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Trial registered on ANZCTR
Registration number
ACTRN12613000429752
Ethics application status
Approved
Date submitted
12/04/2013
Date registered
16/04/2013
Date last updated
12/01/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Screening Education And Recognition by primary Care pHysician of Atrial Fibrillation for prevention of stroke (SEARCH-AF II)
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Scientific title
In an ambulatory population over 65 years of age attending general practices, is a handheld single-lead ECG attached to an iPhone an acceptable and effective screening tool to identify atrial fibrillation?
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Secondary ID [1]
282161
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
SEARCH-AF II
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Atrial fibrillation
288669
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Stroke
288904
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Condition category
Condition code
Cardiovascular
289014
289014
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0
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Other cardiovascular diseases
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Public Health
289015
289015
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0
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Health promotion/education
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Stroke
289016
289016
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0
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Ischaemic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Receptionists in general practice clinics will be trained to screen eligible patients for atrial fibrillation using a handheld single-lead ECG (the AliveCor Heart Monitor for iPhone). This will be a one-off screening of approximately 30 seconds duration. Following the screening, the iPhone will transmit a pdf of the ECG recording to a secure website toghether with an automated computer diagnosis of whether the patient is likely to have atrial fibrillation or not. During the patient's consultation, the GP will log in to the secure website and review the ECG. The GP will advise the patient if any additional treatment is required.
The screening trial will be conducted over a 6 month period.
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Intervention code [1]
286770
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Early detection / Screening
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Comparator / control treatment
N/A
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
289133
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The feasibility and acceptability of screening for AF using a hand-held single-lead ECG device in people aged 65 years and over in the general practice setting. A detailed process evaluation will be undertaken to assess these outcomes. As part of this evaluation, selected patients, GPs and reception staff will be asked to participate in semi-structured interviews. The audio from these interviews will be recorded, then coded and analysed using grounded theory.
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Assessment method [1]
289133
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Timepoint [1]
289133
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At completion of screening period.
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Primary outcome [2]
289134
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The satisfaction of GPs, reception staff and patients with the screening process in the general practice setting. As noted above in relation to primary outcome 1, this will be assessed through semi-structured interviews of selected GPs, reception staff and patients.
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Assessment method [2]
289134
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Timepoint [2]
289134
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During and after the screening process.
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Secondary outcome [1]
301900
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Process measures, such as the time taken to complete the intervention, competing demands for practice reception staff time, and the attitudes of patients and staff involved in the intervention. As noted above in relation to primary outcome 1, this will be assessed through semi-structured interviews of selected GPs, reception staff and patients.
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Assessment method [1]
301900
0
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Timepoint [1]
301900
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During and after the screening process.
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Secondary outcome [2]
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Barriers (including technological barriers), enablers and other information relevant to the process of developing a larger-scale implementation study. This will be assessed through semi-structured interview data together with any other information gathered by the research team during the conduct of the study either directly or from any of the involved general practices.
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Assessment method [2]
301901
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Timepoint [2]
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At completion of screening period.
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Eligibility
Key inclusion criteria
People will be eligible to participate if they are attending the general practice for a consultation with their GP and are aged 65 years or over.
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Minimum age
65
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion criteria include:
a. diagnosis of a severe coexisting medical condition that would prevent participation (eg, dementia, terminal illness); or
b. the inability to read/understand the consent form and participant information statement in English.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
29/04/2013
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Actual
1/05/2013
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Date of last participant enrolment
Anticipated
15/10/2013
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Actual
31/10/2013
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Date of last data collection
Anticipated
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Actual
31/10/2013
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Sample size
Target
100
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Accrual to date
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Final
88
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
286932
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Commercial sector/Industry
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Name [1]
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Bristol-Myers Squibb Company
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Address [1]
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345 Park Avenue
New York, New York
10154
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Country [1]
286932
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United States of America
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Primary sponsor type
Charities/Societies/Foundations
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Name
The George Institute for Global Health
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Address
Level 10, King George V Building
83-117 Missenden Rd
Camperdown NSW 2050
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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The University of Sydney
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Address [1]
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The University of Sydney
NSW 2006
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Country [1]
285721
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Sydney Human Research Ethics Committee
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Ethics committee address [1]
288988
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Human Ethics University of Sydney NSW 2006
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Ethics committee country [1]
288988
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Australia
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Date submitted for ethics approval [1]
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06/02/2013
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Approval date [1]
288988
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01/03/2013
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Ethics approval number [1]
288988
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2013/135
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Summary
Brief summary
Atrial fibrillation (AF) is the most common heart arrhythmia affecting at least 240,000 Australians. Prevalence rises with age from approximately 1% of the whole population to 5% in those over 65 years. People with AF are up to seven times more likely to have a stroke than the general population, and AF related strokes are also likely to be more severe. In addition, one in every six strokes is AF related. Stroke is highly preventable in AF with the use of appropriate thromboprophylaxis. Therefore early identification and appropriate evidence based management of AF could lead to subsequent stroke prevention, significant reduction in the overall stroke burden and substantial savings to the health system. The study is designed to examine the feasibility of screening to identify undiagnosed AF in a primary care setting. Our hypothesis is that a simple primary care screening program may be effective in detecting those with undiagnosed AF. The specific aims are to: 1. Assess the feasibility and acceptability of screening for AF using a hand-held single-lead ECG device in people aged 65 years and over in the general practice setting. 2. Assess the satisfaction of GPs, reception staff and patients with the screening process in the general practice setting. 3. Examine process measures, such as the time taken to complete the intervention, competing demands for practice reception staff time, and the attitudes of patients and staff involved in the intervention. 4. Identify barriers (including technological barriers), enablers and other information relevant to the process of developing a larger-scale implementation study. We propose a cross-sectional study offered in up to 5 general practices in the Sydney metropolitan area. People aged 65 and over, attending general practices will be invited to volunteer for the screening. The screening will consist of an assessment with a handheld single-lead ECG device attached to an iPhone by the practice receptionist. This ECG will be transmitted to a secure website and reviewed by the patient's GP during their consultation. The primary outcome measure will be the acceptability of the screening process. A process evaluation will also be undertaken to better appreciate factors that might influence sustainability beyond the trial setting.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Lis Neubeck
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Address
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Senior Research Fellow, Cardiovascular
Adjunct Senior Lecturer, Sydney Nursing School, University of Sydney
Level 10, King George V Building
83-117 Missenden Rd
Camperdown NSW 2050
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Country
38650
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Australia
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Phone
38650
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+61 2 8507 2521
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Fax
38650
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Email
38650
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[email protected]
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Contact person for public queries
Name
38651
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Jessica Orchard
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Address
38651
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Level 2, Charles Perkins Centre (D17)
University of Sydney
NSW 2006
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Country
38651
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Australia
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Phone
38651
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+61 2 8627 1644
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Fax
38651
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Email
38651
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[email protected]
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Contact person for scientific queries
Name
38652
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Lis Neubeck
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Address
38652
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Senior Research Fellow, Cardiovascular
Adjunct Senior Lecturer, Sydney Nursing School, University of Sydney
Level 10, King George V Building
83-117 Missenden Rd
Camperdown NSW 2050
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Country
38652
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Australia
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Phone
38652
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+61 2 8507 2521
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Fax
38652
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Email
38652
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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