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Trial registered on ANZCTR
Registration number
ACTRN12622001124729
Ethics application status
Approved
Date submitted
8/08/2022
Date registered
16/08/2022
Date last updated
2/09/2022
Date data sharing statement initially provided
16/08/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Computerized Tomography (CT) Larynx for diagnosis of Vocal Cord Dysfunction
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Scientific title
Computerized Tomography (CT) Larynx for diagnosis of Vocal Cord Dysfunction, a comparison to laryngoscopy
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Secondary ID [1]
307722
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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:
Vocal Cord Dysfunction
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Condition category
Condition code
Respiratory
324420
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0
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Other respiratory disorders / diseases
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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
Computed Tomography larynx and laryngoscopy are both conducted to assess for vocal cord dysfunction. There are no contrast dyes administered, this is a non-contrast scan. The anticipated duration of this CT is 10-15 minutes and laryngoscopy is done over 10-15 minutes.
The CT Larynx is conducted and assessed by the radiologist and the laryngoscopy is done by the ENT practitioner. Both procedures are done once.
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Intervention code [1]
324197
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Diagnosis / Prognosis
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Comparator / control treatment
Both CT larynx and Laryngoscopy are done to assess for VCD. The CT is compared to the gold-standard which is laryngoscopy.
CT larynx as well as the laryngoscopy are done either within one hour or on separate days, This was done to examine temporal concordance (within an hour) and to compare testing on separate occasions.
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Control group
Active
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Outcomes
Primary outcome [1]
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Comparison of the accuracy of CT larynx versus laryngoscopy. Sensitivity and specificity of CT larynx calculated relative to gold-standard (laryngoscopy) Sensitivity and specificity be analysed together as a composite outcome.
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Assessment method [1]
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Timepoint [1]
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Within one hour of assessment
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Secondary outcome [1]
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Positive and negative predictive values based on estimated prevalence of VCD in the cohorts of 30%, 10% and 50%. False positive value also calculated.
Positive and negative predictive values will be derived from the primary outcome data (sensitivity and specificity). This secondary outcome is dependent on prevalence of VCD in the cohorts and estimates of 30%, 10% and 50% will be presented. False positive values will also be calculated from the primary outcome data.
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Assessment method [1]
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Timepoint [1]
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Comparisons made based on findings in two case series:
- Patients compared having testing within one hour.
- Patients compared having testing on separate days.
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Eligibility
Key inclusion criteria
Patients with suspected vocal cord dysfunction assessed by computed tomography larynx and laryngoscopy as part of standard care.
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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
No clinical suspicion of vocal cord dysfunction.
Other explanation for symptoms.
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Data analyses will be conducted to assess concordance between the tests. Laryngoscopy is used as the gold standard for case definition and compared to CT larynx. Sensitivity, specificity, positive predictive values, negative predictive values and falso positive rates will be calculated. Inter-rater reliability will be examined using Cohen’s Kappa and all statistical analyses will be conducted using SPSS.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/05/2018
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Date of last participant enrolment
Anticipated
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Actual
30/07/2021
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Date of last data collection
Anticipated
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Actual
30/07/2021
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Sample size
Target
28
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Accrual to date
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Final
31
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment postcode(s) [1]
38230
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3168 - Clayton
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Monash Health Lung and Sleep Institute
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Address [1]
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Monash Medical Centre Clayton
246 Clayton Road, 3168 Clayton, Victoria
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Country [1]
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Australia
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Funding source category [2]
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Government body
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Name [2]
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NH&MRC
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Address [2]
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16 Marcus Clarke St, Canberra ACT 2601
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Country [2]
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Australia
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Primary sponsor type
Hospital
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Name
Monash Lung Sleep Allergy & Immunology
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Address
Monash Medical Centre Clayton
246 Clayton Road, 3168 Clayton, Victoria
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
313488
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Country [1]
313488
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Monash Health Human Research Ethics Committee
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Ethics committee address [1]
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Monash Medical Centre 246 Clayton Road, 3168 Clayton, Victoria
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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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Approval date [1]
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01/01/2016
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Ethics approval number [1]
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Monash Health Ref: RES-18-0000-084L
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Summary
Brief summary
Vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO) is common but seldom recognised at first since patients experience intermittent breathlessness leading in most cases to a diagnosis of asthma and treatment with inhaled corticosteroids (CS). Diagnosis of VCD/ILO is further complicated by coexistence of asthma and VCD/ILO in 20-40% of asthmatics and VCD/ILO can make asthma seem more severe leading to over-treatment with high-dose inhaled or oral CS. To date a swift diagnosis is seldom achieved. The current gold-standard for diagnosis of VCD/ILO is laryngoscopy and the quintessential abnormality is inspiratory closure of the vocal cords and formation of a diamond-shaped small opening or ‘chink’ posteriorly. Laryngoscopy requires expertise that may not be available within a reasonable time-frame and the procedure can be technically challenging or fail if a patient is breathless and distressed. Consequently, laryngoscopy may be delayed or not performed. Laryngoscopy in expert hands remains the definitive diagnostic modality but innovations in diagnostic imaging have created alternative options. Present-day imaging technologies with superior spatial and temporal resolution have made it possible to visualise not only anatomical features, but also movement and function of a particular organ. We have developed dynamic CT larynx to detect and quantify laryngeal movement, a technology that can be applied wherever cardiac CT is performed. We hypothesised that dynamic CT larynx would have comparable diagnostic accuracy to laryngoscopy in VCD/ILO, when performed contemporaneously and when utilised in a real-world clinical context.
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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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Prof Philip Bardin
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Address
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Monash Health Lung Sleep Allergy & immunology, 246 Clayton Rd, Clayton VIC 3168
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Country
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Australia
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Phone
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+61 395942281
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Fax
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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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Philip Bardin
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Address
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Monash Health Lung Sleep Allergy & immunology, 246 Clayton Rd, Clayton VIC 3168
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Country
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Australia
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Phone
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+61 395942281
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Fax
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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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Philip Bardin
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Address
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Monash Health Lung Sleep Allergy & immunology, 246 Clayton Rd, Clayton VIC 3168
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Country
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Australia
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Phone
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+61 395942281
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Fax
121024
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Email
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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)?
Yes
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What data in particular will be shared?
Deidentified data, individual participant data underlying published results only
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When will data be available (start and end dates)?
Beginning 3 months and ending 5 years following main results publication
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Available to whom?
Case-by-case basis at the discretion of Primary Investigator.
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Available for what types of analyses?
To achieve the aims in the approved proposal.
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How or where can data be obtained?
Access subject to approval by Principal Investigator:
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
17080
Study protocol
[email protected]
17081
Statistical analysis plan
[email protected]
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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