Trial Outcomes & Findings for The Effectiveness of High Resolution Microendoscopy for People Living With HIV (NCT NCT04563754)

NCT ID: NCT04563754

Last Updated: 2025-04-23

Results Overview

The primary outcome of this study is to measure the operating characteristics including SN, SP, PPV and NPV comparing the physician- and algorithm- guided HRME-based image compared to the Lugol's- guided physician diagnosis of HSIL during HRA. Gold standard consensus pathology was used and pathology data needs to be obtained, verified, and entered.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

163 participants

Primary outcome timeframe

1 day

Results posted on

2025-04-23

Participant Flow

Participants were recruited at two anal dysplasia clinics: Tisch Cancer Institute Mount Sinai in New York, NY, and Thomas Street Health Center in Houston, TX. At Tisch Cancer Institute Mount Sinai, participants were recruited between July 30, 2019, and September 28, 2021. At Thomas Street Health Center, participants were recruited between December 8, 2021, and March 28, 2023. Participants were consented and screened for eligibility at time of presentation to the two recruitment sites.

Participant milestones

Participant milestones
Measure
Tisch Cancer Institute Mount Sinai
Participants enrolled in the Tisch Cancer Institute Mount Sinai.
Thomas Street Health Center
Participants enrolled in the Thomas Street Health Center, excluding the first 18 participants used as test subjects.
Training Set Cohort
The first 18 participants enrolled in the Thomas Street Health Center as test subjects.
HRME Procedure
STARTED
79
66
18
HRME Procedure
COMPLETED
68
60
0
HRME Procedure
NOT COMPLETED
11
6
18
Follow up
STARTED
79
66
18
Follow up
COMPLETED
18
13
13
Follow up
NOT COMPLETED
61
53
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Tisch Cancer Institute Mount Sinai
Participants enrolled in the Tisch Cancer Institute Mount Sinai.
Thomas Street Health Center
Participants enrolled in the Thomas Street Health Center, excluding the first 18 participants used as test subjects.
Training Set Cohort
The first 18 participants enrolled in the Thomas Street Health Center as test subjects.
HRME Procedure
No HRA and/or HRME data due to technical difficulties or quality control issues with HRME imaging
11
6
0
HRME Procedure
Optimization/validation of 3D imaging and HRME
0
0
18
Follow up
Lost to Follow-up
61
23
5
Follow up
Death
0
2
0
Follow up
Ongoing
0
28
0

Baseline Characteristics

The Effectiveness of High Resolution Microendoscopy for People Living With HIV

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Tisch Cancer Institute Mount Sinai
n=79 Participants
Participants enrolled in the Tisch Cancer Institute Mount Sinai.
Thomas Street Health Center
n=66 Participants
Participants enrolled in the Thomas Street Health Center, excluding the first 18 participants used as test subjects.
Training Set Cohort
n=18 Participants
The first 18 participants enrolled in the Thomas Street Health Center as test subjects.
Total
n=163 Participants
Total of all reporting groups
Age, Continuous
45.0 years
n=5 Participants
48.0 years
n=7 Participants
50.5 years
n=5 Participants
47.0 years
n=4 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
5 Participants
n=7 Participants
2 Participants
n=5 Participants
11 Participants
n=4 Participants
Sex: Female, Male
Male
75 Participants
n=5 Participants
61 Participants
n=7 Participants
16 Participants
n=5 Participants
152 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
34 Participants
n=5 Participants
36 Participants
n=7 Participants
12 Participants
n=5 Participants
82 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
45 Participants
n=5 Participants
30 Participants
n=7 Participants
6 Participants
n=5 Participants
81 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
8 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
8 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
24 Participants
n=5 Participants
26 Participants
n=7 Participants
4 Participants
n=5 Participants
54 Participants
n=4 Participants
Race (NIH/OMB)
White
33 Participants
n=5 Participants
12 Participants
n=7 Participants
6 Participants
n=5 Participants
51 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
12 Participants
n=5 Participants
25 Participants
n=7 Participants
8 Participants
n=5 Participants
45 Participants
n=4 Participants

PRIMARY outcome

Timeframe: 1 day

Population: The training set cohort (n=18) was used to optimize and develop the automated algorithms assessed for primary and secondary outcomes in the actual clinical study. In both the training set cohort and the clinical study, subjects unable to complete the HRME examination or undergo evaluation with the automated algorithm (n=26) were excluded. The remaining 137 evaluable subjects had images assessed by the algorithm and were analyzed separately by study site and the training set cohort.

The primary outcome of this study is to measure the operating characteristics including SN, SP, PPV and NPV comparing the physician- and algorithm- guided HRME-based image compared to the Lugol's- guided physician diagnosis of HSIL during HRA. Gold standard consensus pathology was used and pathology data needs to be obtained, verified, and entered.

