Trial Outcomes & Findings for POCUS Assessment of Bladder Fullness for Girls Awaiting Radiology-Performed Transabdominal Pelvic Ultrasound (NCT NCT02923245)

NCT ID: NCT02923245

Last Updated: 2019-03-19

Results Overview

Median time from enrollment to successful completion of TAPUS

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

120 participants

Primary outcome timeframe

on same day as study enrollment

Results posted on

2019-03-19

Participant Flow

Participant milestones

Participant milestones
Measure
Point-of-care Ultrasound (POCUS)
Patients will be given consecutive intravenous (IV) fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the emergency department (ED) physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care (UC)
Patients will be given consecutive intravenous (IV) fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Overall Study
STARTED
60
60
Overall Study
COMPLETED
58
59
Overall Study
NOT COMPLETED
2
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Point-of-care Ultrasound (POCUS)
Patients will be given consecutive intravenous (IV) fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the emergency department (ED) physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care (UC)
Patients will be given consecutive intravenous (IV) fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Overall Study
ultrasound order was cancelled
2
1

Baseline Characteristics

POCUS Assessment of Bladder Fullness for Girls Awaiting Radiology-Performed Transabdominal Pelvic Ultrasound

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
POCUS
n=60 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the ED physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care
n=60 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Total
n=120 Participants
Total of all reporting groups
Age, Continuous
14.1 years
STANDARD_DEVIATION 2.43 • n=5 Participants
14.7 years
STANDARD_DEVIATION 2.34 • n=7 Participants
14.4 years
STANDARD_DEVIATION 2.39 • n=5 Participants
Sex: Female, Male
Female
60 Participants
n=5 Participants
60 Participants
n=7 Participants
120 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Non-Hispanic White
31 Participants
n=5 Participants
37 Participants
n=7 Participants
68 Participants
n=5 Participants
Race/Ethnicity, Customized
Non-Hispanic Black
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
22 Participants
n=5 Participants
14 Participants
n=7 Participants
36 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
2 Participants
n=5 Participants
4 Participants
n=7 Participants
6 Participants
n=5 Participants
Region of Enrollment
United States
60 Participants
n=5 Participants
60 Participants
n=7 Participants
120 Participants
n=5 Participants
Body Mass Index (BMI)
23.0 kg/m2
STANDARD_DEVIATION 4.81 • n=5 Participants
25.4 kg/m2
STANDARD_DEVIATION 6.57 • n=7 Participants
24.2 kg/m2
STANDARD_DEVIATION 5.86 • n=5 Participants
Time since last void
126.5 minutes
n=5 Participants
120.5 minutes
n=7 Participants
125 minutes
n=5 Participants
Time from TAPUS order by physician to study enrollment
32.0 minutes
n=5 Participants
34.5 minutes
n=7 Participants
32.5 minutes
n=5 Participants
Chief Complaint
Abdominal Pain
56 Participants
n=5 Participants
50 Participants
n=7 Participants
106 Participants
n=5 Participants
Chief Complaint
Vomiting
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Chief Complaint
Dysuria/flank pain/hematuria
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Chief Complaint
Other
0 Participants
n=5 Participants
3 Participants
n=7 Participants
3 Participants
n=5 Participants

PRIMARY outcome

Timeframe: on same day as study enrollment

Median time from enrollment to successful completion of TAPUS

Outcome measures

Outcome measures
Measure
POCUS
n=58 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the ED physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care
n=59 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Median Fill-To-Done (FTD) Time
87.5 minutes
Interval 67.0 to 126.0
139 minutes
Interval 92.0 to 193.0

SECONDARY outcome

Timeframe: on same day as study enrollment

Outcome measures

Outcome measures
Measure
POCUS
n=58 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the ED physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care
n=59 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Number of Participants Who Had a Successful Transabdominal Pelvic Ultrasound (TAPUS) on First Attempt
58 Participants
50 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: day of enrollment

Outcome measures

Outcome measures
Measure
POCUS
n=58 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the ED physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care
n=59 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Number of Participants Receiving IV Narcotics in the Emergency Department
21 Participants
26 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: day of enrollment

Outcome measures

Outcome measures
Measure
POCUS
n=58 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the ED physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care
n=59 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Total IV Fluids Given Prior to TAPUS
19.4 ml/Kg
Standard Deviation 15.1
22.9 ml/Kg
Standard Deviation 13.5

OTHER_PRE_SPECIFIED outcome

Timeframe: day of enrollment

Outcome measures

Outcome measures
Measure
POCUS
n=58 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the ED physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care
n=59 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
TAPUS Result
Normal
46 Participants
48 Participants
TAPUS Result
Abnormal
12 Participants
11 Participants
TAPUS Result
Ovarian torsion
4 Participants
2 Participants
TAPUS Result
Simple ovarian cyst
1 Participants
3 Participants
TAPUS Result
Ruptured/hemorrhagic cyst
5 Participants
5 Participants
TAPUS Result
Other ovarian abnormality
2 Participants
0 Participants
TAPUS Result
Uterine anomaly
0 Participants
1 Participants
TAPUS Result
Pathologic free fluid
1 Participants
2 Participants
TAPUS Result
Hydrosalpinx
1 Participants
0 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: day of enrollment

Outcome measures

Outcome measures
Measure
POCUS
n=58 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the ED physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care
n=59 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Disposition From ED
Discharged home
43 Participants
44 Participants
Disposition From ED
Admit to ward
11 Participants
11 Participants
Disposition From ED
Admitted to operating room
5 Participants
5 Participants
Disposition From ED
Transferred
1 Participants
0 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: at close of study

Population: 304 images were available for assessment of inter-rater reliability

Agreement between the POCUS sonographer and the blinded reviewer

Outcome measures

Outcome measures
Measure
POCUS
n=304 Participants
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until a full bladder is visualized by the ED physician on POCUS or the patient endorses maximal bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician. point-of-care ultrasound
Usual Care
Patients will be given consecutive IV fluid boluses and assessed at 30 minute intervals for sensation of bladder fullness on a 0-4 Likert scale and POCUS assessments of the bladder. Protocol continues until the patient endorses sensation of maximum bladder fullness on a 0-4 Likert Scale. The patient will then have a transabdominal pelvic ultrasound performed by a radiologist or ultrasound technician.
Inter-rater Agreement
0.83 weighted kappa
Interval 0.79 to 0.87

Adverse Events

POCUS

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Usual Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Almaz Dessie, MD

Brown University

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place