Non-Invasive Eye Tracking for the Diagnosis of Delirium on ICU

NCT ID: NCT04589169

Last Updated: 2020-12-08

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

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-12-07

Study Completion Date

2021-10-12

Brief Summary

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In this trial, the investigators seek to demonstrate the feasibility of a system in continuously detecting 'inattention' as a subset of CAM-ICU in a small representative sample of patients in the Intensive Care Unit (ICU) at Chelsea \& Westminster NHS Foundation Trust.

Detailed Description

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Delirium is an acute confusional state that affects many patients admitted to the hospital, especially intensive care. The current diagnosis of delirium is through the use of the Confusional Assessment Method in Intensive Care Unit (CAM-ICU) task based questionnaire. The core prinicipal to CAM-ICU is inattention; this is tested through asking the patient to remember a task and execute it on demand, e.g. squeezing the operator's hand everytime the letter A is said and then spelling CASABLANCA.

The aim of this study is to find correlates to inattention. Eye-gaze data is ideally suited for this task as eyes move to pay attention to the environment.

A video camera based eye-tracker has been developed that sits at the end of the bed (head-camera) and another behind the patient (scene-camera). The head-camera uses machine learning to measure the gaze of the patient's eyes while the scene-camera finds what the patient is looking at. Simulations are then run from the scene camera and the patient's gaze is then compared to find whether the patient is paying attention to what is simulated.

Once per day, a member of the local research team will fill in a non-validated questionnaire based on work by MacMurchy et al.

M. MacMurchy, S. Stemler, M. Zander, C. P. Bonafide, Acceptability, Feasibility, and Cost of Using Video to Evaluate Alarm Fatigue, Biomedical Instrumentation \& Technology 51 (2017) 25-33.

Conditions

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Delirium

Keywords

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Delirium Inattention Eye-gaze ICU

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Positive cohort

Patients who develop delirium

No interventions assigned to this group

Experimental control group

Patients who do not develop delirium

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. Aged \>18
2. Predicted Delirium as defined by the Early PREdiction of DELIRium in ICU patients (E-PREDELIRIC) score ≥ 20%
3. Expected length of stay ≥ 2 days

Exclusion Criteria

1. Non-concordant eyes
2. Visual Impairment
3. Dementia
4. Inability for facial recognition and eye tracking to be performed reliably
5. Lack of signed consent form / nominated consultee form
6. In-ability to perform CAM-ICU reliably
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Westminster Medical School Research Trust

UNKNOWN

Sponsor Role collaborator

BMA Foundation for Medical Research

UNKNOWN

Sponsor Role collaborator

Chelsea and Westminster NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ahmed Al-Hindawi, BMBS, MRCA

Role: PRINCIPAL_INVESTIGATOR

Chelsea and Westminster NHS Foundation Trust

Locations

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Chelsea and Westminster Hospital NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Research Delivery Operations Manager

Role: CONTACT

Phone: 020 3315 6825

Email: [email protected]

Marcela Vizcaychipi, MD, PhD

Role: CONTACT

Phone: 02033158024

Email: [email protected]

Facility Contacts

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Research Delivery Operations Manager

Role: primary

Marcela Vizcaychipi, MD, PhD

Role: backup

References

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McCusker J, Cole M, Abrahamowicz M, Primeau F, Belzile E. Delirium predicts 12-month mortality. Arch Intern Med. 2002 Feb 25;162(4):457-63. doi: 10.1001/archinte.162.4.457.

Reference Type BACKGROUND
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Reference Type BACKGROUND
PMID: 1907117 (View on PubMed)

Meagher DJ. Delirium: optimising management. BMJ. 2001 Jan 20;322(7279):144-9. doi: 10.1136/bmj.322.7279.144. No abstract available.

Reference Type BACKGROUND
PMID: 11159573 (View on PubMed)

Lin SM, Liu CY, Wang CH, Lin HC, Huang CD, Huang PY, Fang YF, Shieh MH, Kuo HP. The impact of delirium on the survival of mechanically ventilated patients. Crit Care Med. 2004 Nov;32(11):2254-9. doi: 10.1097/01.ccm.0000145587.16421.bb.

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Ouimet S, Kavanagh BP, Gottfried SB, Skrobik Y. Incidence, risk factors and consequences of ICU delirium. Intensive Care Med. 2007 Jan;33(1):66-73. doi: 10.1007/s00134-006-0399-8. Epub 2006 Nov 11.

Reference Type BACKGROUND
PMID: 17102966 (View on PubMed)

Pisani MA, Araujo KL, Van Ness PH, Zhang Y, Ely EW, Inouye SK. A research algorithm to improve detection of delirium in the intensive care unit. Crit Care. 2006;10(4):R121. doi: 10.1186/cc5027.

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Y. Zhang, T. Wilcockson, K. I. Kim, T. Crawford, H. Gellersen, P. Sawyer, Monitoring Dementia with Automatic Eye Movements Analysis, in: I. Czarnowski, A. M. Caballero, R. J. Howlett, L. C. Jain (Eds.), Intelligent Decision Technologies 2016, volume 57, Springer International Publishing, Cham, 2016, pp. 299-309.

Reference Type BACKGROUND

Exton C, Leonard M. Eye tracking technology: a fresh approach in delirium assessment? Int Rev Psychiatry. 2009 Feb;21(1):8-14. doi: 10.1080/09540260802675106.

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MacMurchy M, Stemler S, Zander M, Bonafide CP. Research: Acceptability, Feasibility, and Cost of Using Video to Evaluate Alarm Fatigue. Biomed Instrum Technol. 2017 Jan-Feb;51(1):25-33. doi: 10.2345/0899-8205-51.1.25. No abstract available.

Reference Type BACKGROUND
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Other Identifiers

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IRAS number 264759

Identifier Type: OTHER

Identifier Source: secondary_id

C&W19/064

Identifier Type: -

Identifier Source: org_study_id