since the patient's presentation will be calculated. These times will then be compared to find which is the most efficient method to obtain a BhCG result, and if there is a difference depending on time of day of patient presentation.
Clinicians are likely to be aware of the results from the urine and whole blood point of care tests, but only the lab serum B-hCG result will be used to determine patient care.
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Intervention code [1]
298962
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Diagnosis / Prognosis
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Comparator / control treatment
Urine and blood samples from each patient will be compared against each other for time taken to obtain results. The reference standard will be the time taken to obtain a result from a blood sample sent to the lab (serum BhCG result). The comparator tests will be whole blood tested on the point of care BhCG test cartridge, and urine tested on the point of care BhCG test cartridge.
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Control group
Active
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Outcomes
Primary outcome [1]
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Time taken (since patient presentation) to obtain the B-hCG result from whole blood on point of care testing B-hCG cartridge compared to urine on point of care testing B-hCG cartridge.
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Assessment method [1]
301964
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Timepoint [1]
301964
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During patient's stay in the Emergency Department.
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Primary outcome [2]
301965
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Time taken (since patient presentation) to obtain the B-hCG result from whole blood on point of care testing B-hCG cartridge compared to the blood sample sent to the lab for serum testing.
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Assessment method [2]
301965
0
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Timepoint [2]
301965
0
During the patient's stay in the Emergency Department.
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Secondary outcome [1]
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None
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Assessment method [1]
334389
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Timepoint [1]
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None
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Eligibility
Key inclusion criteria
Females of reproductive age (18-50) presenting to the Mater Adults Hospital Emergency Department
Patients who will have their pregnancy status tested as part of their usual care given their presenting complaint
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients who do not consent or withdraw consent from the study.
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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)
Not applicable
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable
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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
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Sample size:
n1 + n2 = (4o2 (Z 1-a/2 + Z 1-ß)2) / (µ1 - µ2)
o = sample mean = 130 mins (calculated based on an analysis of times taken to obtain results from whole blood sent to the lab for 50 sequential patients)
Z 1-a/2 = 1.96 for a = 0.05
Z 1-ß = 1.282 for Power = 1-ß = 0.9
µ1 - µ2 = difference to be detected = 15 mins
n1 + n2 = 630 --> n = number of observations to be done in each group
--> 315 participants required as 2 observations for comparison will be done on each participant
This is the calculation for the comparison between times taken to get a result from whole blood being used on the point of care B-hCG test cartridge and the blood sample sent to the lab for a serum B-hCG result. At this stage, the times taken to obtain a urine result from patients is not clearly recorded, so it is not possible to calculate a sample mean. A post-hoc analysis will be done for the comparison between times taken to get a result from whole blood being used on the point of care B-hCG test cartridge and urine being used on the point of care B-hCG test cartridge to ensure that the sample size is adequate to power the study to detect a 15 minute difference.
Assuming a similar sample mean for time taken to obtain a urine BhCG result, 315 participants would be required to make that comparison as well.
--> participants require for the study = 630
This is being done concurrently with a study to validate the sensitivity and specificity of whole blood being used on the point of care B-hCG test cartridge. 1098 patients will be recruited for the study.
Analysis:
A paired T-test will be done to determine if there is a significant difference between the mean times to results using each B-hCG testing method of greater than 15 minutes. The times to results using whole blood on the point of care B-hCG test cartridge will be compared with the times to results from whole blood samples sent to the lab for serum B-hCG testing. The times to results using whole blood on the point of care B-hCG test cartridge will be compared with times to results using urine on the point of care B-hCG test cartridge.
The results will also be divided into patient presentations by shift times (Day = 0800-1600,Evening = 1600-0000, Night = 0000-0800). A further analysis will be done to see if the efficiency of testing methods changes depending on the time of patient presentation.
