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Trial registered on ANZCTR
Registration number
ACTRN12607000475448
Ethics application status
Approved
Date submitted
19/07/2007
Date registered
21/09/2007
Date last updated
21/04/2008
Type of registration
Prospectively registered
Titles & IDs
Public title
Does point of care troponin testing speed up care of cardiac patients in emergency?
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Scientific title
A randomized controlled trial of point of care troponin estimation vs in-lab methods to reduce length of stay in Emergency Department cardiac patients.
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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:
Possible Acute Coronary Syndrome in emergency patients
2179
0
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Possible Acute Coronary Syndrome in emergency patients
2350
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Condition category
Condition code
Cardiovascular
2274
2274
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0
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Other cardiovascular diseases
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Cardiovascular
2456
2456
0
0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Point of care troponin testing will be made available on some weeks.On other weeks the point of care troponin machine will be unavailable.The availability of the machine represents the intervention and the weeks that it is available will determined by computer generated randomization prior to the study and then concealed until the monday morning at the beginning of each week.At that time after opening that weeks allocation the machine will either be made available for use( which may save time for patients or not) or withdrawn for one week. If the machine is withdrawn for that week the clinical staff will be forced to use usual (laboratory bench-top methods) of testing troponin.The expected duration of the trial is 3 months assuming adequate numbers to power the study (150 in each arm)are recruited.
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Intervention code [1]
1948
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Diagnosis / Prognosis
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Intervention code [2]
2072
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Diagnosis / Prognosis
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Comparator / control treatment
Control will be non availability of point of care, ie use usual in-lab methods. In lab methods means measuring the troponin level with a beckman coulter troponin assay system in the hospital laboratory
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Control group
Active
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Outcomes
Primary outcome [1]
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Reduced Length of Stay in the emergency department
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Assessment method [1]
3279
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Timepoint [1]
3279
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measured from time of arrival to patient departure from emergency Department
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Primary outcome [2]
3356
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Reduced Length of Stay in the emergency department
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Assessment method [2]
3356
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Timepoint [2]
3356
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measured from time of arrival to patient departure from emergency Department
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Secondary outcome [1]
5461
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The primary analysis will be intention to treat, however it is intended to perform a secondary efficacy analysis which may demonstrate that the machines save time if not always actually used. This is because there will not be mandatory use of the intervention and staff may choose not to use it.
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Assessment method [1]
5461
0
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Timepoint [1]
5461
0
measured immediately on discharge
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Eligibility
Key inclusion criteria
All patients presenting to emergency with possible acute coronary syndrome
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Minimum age
25
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
1.patients with acute elevation of the ess to tee segment of their electrocardiogram 2.patients arriving with known elevated troponin.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
All consecutive eligible patients with possible coronary syndrome will be enrolled. Diagnostic test (i.e. lab vs point of care) will be assigned according to randomisation scheme for that week.This weill be by sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated randomization of weeks will determine when point of care machine (intervention) will be used; during control weeks the point of care machine will be removed and usual lab methods (control) will be used
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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
Parallel
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Other design features
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Phase
Phase 3 / Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
5/11/2007
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Actual
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Date of last participant enrolment
Anticipated
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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
300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
2540
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Government body
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Name [1]
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NSW Department of Health
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Address [1]
2540
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73 Miller Street
North Sydney NSW 2060
Australia
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Country [1]
2540
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Australia
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Primary sponsor type
Individual
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Name
Conrad Loten
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Address
Dept of Emergency Medicine
John Hunter Hospital
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Country
Australia
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Secondary sponsor category [1]
2298
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Individual
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Name [1]
2298
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John Attia
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Address [1]
2298
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Dept of General Medicine
John Hunter Hospital
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Country [1]
2298
0
Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
4457
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Hunter New England Health Ethics Committee
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Ethics committee address [1]
4457
0
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Ethics committee country [1]
4457
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Australia
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Date submitted for ethics approval [1]
4457
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Approval date [1]
4457
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21/06/2007
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Ethics approval number [1]
4457
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07/06/20/5.05
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Summary
Brief summary
A randomized comparison of two types of troponin testing for ED patients.Currently ED patients with possible coronary syndromes wait significant times to be "cleared " or declared low enough risk for stress testing or discharge. One component of this wait is the time for troponin results to become available which may be reduced by using bedside or point of care(POC) tests.This could result in acute ED bed space being more efficiently utilized.Many other factors however may affect the speed of patient flow and a controlled trial will help to quantify this.
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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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Address
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Country
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Phone
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Fax
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Email
27711
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Contact person for public queries
Name
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Conrad Loten
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Address
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Division of Emegency Medicine
John Hunter Hospital
Hunter New England Health
Lookout road
New Lambton2305
PO Box 91
Waratah NSW 2298
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Country
11086
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Australia
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Phone
11086
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+61 2 49213000
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Fax
11086
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Email
11086
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[email protected]
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Contact person for scientific queries
Name
2014
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Conrad Loten
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Address
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Division of Emegency Medicine
John Hunter Hospital
Hunter New England Health
Lookout road
New Lambton2305
PO Box 91
Waratah NSW 2298
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Country
2014
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Australia
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Phone
2014
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+61 2 49213000
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Fax
2014
0
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Email
2014
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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