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Trial registered on ANZCTR
Registration number
ACTRN12617000774325
Ethics application status
Approved
Date submitted
23/05/2017
Date registered
26/05/2017
Date last updated
15/11/2019
Date data sharing statement initially provided
17/07/2019
Date results provided
17/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Pilot testing of a new Blood Pressure measuring device on healthy adult volunteers
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Scientific title
Phase 0 (pilot) testing of a new Blood Pressure measuring device on healthy adult volunteers at Cabrini Emergency Department, comparing the new skin contact device against gold standard devices; during rest, exercise and after administration of glyceryl trinitrate, to assess device performance for Blood Pressure measurement accuracy.
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Secondary ID [1]
291851
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nil
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Universal Trial Number (UTN)
U1111-1196-2656
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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:
measurement of blood pressure
303104
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Condition category
Condition code
Cardiovascular
302565
302565
0
0
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Normal development and function of the cardiovascular system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is a device that utilises new technology to measure blood pressure non-invasively and cufflessly using a methodology called Pulse Transit Time (PTT). Simple electrodes and a radar device are placed on the skin between two points of an artery (in this case, the aorta in the chest). The blood pressure is deducted from the resultant delay of the electrical and mechanical impulse created by the blood moving along the artery between the two points.
The device consists of:
(i) Electrodes and leads:
*An electrode placed on each shoulder (similar to currently used ECG dots)
*A chest electrode (the radar) placed in the middle of the sternum
*A lead connecting the electrodes to the central processing unit
(ii) Central processing unit (CPU)
*A box that generates the radar signal out to the chest electrodes and receives the signals from the shoulder electrodes
(iii) Laptop computer
*Used to input the patient’s demographic data, non invasive arm cuff BP readings, visualise data obtained from the CPU, and host the algorithms used to deduct BP
To test this device, the following procedures will be followed:
Healthy adult volunteers will be enrolled.
A minimum of 29 participants will undergo static and blood pressure raising protocol. These participants will undertake the following:
Steps and manoeuvres
1 Measure lying BP
2 Change to sitting measure sitting BP
3 Handgrip both arms till failure, measure handgrip BP
4 Change to standing position, measure standing BP
5 Move to bike, Cycle for 2 min at 10-22 km/h or light effort
Measure BP after light exercise (brief rest following this whilst BPs are measured only)
6 Cycle for 2 min at 22-30 km/h or Medium effort
Measure BP after medium exercise (brief rest following this whilst BPs are measured only)
7 Cycle for 2 min at 30-40 km/h or Maximal effort
Measure BP after heavy exercise (rest following this, see below)
8 Rest at sitting position for 5 min
Measure sitting BP after 5 minutes rest
A minimum of 16 further participants will undergo a static and Blood Pressure lowering protocol:
First they will be screened for medical contraindications and consented for the utilisation of glyceryl trinitrate (GTN) medication. If able to proceed, the protocol will be as follows:
Participants rest supine for 10 minutes, then they would have 300 micrograms of GTN administered sublingually (under the tongue) and possibly another 300mcg 10 minutes later. BPs would be measured before and after the medication administration. The second dose will be given if the participant remains well and the BP has been lowered at first post GTN dose by less than 15mmHg. (minimum of 50% of BP lowering measurements have to be in the range of - 16 to - 30mmHg from baseline reading, the remaining lowered BP readings have to be between -15 to -1mmHg from baseline). BPs will be measured 3 minutely from the first dose of GTN onwards for 30 minutes total.
For all measurements of blood pressure by the new device, there will be a simultaneous measurement of the blood pressure by the gold standard control device. Blood pressures will be measured by a researcher who has been trained to take Blood Pressures accurately. This may be a research assistant with a science background, an engineer or a medical practitioner (Emergency Physician).
The approximate duration of each session for each participant in either group will be approximately an hour.
Training for researchers in how to measure Blood Pressures will meet or exceed the standards described in the International engineering protocol.
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Intervention code [1]
297960
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Diagnosis / Prognosis
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Comparator / control treatment
Digital, oscillometric, arm-cuffed sphygmomanometer, (or similar gold-standard device as determined by international engineering standards) calibrated and tested for accuracy according to engineering standards prior to utilisation.
As in the device testing protocol above, the same researchers will measure the control BP readings, with the training described above. (as per international standard engineering protocol)
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Control group
Active
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Outcomes
Primary outcome [1]
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Testing for precision (mean absolute difference accuracy level) against engineering standards for new devices, compared to gold standard (arm-cuffed sphygmomanometer) to determine if the new device would be likely to meet those standards.
(International engineering standard IEEE 1708 for BP measurement)
Precision testing accuracy is undertaken by following the engineering standard IEEE 1708 for BP measurement and then comparing against "Table 3 - MAD accuracy level with comparison to the ANSI/AAMI SP10 and BHS evaluation systems"
This grades accuracy of readings into a recommended grading of A through to D. We aim to measure against Grade A which is a pass according to the standards.