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Recruitment
Recruitment status
Withdrawn
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Reason for early stopping/withdrawal
Other reasons/comments
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Other reasons
Study was approved by Ethics and Governance, but the Pathology department would not support the study. It would require a significant protocol change to do the study without Pathology support (includes the phlebotomists), which would result in study outcomes not reflecting our actual clinical practice.
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Date of first participant enrolment
Anticipated
4/09/2017
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Actual
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Date of last participant enrolment
Anticipated
4/09/2019
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Actual
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Date of last data collection
Anticipated
4/09/2019
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Actual
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Sample size
Target
630
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
8521
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Mater Adult Hospital - South Brisbane
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Recruitment postcode(s) [1]
16614
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4101 - South Brisbane
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Funding & Sponsors
Funding source category [1]
296336
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Hospital
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Name [1]
296336
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Mater Adult Hospital Brisbane Emergency Department
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Address [1]
296336
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Raymond Terrace
South Brisbane
QLD 4101
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Country [1]
296336
0
Australia
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Primary sponsor type
Hospital
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Name
Mater Adult Hospital Brisbane Emergency Department
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Address
Raymond Terrace
South Brisbane
QLD 4101
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Country
Australia
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Secondary sponsor category [1]
295265
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None
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Name [1]
295265
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Address [1]
295265
0
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Country [1]
295265
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297567
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Mater Health Services Research Ethics
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Ethics committee address [1]
297567
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Room 294, Level 2, Aubigny Place Raymond Terrace South Brisbane Qld 4101
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Ethics committee country [1]
297567
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Australia
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Date submitted for ethics approval [1]
297567
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20/06/2017
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Approval date [1]
297567
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09/01/2018
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Ethics approval number [1]
297567
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HREC/17/MHS/48
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Summary
Brief summary
This study aims to investigate the utility of the use of whole blood for point of care testing for B-hCG to rapidly differentiate pregnant and non-pregnant patients. This is important in time-critical conditions such as ruptured ectopic pregnancy. It would also expedite things in the situation where medical imaging involving ionising radiation is delayed until pregnancy can be excluded. The current testing options are a urine point of care test, or a serum sample sent to the pathology lab. The point of care test pack inserts state that whole blood cannot be used with them, but in practice they have been used that way and expedited decision-making. A convenience sample of female patients of reproductive age presenting to the Emergency Department who would typically have their pregnancy status checked, will be recruited to the study. A whole blood B-hCG (point of care), a urine B-hCG (point of care), and a serum sample for quantitative hCG will be tested. The blood sample will be sent to pathology for a quantitative serum B-hCG result, and will be used as the standard for comparison. A result of <1.2 units/L is a negative pregnancy test. The results from the urine and whole blood point of care tests will be compared against this, to determine their sensitivity and specificity in a separate analysis. The time taken to obtain a result from the point of care B-hCG testing using urine and whole blood will be compared against the time taken to obtain a result from the sample sent to the lab. We will then be able to compare the differences between length of time taken to obtain a urine or blood sample, and the differences between length of time taken to obtain test results for each of these samples.
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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
74462
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Dr Xiu Lee
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Address
74462
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Emergency Department
Mater Adult Hospital Brisbane
Raymond Terrace
QLD 4101
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Country
74462
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Australia
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Phone
74462
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+61 7 3163 8111
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Fax
74462
0
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Email
74462
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[email protected]
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Contact person for public queries
Name
74463
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Xiu Lee
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Address
74463
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Emergency Department
Mater Adult Hospital Brisbane
Raymond Terrace
QLD 4101
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Country
74463
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Australia
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Phone
74463
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+61 7 3163 8111
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Fax
74463
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Email
74463
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[email protected]
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Contact person for scientific queries
Name
74464
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Xiu Lee
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Address
74464
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Emergency Department
Mater Adult Hospital Brisbane
Raymond Terrace
QLD 4101
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Country
74464
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Australia
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Phone
74464
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+61 7 3163 8111
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Fax
74464
0
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Email
74464
0
[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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