ShuntCheck-Micro-Pumper Pediatric Clinical Outcomes Study

NCT ID: NCT01881711

Last Updated: 2015-06-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-05-31

Study Completion Date

2015-09-30

Brief Summary

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Primary objective is to demonstrate that data collected from ShuntCheck-Micro-Pumper (SCMP) testing results can be used in conjunction with imaging to diagnose shunt patency or obstruction in pediatric/adolescent subjects presenting to an Emergency Department or Neurosurgery Clinic (ED/NC). SCMP results and SCMP results combined with other diagnostic methods, including the Attending Physician's and the Neurosurgeon's clinical judgment will be compared to clinical outcomes within 7 days of ED/NC visit - either shunt obstruction confirmed during shunt revision surgery or shunt patency confirmed by no surgery or patency confirmed in surgery.

Detailed Description

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Conditions

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Suspected CSF Shunt Obstruction

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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SCMP plus Imaging

SCMP plus Imaging will be compared to clinical outcomes within 7 days of ED/NC visit - either shunt obstruction confirmed during shunt revision surgery or shunt patency confirmed by no surgery or patency confirmed in surgery.

Group Type EXPERIMENTAL

ShuntCheck-Micro-Pumper (SCMP)

Intervention Type DEVICE

ShuntCheck uses thermal dilution to detect flow in CSF shunts. CSF is cooled transcutaneously with an ice pack and ShuntCheck's thermosensor detects a temperature drop due to CSF flow "downstream" of the ice. Micro-Pumper is a handheld device which vibrates the shunt valve to generate a temporary increase in CSF flow in patent but temporarily non-flowing shunts. This flow increase can be detected by ShuntCheck.

Imaging

Intervention Type DEVICE

Imaging of ventricle size

Imaging Alone

Imaging alone will be compared to clinical outcomes within 7 days of ED/NC visit - either shunt obstruction confirmed during shunt revision surgery or shunt patency confirmed by no surgery or patency confirmed in surgery.

Group Type ACTIVE_COMPARATOR

Imaging

Intervention Type DEVICE

Imaging of ventricle size

SCMP Rule Out for Low Risk Cases

SCMP results in patients judged by the physician to be "Unlikely to require shunt surgery" will be compared to clinical outcomes within 7 days of ED/NC visit - either shunt obstruction confirmed during shunt revision surgery or shunt patency confirmed by no surgery or patency confirmed in surgery - to determine Negative Predictive Value in ruling out shunt malfunction

Group Type EXPERIMENTAL

ShuntCheck-Micro-Pumper (SCMP)

Intervention Type DEVICE

ShuntCheck uses thermal dilution to detect flow in CSF shunts. CSF is cooled transcutaneously with an ice pack and ShuntCheck's thermosensor detects a temperature drop due to CSF flow "downstream" of the ice. Micro-Pumper is a handheld device which vibrates the shunt valve to generate a temporary increase in CSF flow in patent but temporarily non-flowing shunts. This flow increase can be detected by ShuntCheck.

Imaging Rule for Low Risk Cases

Imaging results in patients judged by the physician to be "Unlikely to require shunt surgery" will be compared to clinical outcomes within 7 days of ED/NC visit - either shunt obstruction confirmed during shunt revision surgery or shunt patency confirmed by no surgery or patency confirmed in surgery - to determine Negative Predictive Value in ruling out shunt malfunction

Group Type ACTIVE_COMPARATOR

Imaging

Intervention Type DEVICE

Imaging of ventricle size

SCMP plus Imaging in Uncertain Cases

SCMP plus imaging results in patients who are admitted for observation results in patients judged by the physician to be "Unlikely to require shunt surgery" will be compared to clinical outcomes within 7 days of ED/NC visit - either shunt obstruction confirmed during shunt revision surgery or shunt patency confirmed by no surgery or patency confirmed in surgery - to determine Positive and Negative Predictive Value

Group Type EXPERIMENTAL

ShuntCheck-Micro-Pumper (SCMP)

Intervention Type DEVICE

ShuntCheck uses thermal dilution to detect flow in CSF shunts. CSF is cooled transcutaneously with an ice pack and ShuntCheck's thermosensor detects a temperature drop due to CSF flow "downstream" of the ice. Micro-Pumper is a handheld device which vibrates the shunt valve to generate a temporary increase in CSF flow in patent but temporarily non-flowing shunts. This flow increase can be detected by ShuntCheck.

Imaging

Intervention Type DEVICE

Imaging of ventricle size

Imaging alone in Uncertain Cases

Imaging results in patients who are admitted for observation results in patients judged by the physician to be "Unlikely to require shunt surgery" will be compared to clinical outcomes within 7 days of ED/NC visit - either shunt obstruction confirmed during shunt revision surgery or shunt patency confirmed by no surgery or patency confirmed in surgery - to determine Positive and Negative Predictive Value

Group Type ACTIVE_COMPARATOR

Imaging

Intervention Type DEVICE

Imaging of ventricle size

Interventions

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ShuntCheck-Micro-Pumper (SCMP)

ShuntCheck uses thermal dilution to detect flow in CSF shunts. CSF is cooled transcutaneously with an ice pack and ShuntCheck's thermosensor detects a temperature drop due to CSF flow "downstream" of the ice. Micro-Pumper is a handheld device which vibrates the shunt valve to generate a temporary increase in CSF flow in patent but temporarily non-flowing shunts. This flow increase can be detected by ShuntCheck.