Readings are compared to a gold standard device; which is determined by the engineering standards (e.g. Digital, oscillometric, arm-cuffed sphygmomanometer) or other device meeting the same gold-standard requirements as determined b the engineering standard.
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Assessment method [1]
301981
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Timepoint [1]
301981
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December 2017, assessed at sequential testing sessions (5-10 participants per session) until the complete sample size is enrolled.
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Secondary outcome [1]
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Determination of the best electrode placement location on the chest. Several electrodes will be placed across the chest wall. The most accurate will be determined by comparing against the gold standard readings. The most accurate location will inform future electrode lead placement.
Gold standard readings are assessed compared to a simultaneous digital, oscillometric, arm-cuffed sphygmomanometer (or other device meeting the same gold-standard requirements as determined b the engineering standard).
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Assessment method [1]
334434
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Timepoint [1]
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December 2017, assessed at sequential testing sessions (5-10 participants per session) until the complete sample size is enrolled.
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Eligibility
Key inclusion criteria
Adult volunteers (age 18 and over)
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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?
Yes
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Key exclusion criteria
Exclusion from any participation
Inability to undergo informed consent (e.g. speak or read English, reliably process information to make an informed decision)
Inability to undertake mild to moderate aerobic exercise (ride an exercise bike for 5 minutes)
Inability to undertake mild to moderate isotonic exercise (clenched hand grips)
Allergy to medical grade skin adhesive tapes
History of mastectomy with axillary node clearance, preventing the use of arm Blood Pressure measurement devices
Exclusion from the glyceryl trinitrate arm of the study
Unwillingness to divulge past medical history to a research medical practitioner
Past medical history of ischaemic heart disease (heart attack)
Past medical history of cerebrovascular disease (stroke)
Hypersensitivity to glyceryl trinitrate
Systolic blood pressure less than 100 mmHg
Pulse rate <50 or >150
Phosphodiesterase type 5 inhibitor use (sildenafil, vardenafil) within the last 4 days
Allergy to medical grade skin adhesive tapes
History of mastectomy with axillary node clearance, preventing the use of arm Blood Pressure measurement devices
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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)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not randomised
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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
Participants act as their own controls, readings are taken simultaneously from the test and control device
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
We will measure the device performance against international engineering standard IEEE 1708 for BP measurement; which defines the analysis standards and statistical methodology
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2017
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Actual
1/10/2017
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Date of last participant enrolment
Anticipated
30/09/2017
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Actual
30/10/2017
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Date of last data collection
Anticipated
30/09/2017
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Actual
30/11/2017
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Sample size
Target
45
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Accrual to date
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Final
43
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
7928
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Cabrini Hospital - Malvern - Malvern
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Recruitment postcode(s) [1]
15888
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3144 - Malvern
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Funding & Sponsors
Funding source category [1]
296348
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University
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Name [1]
296348
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Monash University
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Address [1]
296348
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Department of Electrical and Computer Systems Engineering
Building 72
Room:229
14 Alliance Lane
Monash University
Clayton
Victoria
3168
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Country [1]
296348
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Australia
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Funding source category [2]
296349
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Hospital
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Name [2]
296349
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Cabrini Hospital
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Address [2]
296349
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Emergency Department
183 Wattletree Rd
Malvern
Vic
3144
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Country [2]
296349
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Australia
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Funding source category [3]
296350
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Government body
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Name [3]
296350
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Victorian Government future industries fund
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Address [3]
296350
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121 Exhibition Street
Melbourne
Vic
3000
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Country [3]
296350
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Australia
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Funding source category [4]
296351
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Commercial sector/Industry
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Name [4]
296351
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Planet Innovation
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Address [4]
296351
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436 Edgar Rd
Box Hill
Vic
3128
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Country [4]
296351
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
Department of Electrical and Computer Systems Engineering
Building 72
Room:229
14 Alliance Lane
Monash University
Clayton
Victoria
3168
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Country
Australia
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Secondary sponsor category [1]
295280
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Commercial sector/Industry
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Name [1]
295280
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Planet Innovation
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Address [1]
295280
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436 Edgar Rd
Box Hill
Vic
3128
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Country [1]
295280
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Australia
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Secondary sponsor category [2]
295281
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Charities/Societies/Foundations
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Name [2]
295281
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Cabrini Institute
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Address [2]
295281
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154 Wattletree Rd
Malvern
VIC
3144
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Country [2]
295281
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Australia
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Secondary sponsor category [3]
295282
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Individual
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Name [3]
295282
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A/Prof Keith Joe
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Address [3]
295282
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Emergency Department
Cabrini
183 Wattletree Rd
Malvern
Vic
3144
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Country [3]
295282
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
279554
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Dr Katherine Walker