Outcome measures

Outcome measures
Measure
Tisch Cancer Institute Mount Sinai
n=101 Biopsies
Participants enrolled in the Tisch Cancer Institute Mount Sinai.
Thomas Street Health Center
n=126 Biopsies
Participants enrolled in the Thomas Street Health Center, excluding the first 18 participants used as test subjects.
Training Set Cohort
n=20 Biopsies
The first 18 participants enrolled in the Thomas Street Health Center as test subjects.
Performance Characteristics: Sensitivity (SN), Specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Values (NPV)
HRA - SN
90.0 percentage of biopsies
Interval 76.3 to 97.2
76.9 percentage of biopsies
Interval 56.4 to 91.0
100.0 percentage of biopsies
Interval 66.4 to 100.0
Performance Characteristics: Sensitivity (SN), Specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Values (NPV)
HRA - SP
65.6 percentage of biopsies
Interval 52.3 to 77.3
48.0 percentage of biopsies
Interval 37.9 to 58.2
90.9 percentage of biopsies
Interval 58.7 to 99.8
Performance Characteristics: Sensitivity (SN), Specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Values (NPV)
HRA - PPV
63.2 percentage of biopsies
Interval 49.3 to 75.6
27.8 percentage of biopsies
Interval 17.9 to 39.6
90.0 percentage of biopsies
Interval 55.5 to 99.7
Performance Characteristics: Sensitivity (SN), Specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Values (NPV)
HRA - NPV
90.9 percentage of biopsies
Interval 78.3 to 97.5
88.9 percentage of biopsies
Interval 77.4 to 95.8
100.0 percentage of biopsies
Interval 69.2 to 100.0
Performance Characteristics: Sensitivity (SN), Specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Values (NPV)
HRME - SN
90.0 percentage of biopsies
Interval 76.3 to 97.2
92.3 percentage of biopsies
Interval 74.9 to 99.1
100.0 percentage of biopsies
Interval 66.4 to 100.0
Performance Characteristics: Sensitivity (SN), Specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Values (NPV)
HRME - SP
67.2 percentage of biopsies
Interval 54.0 to 78.7
68.0 percentage of biopsies
Interval 57.9 to 77.0
100.0 percentage of biopsies
Interval 71.5 to 100.0
Performance Characteristics: Sensitivity (SN), Specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Values (NPV)
HRME - PPV
64.3 percentage of biopsies
Interval 50.4 to 76.6
42.9 percentage of biopsies
Interval 29.7 to 56.8
100.0 percentage of biopsies
Interval 66.4 to 100.0
Performance Characteristics: Sensitivity (SN), Specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Values (NPV)
HRME - NPV
91.1 percentage of biopsies
Interval 78.8 to 97.5
97.1 percentage of biopsies
Interval 90.1 to 99.7
100.0 percentage of biopsies
Interval 71.5 to 100.0

SECONDARY outcome

Timeframe: 1 day

Population: The training set cohort (n=18) was used to optimize and develop the automated algorithms assessed for primary and secondary outcomes in the actual clinical study. In both the training set cohort and the clinical study, subjects unable to complete the HRME examination or undergo evaluation with the automated algorithm (n=26) were excluded. The remaining 137 evaluable subjects had images assessed by the algorithm and were analyzed separately by study site and the training set cohort.

Diagnostic yield: The number of neoplastic biopsies/total number of biopsies obtained in patients who received biopsies.

Outcome measures

Outcome measures
Measure
Tisch Cancer Institute Mount Sinai
n=101 Biopsies
Participants enrolled in the Tisch Cancer Institute Mount Sinai.
Thomas Street Health Center
n=126 Biopsies
Participants enrolled in the Thomas Street Health Center, excluding the first 18 participants used as test subjects.
Training Set Cohort
n=20 Biopsies
The first 18 participants enrolled in the Thomas Street Health Center as test subjects.
Procedure Efficiency
39.6 percentage of biopsies
Interval 30.0 to 49.8
20.6 percentage of biopsies
Interval 13.9 to 28.8
45.0 percentage of biopsies
Interval 23.1 to 68.5

SECONDARY outcome

Timeframe: 1 day

Population: The training set cohort (n=18) was used to optimize and develop the automated algorithms assessed for primary and secondary outcomes in the actual clinical study. In both the training set cohort and the clinical study, subjects who did not have both the procedure start and end times recorded were excluded (n=10). The remaining 153 subjects were analyzed separately by study site and the training set cohort.

Total procedure time (HRA+HRME+biopsies) vs HRME time alone

Outcome measures

Outcome measures
Measure
Tisch Cancer Institute Mount Sinai
n=77 Participants
Participants enrolled in the Tisch Cancer Institute Mount Sinai.
Thomas Street Health Center
n=61 Participants
Participants enrolled in the Thomas Street Health Center, excluding the first 18 participants used as test subjects.
Training Set Cohort
n=15 Participants
The first 18 participants enrolled in the Thomas Street Health Center as test subjects.
Procedure Time
Total procedure time
8 minutes
Interval 6.0 to 13.0
12 minutes
Interval 10.0 to 15.0
17 minutes
Interval 13.0 to 18.0
Procedure Time
HRME time
2 minutes
Interval 1.0 to 3.0
4 minutes
Interval 3.0 to 5.0
5 minutes
Interval 4.0 to 6.0

Adverse Events

Tisch Cancer Institute Mount Sinai

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

Thomas Street Health Center

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

Training Set Cohort

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

Dr. Sharmila Anandasabapathy

Baylor College of Medicine

Phone: 713-798-8105

Results disclosure agreements

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