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Trial registered on ANZCTR
Registration number
ACTRN12615000035527
Ethics application status
Approved
Date submitted
10/11/2014
Date registered
19/01/2015
Date last updated
7/05/2019
Date data sharing statement initially provided
7/05/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Diathermy artefact in LLETZ specimens: A randomised controlled trial of high versus low power pure cut diathermy
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Scientific title
Diathermy artefact in LLETZ specimens: A randomised controlled trial of high versus low power pure cut diathermy
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Secondary ID [1]
285587
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Nil
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Universal Trial Number (UTN)
U1111-1163-6248
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pre-malignant cervical lesions
293423
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Condition category
Condition code
Surgery
293699
293699
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0
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Surgical techniques
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Cancer
293808
293808
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0
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Cervical (cervix)
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Renal and Urogenital
293809
293809
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0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A small amount of cervical tissue (1-2cm) will be removed using a technique called 'Large Loop Excision of the Transformation Zone' (LLETZ). A LLETZ involves a wire loop which uses electricity to cut through the cervix removing the abnormal area.
Different settings are used on the machine to perform a LLETZ. We have chosen the lowest and highest settings used in our hospital. The lowest setting (50W) will be the control and the highest setting (100W) will be the intervention.
The procedure will be performed by the same surgeon who is a specialist in women's cancers.
The whole procedure takes only a few minutes.
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Intervention code [1]
290537
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Treatment: Surgery
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Comparator / control treatment
Pure cut diathermy low power (50W)
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Diathermy artefact
Defined as the outer zone of the specimen in contact with the diathermy loop where the thermal artefact makes the margin of the specimen uninterpretable.
A small ruler, called a micrometer, can be seen when viewing a specimen under a microscope. The pathologist will measure the distance from the outer zone of the specimen in contact with the diathermy loop to the zone where no tissue damage has occurred.
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Assessment method [1]
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Timepoint [1]
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Measured after the cervical specimen has been processed by pathology. Usually a couple of days
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Secondary outcome [1]
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Specimen fragmentation
Defined as more than one piece of cervical tissue removed with the LLETZ loop. If the cervical sample is removed in one piece there is no fragmentation.
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Assessment method [1]
311342
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Timepoint [1]
311342
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At time of surgery
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Secondary outcome [2]
311343
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Haemorrhage
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Assessment method [2]
311343
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Timepoint [2]
311343
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At time of surgery
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Eligibility
Key inclusion criteria
>18yrs of age
High grade intraepithelial lesion of the cervix (HSIL) or persistent low grade intraepithelial lesion of the cervix (LSIL)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Previous cervical procedures including LLETZ or cone biopsy
Pregnancy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients will be randomly assigned to either low or high power diathermy settings. The surgeon and pathologist will be unaware to which group they will be allocated.
Randomisation will be conducted using sequentially numbered opaque sealed envelopes which will be opened on the day of surgery.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation of sealed opaque envelopes. Once the envelopes are created for each group they will be combined and shuffled.
Each envelope will then be number from one to forty. The envelopes will be selected in order as each patient has their surgery.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Using data from Nagar a standard deviation of 0.07mm was calculated for diathermy artefact. Sample size was calculated using a power level of 80% to detect a difference of 0.1mm with a p value <0.05
Nagar H, Dobbs S, McClelland H, Price J, McClean G, McCluggage W. The large loop excision of the transformation zone cut or blend thermal artefact study: a randomized controlled trial Int J Cynecol Cancer 2004, 14, 1108-1111
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/12/2014
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Actual
6/05/2015
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Date of last participant enrolment
Anticipated
30/05/2015
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Actual
12/08/2016
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Date of last data collection
Anticipated
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Actual
12/08/2016
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Sample size
Target
40
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Accrual to date
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Final
62
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
3132
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John Hunter Hospital Royal Newcastle Centre - New Lambton
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Recruitment postcode(s) [1]
8884
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2305 - New Lambton Heights
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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John Hunter Hospital
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Address [1]
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Lookout Road
New Lambton Heights NSW 2305
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
John Hunter Hospital
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Address
Lookout Road
New Lambton Heights NSW 2305
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
288928
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Country [1]
288928
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
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Research Ethics and Governance Unit District Headquarters, Administration Building Lookout Road, New Lambton NSW 2305
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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05/11/2014
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Ethics approval number [1]
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HNE HREC 14/10/15/3.03 ; NSW HREC HREC/14/HNE/386
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Summary
Brief summary
This study will evaluate the way we treat pre-cancerous lesions on the cervix. These lesions are commonly removed using a wire loop termed large loop excision of the transformation zone (LLETZ). The objective of this study is to compare different settings on the machine used to perform a LLETZ and compare the quality of the tissue obtained. All samples of tissue obtained from a LLETZ have a degree of tissue damage to the outer part of the tissue sample caused by the heat of the wire loop. This tissue damage is dependent on the settings used to obtain a LLETZ. Currently there are a wide range of different settings used to perform a LLETZ procedure. We wish to compare two settings, low vs high power, which are already used by surgeons in the hospital to see which setting gives the best quality sample of tissue. High quality samples help determine if all of the abnormal tissue was removed from the cervix. Each patient will have the procedure performed by the same surgeon who is a specialist in women’s cancers. The surgeon will not know which group the patient is allocated to, which is called blinding, to help improve the accuracy of the results. The doctor who will look at the tissue samples under the microscope, called a pathologist, will also be blinded. We will then measure how much tissue damage occurs between the two groups using a small ruler in a microscope.
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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 Malcolm Godfrey
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Address
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John Hunter Hospital
Lookout Road
New Lambton Heights NSW 2305
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Country
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Australia
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Phone
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+61 2 4921 3000
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Malcolm Godfrey
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Address
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John Hunter Hospital
Lookout Road
New Lambton Heights NSW 2305
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Country
52463
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Australia
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Phone
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+61 2 4921 3000
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Fax
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Email
52463
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[email protected]
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Contact person for scientific queries
Name
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Malcolm Godfrey
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Address
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John Hunter Hospital
Lookout Road
New Lambton Heights NSW 2305
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Country
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Australia
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Phone
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+61 2 4921 3000
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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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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