Determining the Validity of ThinkSono Guidance for Ultrasound Image Acquisition and Remote Detection

NCT ID: NCT06652568

Last Updated: 2025-12-15

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

RECRUITING

Clinical Phase

NA

Total Enrollment

500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-08

Study Completion Date

2025-12-31

Brief Summary

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The purpose of this study is to confirm the safety and efficacy of the ThinkSono Guidance System, a software data collection and communication tool designed to collect ultrasound data to help detect blood clots in veins. The ThinkSono system is CE Mark approved in the European Union and in clinical use in Europe. Usually, when an ultrasound is conducted to diagnose blood clots in veins, a sonographer (trained technologist who conducts ultrasounds) and/or radiologist will conduct the procedure, including a compression ultrasound exam, and the scan may require a bulky cart and ultrasound equipment. The ThinkSono Guidance System is a mobile software application that enables other healthcare professionals such as nurses, non-radiologist physicians including general practitioners, and other allied healthcare professionals to perform the ultrasound at the point of care using guidance from the software app. This is a multi-site non-randomized, double-blinded, prospective cohort pivotal study.

Detailed Description

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Deep vein thrombosis (DVT) is well recognized to cause significant morbidity and mortality both at the time of diagnosis and post-diagnosis. With an estimated incidence of 1- 2 per 1,000 people, over to 300,000 people in the US will be diagnosed with venous thromboembolism (VTE) per annum and two-thirds of these will be DVT. However, positive cases only represent 12-25% of the total number of patients who present with suspected DVT. In other words, between 75-88% of suspected DVT cases, when fully investigated, are negative. Estimates have placed the yearly cost of VTE to the US healthcare system at up to $10 billion.

It is notoriously difficult to diagnose a DVT by clinical acumen alone. The standard approach to making a diagnosis of proximal DVT currently involves an algorithm combining pre-test probability assessment through the Well's score, and compression ultrasonography. Handheld ultrasound probes have recently become available. These probes have enabled 'app-based' compression ultrasonography to be performed without the need for bulky cart or laptop-based ultrasound machines. These new machines have a small form factor, meaning only the ultrasound probe is required for diagnostic purposes in conjunction with a smartphone or tablet.

At present, although the new handheld probes are smaller and are better suited for point of care diagnosis, they still require an experienced radiologist or sonographer to perform the compression exam. This means that these devices can only be used wherever sonographers/radiologists are based most often i.e. hospital radiology departments. However, due to recent advances in "machine learning", software is now being developed for these 'app-based' probes that can assist non-radiology specialist healthcare professionals (e.g. nurses, non-radiologist physicians, general practitioners and other allied healthcare professionals) to carry out the compression ultrasound exam with minimal training.

The ThinkSono Guidance System is a guidance software expected to help non-radiology specialist healthcare professionals produce compression ultrasound image data that meet or exceed the minimal image quality criteria for a remote diagnosis by an expert (e.g. radiologist). The ThinkSono system is CE Mark approved in the European Union and in clinical use in Europe.

This study is a multi-site non-randomized, double-blinded, prospective cohort pivotal study. The purpose of this study is to confirm the safety and efficacy of the ThinkSono Guidance System as per the intended use defined as:

ThinkSono Guidance System is a guidance, data acquisition and communication tool that guides non-ultrasound-trained healthcare staff to collect point of care compression ultrasound data in the proximal deep venous system of the lower extremity for interpretation by qualified clinicians.

Conditions

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Deep Vein Thrombosis Deep Vein Thrombosis, Pulmonary Embolus

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Single arm comparison study between the ThinkSono device and standard of care venous duplex ultrasound.
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Though not masked, the study is double blinded. Double blinding will be ensured by the ThinkSono software, as it will not be giving any indication of diagnosis or image quality to the operator. The comparison scan will be done by a qualified imaging specialist as per the standard of care at the local institution, but they will also not know the results of the ThinkSono scan. There will also be "remote qualified clinicians" reviewing the ThinkSono data (separately from local staff) who also will not know the results of the local imaging specialist. Only at the final data assessment upon study completion will outcome assessors be aware of ThinkSono device results and local site imaging results.

Study Groups

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Comparison Arm

This arm of patients will undergo an ultrasound scan using the ThinkSono system and a comparison standard of care duplex ultrasound scan.

Group Type OTHER

ThinkSono System

Intervention Type DEVICE

The ThinkSono Guidance System is a guidance software expected to help non-radiology specialist healthcare professionals produce compression ultrasound image data that meet or exceed the minimal image quality criteria for a remote diagnosis by an expert (e.g. radiologist).

Interventions

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ThinkSono System

The ThinkSono Guidance System is a guidance software expected to help non-radiology specialist healthcare professionals produce compression ultrasound image data that meet or exceed the minimal image quality criteria for a remote diagnosis by an expert (e.g. radiologist).

