NCT03458000

Brief Summary

This is a multi-center randomized controlled trial examining the use of Video Capsule Endoscopy (VCE) to discharge low-moderate risk patients with suspected upper gastrointestinal bleeds (UGIB) from the Emergency Department (ED.) The investigators will enroll 100 subjects at 4 sites who present with signs of hemodynamically stable UGIBs and compare VCE risk assessment to an Active Control (AC) group who receive inpatient upper endoscopy (EGD).

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
24

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Apr 2018

Typical duration for not_applicable

Geographic Reach
1 country

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 1, 2018

Completed
7 days until next milestone

First Posted

Study publicly available on registry

March 8, 2018

Completed
1 month until next milestone

Study Start

First participant enrolled

April 17, 2018

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 15, 2020

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 7, 2020

Completed
2.7 years until next milestone

Results Posted

Study results publicly available

June 1, 2023

Completed
Last Updated

June 1, 2023

Status Verified

May 1, 2023

Enrollment Period

1.9 years

First QC Date

March 1, 2018

Results QC Date

October 22, 2021

Last Update Submit

May 4, 2023

Conditions

Keywords

capsule endoscopyPillCamupper Endoscopyemergency Departmentupper gastrointestinal bleedingGI bleed

Outcome Measures

Primary Outcomes (1)

  • Number of Participants Discharged for Outpatient Management of Upper GI Bleeds

    Our primary goal is to determine whether ED VCE is able to discharge low risk patients for outpatient management of upper GI bleeds.

    30 Days

Secondary Outcomes (1)

  • Detection Rate of Video Capsule Endoscopy

    30 Days

Other Outcomes (5)

  • Patient Satisfaction With VCE Procedure

    30 Days

  • GI Physician Final Read and Site Physician Agreement on VCE Results

    30 Days

  • Number of Participants With Serious Adverse Events at Day 7 and Day 30

    30 Days

  • +2 more other outcomes

Study Arms (2)

Active Control

ACTIVE COMPARATOR

Video Capsule Endoscopy will be administered during ED, but video will not be read until after inpatient EGD. Subject will have hospital admission with an EGD conducted during hospital stay.

Other: Standard of Care

Experimental

EXPERIMENTAL

Subject will have Video Capsule Endoscopy read during ED length of stay, disposition will be determined using Capsule Endoscopy Risk Assessment.

Device: PillCam UGI

Interventions

An esophageal capsule endoscope which is designed to visualize the upper gastrointestinal tract.

Experimental

Patient was admitted to hospital for care and received in-patient EGD.

Also known as: SOC
Active Control

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • \. Individuals aged ≥ 18 years presenting to the Emergency Department with likely upper GI bleed (bloody emesis and/or coffee ground vomiting and/or melena) that has occurred within the previous 48 hours.

You may not qualify if:

  • Upper GI Bleed with hemodynamic instability (BP\<90 mmHg, pulse\>120 beats per minute, and Hgb \< 9 g/dL)
  • High Risk Upper GI Bleed (Glasgow Blatchford Score\* ≥ 6)
  • Signs, symptoms or history of liver cirrhosis or liver failure
  • Signs, symptoms or history of decompensated heart failure or congestive heart failure
  • Presumed Pregnant, trying to conceive or breastfeeding
  • Known history of gastric cancer
  • Known history of gastric or esophageal varices
  • GI surgery within the last 6 months
  • Prior enrollment in the CHEER Study
  • Prisoner or Ward of State
  • Trouble swallowing, suspected bowel obstruction or perforation, per treating clinician
  • Past UGI tract surgery (e.g., Bilroth I or II, esophagectomy, gastrectomy, bariatric procedure) that changes Gastrointestinal anatomy
  • Known history of gastroparesis, esophageal stricture or Crohn's disease
  • Altered mental status that limits the ability to swallow a capsule
  • Expected to have Magnetic Resonance Imaging (MRI) examination within 7 days
  • +8 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

George Washington University

Washington D.C., District of Columbia, 20037, United States

Location

Duke University School of Medicine

Durham, North Carolina, 27710, United States

Location

Temple University

Philadelphia, Pennsylvania, 19140, United States

Location

Related Publications (1)

  • Meltzer AC, Ali MA, Kresiberg RB, Patel G, Smith JP, Pines JM, Fleischer DE. Video capsule endoscopy in the emergency department: a prospective study of acute upper gastrointestinal hemorrhage. Ann Emerg Med. 2013 Apr;61(4):438-443.e1. doi: 10.1016/j.annemergmed.2012.11.008.

MeSH Terms

Conditions

Gastrointestinal HemorrhageEmergencies

Interventions

Standard of Care

Condition Hierarchy (Ancestors)

Gastrointestinal DiseasesDigestive System DiseasesHemorrhagePathologic ProcessesPathological Conditions, Signs and SymptomsDisease Attributes

Intervention Hierarchy (Ancestors)

Quality Indicators, Health CareQuality of Health CareHealth Services AdministrationHealth Care Quality, Access, and Evaluation

Results Point of Contact

Title
Dr. Andrew Meltzer
Organization
George Washington University

Study Officials

  • Andrew Meltzer, MD

    George Washington University- Department of Emergency Medicine

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
DIAGNOSTIC
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

March 1, 2018

First Posted

March 8, 2018

Study Start

April 17, 2018

Primary Completion

March 15, 2020

Study Completion

September 7, 2020

Last Updated

June 1, 2023

Results First Posted

June 1, 2023

Record last verified: 2023-05

Data Sharing

IPD Sharing
Will not share

Locations