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Address [1]
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Emergency Department
Cabrini
183 Wattletree Rd
Malvern
Vic
3144
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Country [1]
279554
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Australia
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Other collaborator category [2]
279555
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Individual
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Name [2]
279555
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Mr William Dunlop
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Address [2]
279555
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Emergency Department
Cabrini
183 Wattletree Rd
Malvern
Vic
3144
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Country [2]
279555
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Australia
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Other collaborator category [3]
279556
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Individual
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Name [3]
279556
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A/Prof Mehmet Yuce
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Address [3]
279556
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Department of Electrical and Computer Systems Engineering
Building 72
Room:229
14 Alliance Lane
Monash University
Clayton
Victoria
3168
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Country [3]
279556
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Australia
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Other collaborator category [4]
279557
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Individual
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Name [4]
279557
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Dr Jean-Michel Redoute
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Address [4]
279557
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Department of Electrical and Computer Systems Engineering
Building 72
Room:229
14 Alliance Lane
Monash University
Clayton
Victoria
3168
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Country [4]
279557
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Australia
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Other collaborator category [5]
279583
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Individual
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Name [5]
279583
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Mr Malcolm Hebblewhite
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Address [5]
279583
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Planet Innovation
436 Edgar Rd
Box Hill
Vic
3128
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Country [5]
279583
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297580
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Cabrini Human Research Ethics Committee
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Ethics committee address [1]
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Cabrini Institute 154 Wattletree Rd Malvern Vic 3144
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Ethics committee country [1]
297580
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Australia
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Date submitted for ethics approval [1]
297580
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01/06/2017
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Approval date [1]
297580
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29/06/2017
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Ethics approval number [1]
297580
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07-19-06-17
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Summary
Brief summary
Project Summary This is a pilot study of a new, non-invasive, cuffless blood pressure measuring device, worn on the chest. This is a world first for Monash University engineers. Blood pressure (BP) measurement is an essential vital sign, and provides a cornerstone for diagnostic and treatment decisions in healthcare. Existing technology requires either uncomfortable arm cuff inflation, or invasive catheters placed into patient’s arteries. Monash University engineers have developed a device consisting of sensing pads (4 ecg dots) and a radar to be placed on the patient’s chest. Initial lab testing suggests that the device functions well in fit young volunteers. Further testing is now required on volunteers with a range of resting blood pressures and body shapes to determine how the device performs on a broader section of the adult population. We are evaluating this device at Cabrini on a reasonably healthy adult volunteer population aged 18 years and over. Some of the subjects need to have uncomplicated hypertension. The study requires most participants (N=29) to attend for an hour, wear the new device on their chest, and a normal ‘gold-standard’ BP cuff on their arm. The volunteer will then go through a range of tasks whilst having their BP measured both ways. The tasks involve resting on a bed, sitting up, clenching their hands and riding an exercise bike for a few minutes. A smaller sub-group of the healthiest participants (N=16) would be required to take a small dose of glyceryl trinitrate (GTN) to lower their blood pressure by a small amount, whilst resting on a trolley in a treatment room in the Emergency Department at Cabrini. We aim to establish the precision of the device by correlating what the new device against an established ‘gold standard’ method of BP measurement measures (arm cuff). The dataset of BP readings from the chest device allows the engineers to apply mathematical algorithms to convert the data into accurate blood pressure readings. The aim of the research is to develop a method whereby BP can be measured accurately, continuously, and without patient awareness or discomfort, thus in the future eliminating the need for a sphygmomanometer or arterial line catheter for patients.
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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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A/Prof Mehmet Yuce
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Address
74506
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Department of Electrical and Computer Systems Engineering
Building 72
Room:229
14 Alliance Lane
Monash University
Clayton
Victoria
3168
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Country
74506
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Australia
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Phone
74506
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+61395081550
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Fax
74506
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Email
74506
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[email protected]
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Contact person for public queries
Name
74507
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Keith Joe
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Address
74507
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Emergency Department
Cabrini
183 Wattletree Rd
Malvern
Vic
3144
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Country
74507
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Australia
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Phone
74507
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+61395081550
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Fax
74507
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Email
74507
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[email protected]
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Contact person for scientific queries
Name
74508
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Mehmet Yuce
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Address
74508
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Department of Electrical and Computer Systems Engineering
Building 72
Room:229
14 Alliance Lane
Monash University
Clayton
Victoria
3168
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Country
74508
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Australia
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Phone
74508
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+61399053932
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Fax
74508
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Email
74508
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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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
Clinical study of a chest-based cuffless blood pressure monitoring system.
2020
https://dx.doi.org/10.1002/mds3.10091
Dimensions AI
A chest-based continuous cuffless blood pressure method: Estimation and evaluation using multiple body sensors
2020
https://doi.org/10.1016/j.inffus.2019.07.001
N.B. These documents automatically identified may not have been verified by the study sponsor.
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