Intervention Type DEVICE

Imaging

Imaging of ventricle size

Intervention Type DEVICE

Other Intervention Names

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CT Scan MRI

Eligibility Criteria

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Inclusion Criteria

1. Males or females, older than 35 months and less than 20 years of age.
2. Parent/guardian or alert subject (age 18 or over) capable of giving consent; subject less than 18 and of assent age must give assent to participate if appropriate and required by the institution. If the subjects are incapable of giving assent, then only parent/guardian consent is required.
3. Possess an unambiguously identifiable chronically indwelling ventricular shunt which crosses the clavicle.
4. Suspicion of shunt obstruction is great enough to warrant the performance of any diagnostic test for this condition
5. Will be available for follow-up for up to 7 days

Exclusion Criteria

1. Inability or unwillingness of the parent/guardian or alert subject to give informed consent/assent (when appropriate) as required by the Institutional Review Board.
2. Presence of multiple shunts or known non-functioning shunts crossing the clavicle.
3. Evaluating staff rule out shunt obstruction on the basis of a physical/clinical examination.
4. SCMP test would interfere with emergent subject care or if the subject is scheduled to go the OR in short order.
5. Presence of an interfering open wound or edema over the shunt.
6. Likelihood, in the judgment of the investigator, of the subject being lost to follow-up as a result of subject unavailability or clinical outcome being unobtainable.
7. Any other condition that would preclude or bias the results of the study according to the judgment of the investigator.
8. Judgment of the investigator that participation in the study will interfere with, or be detrimental to, administration of optimal health-care to the subject.
Minimum Eligible Age

35 Months

Maximum Eligible Age

29 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

NeuroDx Development

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joseph R Madsen, MD

Role: STUDY_CHAIR

Boston Children's Hospital

George I Jallo, MD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins University

David A Frim, MD

Role: PRINCIPAL_INVESTIGATOR

University of Chicago Comer Children's Hospital

David Sandberg, MD

Role: PRINCIPAL_INVESTIGATOR

University of Texas-Houston/Children's Memorial Hermann Hospital

Phillip B Storm, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital of Philadelphia

Joseph J Zorc, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital of Philadelphia

Robert W Hickey, MD

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh

Mandeep Tamber, MD

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh

Lisa H Merck, MD MPH

Role: PRINCIPAL_INVESTIGATOR

Rhode Island Hospital

Petra M Klinge, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Rhode Isalnd Hospital

Robert F Keating, MD

Role: PRINCIPAL_INVESTIGATOR

Children's National Research Institute

James Chamberlain, MD

Role: PRINCIPAL_INVESTIGATOR

Children's National Research Institute

Jeffrey R Leonard, MD

Role: PRINCIPAL_INVESTIGATOR

Nationwide Children's Hospital

Julie C Leonard, MD MPH

Role: PRINCIPAL_INVESTIGATOR

Nationwide Children's Hospital

Joseph H Piatt, MD

Role: PRINCIPAL_INVESTIGATOR

Alfred I. duPont Hospital for Children

Jonathan E Bennett, MD

Role: PRINCIPAL_INVESTIGATOR

Alfred I. duPont Hospital for Children

David Chesler, MD

Role: PRINCIPAL_INVESTIGATOR

Stony Brook Medical Center

Locations

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A I dePont Hospital for Children

Wilmington, Delaware, United States

Site Status RECRUITING

Children's National Medical Center

Washington D.C., District of Columbia, United States

Site Status RECRUITING

University of Chicago Comer Children's Hospital

Chicago, Illinois, United States

Site Status RECRUITING

Johns Hopkins Hospital

Baltimore, Maryland, United States

Site Status RECRUITING

Boston Children's Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Stony Brook Medical Center

Stony Brook, New York, United States

Site Status RECRUITING

Nationwide Children's Hospital

Columbus, Ohio, United States

Site Status RECRUITING

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Children's Hospital of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Rhode Island Hospital

Providence, Rhode Island, United States

Site Status RECRUITING

University of Texas-Houston/Children's Memorial Hermann Hospital

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Joseph R Madsen, MD

Role: CONTACT

617) 355-6005

Eun-Hyoung Park

Role: CONTACT

617.355.6558

Facility Contacts

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Jonathan E Bennett, MD

Role: primary

301-651-5827

Ashley Simmons

Role: primary

301-565-4288

David Frim, MD

Role: primary

773-702-2475

George I Jallo, MD

Role: primary

410-955-7851

Joseph R Madsen, MD

Role: primary

617-355-6005

Eun Hyoung Park

Role: backup

617.355.6558

Alina Stroia

Role: primary

631-632-9028

Julie C Leonard, MD

Role: primary

631-444-1213

Phillip B Storm, MD

Role: primary

215-590-2780

Joseph J Zorc, MD

Role: backup

(215) 776-4285

Robert W Hickey, MD

Role: primary

412-692-5052

Mandeep Tamber, MD

Role: backup

Blanche Spindell

Role: primary

401-444-2328

David Sandberg, MD

Role: primary

713-500-7306

Other Identifiers

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R44NS067772

Identifier Type: NIH

Identifier Source: secondary_id

View Link

NDxDev-SCMP-2013

Identifier Type: -

Identifier Source: org_study_id

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