Utility of Thermal Imaging in Diagnosis of Cellulitis for Lower Extremity Complaints in the Emergency Department

NCT ID: NCT04928235

Last Updated: 2023-12-07

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

COMPLETED

Total Enrollment

416 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-07-18

Study Completion Date

2023-02-18

Brief Summary

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The overall purpose of the study is to determine how providing physicians with a quantitative measure of skin surface temperature influences diagnoses and diagnostic confidence in potential cellulitis cases when added to the standard evaluation.

Detailed Description

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Previous literature estimates the emergency department misdiagnosis rate for cellulitis exceeds 30% due to conditions which can mimic cellulitis (termed pseudocellulitis). These diagnostic errors are associated with an estimated $195 to $515 million dollars in avoidable healthcare spending each year. Objective skin surface temperature measurement, obtained via thermal imaging cameras, has been proposed as a diagnostic adjunct that may reduce diagnostic error in cases of suspected cellulitis. One recent study, identified that the maximum affected skin temperature in cellulitis is significantly higher than in pseudocellulitis, and the temperature gradient between affected and unaffected sites in patients with cellulitis is significantly higher than in patients with pseudocellulitis.

The overall purpose of the study is to determine how providing physicians with a quantifiable measure of skin surface temperature information influences diagnoses and diagnostic confidence in potential cellulitis cases when added to standard physical exam techniques

The Aims of the study are to :

Specific Aim 1: To characterize the temperature difference between affected and unaffected limbs in patients with cellulitis in the emergency department.

Specific Aim 2: To characterize the temperature difference between cases of cellulitis and pseudocellulitis

Specific Aim 3: To determine how quantifying temperature gradients changes diagnostic confidence and accuracy when added to the standard diagnostic evaluation for potential cellulitis.

The investigators will prospectively enroll a maximum of 560 patients with non-traumatic lower extremity dermatologic complaints with visible erythema (potential cellulitis) in the University of Wisconsin Emergency Department. A thermal image and a photograph of the affected and the unaffected limbs will be taken.

Conditions

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Cellulitis Skin and Subcutaneous Tissue Infection

Keywords

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Diagnostic confidence Diagnostic accuracy Diagnostic error

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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All Participants

All participants will have thermal imaging of their lower extremities. The temperature values will be shared with the attending physician. The physician will be asked questions about their diagnostic confidence before and after seeing the temperature values.

Thermal Imaging as Diagnostic Adjunct

Intervention Type DIAGNOSTIC_TEST

Thermal images of the participants lower extremities will be taken and skin surface temperature values will be provided to the healthcare provider for review during the emergency department encounter.

Interventions

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Thermal Imaging as Diagnostic Adjunct

Thermal images of the participants lower extremities will be taken and skin surface temperature values will be provided to the healthcare provider for review during the emergency department encounter.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Participant is presenting to the University of Wisconsin Emergency Department
* Participant has an acute skin complaint on the lower extremity

Exclusion Criteria

* Participant is has limited English and Spanish proficiency
* There was an acute traumatic injury of affected area in last 5 days- includes burns
* Affected area has a confirmed fracture
* Participant is pregnant
* Participant is a prisoner
* Current complaint is in an area of past surgical procedure (within past 4 weeks)
* Participant has implant or hardware at site
* Animal or human bite is cause of complaint
* Temperature of the leg has been altered in the last one hour
* Unable to provide informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role collaborator

University of Wisconsin, Madison

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael Pulia, MD, MS

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Locations

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University of Wisconsin Emergency Department

Madison, Wisconsin, United States

Site Status

Countries

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United States

Other Identifiers

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A534100

Identifier Type: OTHER

Identifier Source: secondary_id

SMPH/EMERG MED

Identifier Type: OTHER

Identifier Source: secondary_id

1K08HS024342-01A1

Identifier Type: AHRQ

Identifier Source: secondary_id

View Link

2018-0823 Phase 2

Identifier Type: -

Identifier Source: org_study_id