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Trial registered on ANZCTR
Registration number
ACTRN12608000417381
Ethics application status
Approved
Date submitted
27/06/2008
Date registered
25/08/2008
Date last updated
14/10/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
The diagnosis of Obstructive Sleep Apnea (OSA) in primary care
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Scientific title
Development and validation of a diagnostic algorithm for the diagnosis of Obstructive Sleep Apnea (OSA) in primary care
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Secondary ID [1]
676
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Nil
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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:
Obstructive Sleep Apnea (OSA)
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Condition category
Condition code
Respiratory
3484
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0
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Sleep apnoea
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Intervention/exposure
Study type
Observational
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Patient registry
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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
Subjects presenting to the primary care practitioner (PCP) in metropolitan and regional areas with suspected OSA will undergo a clinical evaluation, answer questionnaires, and have a photograph taken of their face and profile. After this visit they also be tested for 3 nights at home on a portable nasal flow monitor (Flow Wizard, DiagnoseIt, Sydney, Australia) and undergo a single night in-hospital polysomnogram (the reference standard test used to diagnose obstructive sleep apnea).
Information collected during the 15-20 minute primary care practitioner visit are:
demographic and anthropometric characteristics (weight, height, neck circumference, waist circumference, hip circumference),
questionnaires of sleep apnea symptoms and sleepiness (Epworth Sleepiness Scale; Multivariate Apnea Prediction Index; Berlin Questionnaire), and digital photography of face and neck (technique analgous to cephalometric x-rays to characterise anatomical variations that may be associated with OSA).
All testing will be performed within a 6-week period.
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Intervention code [1]
3063
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Not applicable
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Comparator / control treatment
Not-applicable - Observational study
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Diagnostic accuracy of a diagnostic algorithm combining the variables and measurements, to rule in and rule out the presence of OSA.
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Assessment method [1]
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Timepoint [1]
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At end of algorithm development when an optimal set of variables to diagnose obstructive sleep apnea will be determined (at approximately 15 months) and end of the validation phases of study (when the algorithm will be tested with a new set of patients, at approximately 27 months).
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Secondary outcome [1]
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Satisfaction and ease-of-use of the diagnostic algorithm, rated by GPs and involved practice staff, rated by Likert-type scales.
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Assessment method [1]
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Timepoint [1]
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End of development (at approximately 15 months) and end of validation phases of study (at approximately 27 months.)
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Secondary outcome [2]
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Patient preference for diagnostic algorithm compared with standard in-laboratory polysomnography.
Patients will rate aspects of the diagnostic algorithm and the standard in-laboratory polysomnography on standard Likert scales.
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Assessment method [2]
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Timepoint [2]
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Upon each patient's completion of the study.
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Eligibility
Key inclusion criteria
age 18-75, presents to GP with suspicion of OSA based on symptoms of sleep apnea (snoring, choking, witnessed apneas or daytime sleepiness) and/or conditions associated with OSA (such as obesity or the metabolic syndrome).
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Minimum age
18
Years
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Maximum age
75
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
unable to comply with procedures, unable to apply the diagnostic device (either by patient or other care-giver), or the diagnosis being considered is primarily a non-OSA sleep disorder such as insomnia, parasomnia or narcolepsy.
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Study design
Purpose
Screening
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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
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2008
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Actual
16/09/2008
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Date of last participant enrolment
Anticipated
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Actual
6/01/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
570
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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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Recruitment postcode(s) [1]
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2050
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Recruitment postcode(s) [2]
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2065
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Recruitment postcode(s) [3]
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2037
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Recruitment postcode(s) [4]
1056
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2170
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Recruitment postcode(s) [5]
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2217
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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GPO Box 1421, Canberra City, ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Other
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Name
Woolcock Institute of Medical Research
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Address
PO Box M77, Missenden Road NSW 2050
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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]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Sydney South West Area Health Service (SSWAHS) Ethics Review Committee (RPAH Zone)
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Ethics committee address [1]
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Research Development Office, Level 8, Building 14, Royal Prince Alfred Hospital, Camperdown, NSW 2050
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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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02/06/2008
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Ethics approval number [1]
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X08-0125
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Summary
Brief summary
Obstructive sleep apnea (OSA) is a common and treatable condition with significant consequences in terms of morbidity as well as mortality. Currently diagnosed with an in-laboratory polysomnogram (PSG) in the context of specialist consultation, this pathway is both labour- and resource-intensive. The burden of undiagnosed and untreated disease imposes a great economic cost to the community in terms of injuries, lost productivity and associated medical conditions. We propose to test the utility of a nasal-flow based diagnostic device, anatomical features from analysis of photographic images of the head and neck, as well as clinical information from questionnaires and biometrics, in General Practice. Subjects presenting to the primary care practitioner (PCP) in metropolitan and regional areas with suspected OSA will undergo a clinical evaluation, answer questionnaires, have a photograph taken of their face and profile and be tested for 3 nights at home on a portable nasal flow monitor. The reference standard will be an in-laboratory polysomnogram. A diagnostic algorithm will be developed and validated, combining the factors giving the best prediction of OSA.
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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 Ronald Grunstein
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Address
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Woolcock Institute of Medical Research
PO Box M77
Missenden Road NSW 2050
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Country
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Australia
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Phone
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+61 2 9114 0000
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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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Keith Wong
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Address
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PO Box M77, Missenden Road NSW 2050, Australia
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Country
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Australia
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Phone
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+61 2 9114 0445
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Fax
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+61 2 9114 0014
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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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Keith Wong
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Address
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PO Box M77, Missenden Road NSW 2050, Australia
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Country
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Australia
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Phone
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+61 2 9114 0445
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Fax
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+61 2 9114 0014
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Email
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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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