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* The participant is willing to provide written informed consent to participate in this research.
* The participant is over the age of 18
* The participant has symptoms suggestive of a deep venous thrombosis (DVT)
* The diagnostic DVT algorithm indicates that an ultrasound is needed

Exclusion Criteria

* Patient consent not given or retracted during the study.
* Local imaging specialists fail to scan the patient or fail to produce a conclusive imaging diagnosis.
* Incomplete ThinkSono Guidance scan due to logistical or other issues such as pain, lack of patient cooperation, barriers such as a cast or other physical limitations.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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NYU Langone Health

OTHER

Sponsor Role collaborator

Temple Health

UNKNOWN

Sponsor Role collaborator

Allegheny Health Network

OTHER

Sponsor Role collaborator

University of Wisconsin, Madison

OTHER

Sponsor Role collaborator

South Texas Veterans Health Care System

FED

Sponsor Role collaborator

ThinkSono, Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Glenn Jacobowitz, MD

Role: PRINCIPAL_INVESTIGATOR

Northwell Health

Locations

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NYU Langone Health

New York, New York, United States

Site Status COMPLETED

Temple Health

Philadelphia, Pennsylvania, United States

Site Status COMPLETED

Allegheny Health Network

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

South Texas Veterans Health System

San Antonio, Texas, United States

Site Status RECRUITING

University of Wisconsin-Madison

Madison, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Giancarlo Speranza, MD, MBA

Role: CONTACT

2122637311

Fouad Al Noor

Role: CONTACT

Facility Contacts

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Senior Clinical Research Nurse

Role: primary

(412) 362-8677

Nilam Soni, MD

Role: primary

(210) 617-5300

Hani Kuttab, MD

Role: primary

(608) 890-8682

References

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Poulikidis KP, Gasparis AP, Labropoulos N. Prospective analysis of incidence, extent and chronicity of lower extremity venous thrombosis. Phlebology. 2014 Feb;29(1):37-42. doi: 10.1258/phleb.2012.012086. Epub 2013 May 6.

Reference Type BACKGROUND
PMID: 23131597 (View on PubMed)

Nothnagel K, Aslam MF. Evaluating the benefits of machine learning for diagnosing deep vein thrombosis compared with gold standard ultrasound: a feasibility study. BJGP Open. 2025 Jan 2;8(4):BJGPO.2024.0057. doi: 10.3399/BJGPO.2024.0057. Print 2024 Dec.

Reference Type BACKGROUND
PMID: 38866404 (View on PubMed)

Grosse SD, Nelson RE, Nyarko KA, Richardson LC, Raskob GE. The economic burden of incident venous thromboembolism in the United States: A review of estimated attributable healthcare costs. Thromb Res. 2016 Jan;137:3-10. doi: 10.1016/j.thromres.2015.11.033. Epub 2015 Nov 24.

Reference Type BACKGROUND
PMID: 26654719 (View on PubMed)

Prandoni P, Kahn SR. Post-thrombotic syndrome: prevalence, prognostication and need for progress. Br J Haematol. 2009 May;145(3):286-95. doi: 10.1111/j.1365-2141.2009.07601.x. Epub 2009 Feb 13.

Reference Type BACKGROUND
PMID: 19222476 (View on PubMed)

Roberts LN, Patel RK, Donaldson N, Bonner L, Arya R. Post-thrombotic syndrome is an independent determinant of health-related quality of life following both first proximal and distal deep vein thrombosis. Haematologica. 2014 Mar;99(3):e41-3. doi: 10.3324/haematol.2013.089870. Epub 2014 Jan 17. No abstract available.

Reference Type BACKGROUND
PMID: 24441147 (View on PubMed)

Kearon C, Julian JA, Newman TE, Ginsberg JS. Noninvasive diagnosis of deep venous thrombosis. McMaster Diagnostic Imaging Practice Guidelines Initiative. Ann Intern Med. 1998 Apr 15;128(8):663-77. doi: 10.7326/0003-4819-128-8-199804150-00011.

Reference Type BACKGROUND
PMID: 9537941 (View on PubMed)

Kainz B, Heinrich MP, Makropoulos A, Oppenheimer J, Mandegaran R, Sankar S, Deane C, Mischkewitz S, Al-Noor F, Rawdin AC, Ruttloff A, Stevenson MD, Klein-Weigel P, Curry N. Non-invasive diagnosis of deep vein thrombosis from ultrasound imaging with machine learning. NPJ Digit Med. 2021 Sep 15;4(1):137. doi: 10.1038/s41746-021-00503-7.

Reference Type BACKGROUND
PMID: 34526639 (View on PubMed)

Oppenheimer J, Mandegaran R, Staabs F, Adler A, Singohl S, Kainz B, Heinrich M, Geroulakos G, Spiliopoulos S, Avgerinos E. Remote Expert DVT Triaging of Novice-User Compression Sonography with AI-Guidance. Ann Vasc Surg. 2024 Feb;99:272-279. doi: 10.1016/j.avsg.2023.08.022. Epub 2023 Oct 10.

Reference Type BACKGROUND
PMID: 37820986 (View on PubMed)

Related Links

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http://thinksono.com

Study sponsor website

Other Identifiers

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012023

Identifier Type: -

Identifier Source: org_study_id

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