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Skin CancerNCT04411810

SpotCheck: Comparison of Enhanced Telemedicine Versus In-person Evaluation for the Diagnosis of Skin Cancer

A study testing Nevisense 3.0, Dermlite Cam and Skin biopsy in people with Skin Cancer, run by NYU Langone Health at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The overall goal of this research is to develop a platform that can increase patient access to expert skin cancer diagnostic services via telemedicine. This is especially important for medically underserved areas where melanoma outcomes are worse than in areas with greater access to in-person evaluations. Read more about this study

Who is it for?
Ages 18 to 90 yearsHealthy volunteers can take part
Conditions the study is for
Skin Cancer
What is being tested?
Nevisense 3.0, Dermlite Cam and Skin biopsy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
149 participants
Where
1 siteUnited States
Study dates
20 Aug 2020to 4 Mar 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 90 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Be 18 years of age or older
  • Have 1-3 lesions for evaluation

Who cannot join

  • Lesions of the hair-bearing scalp, in the mouth, on the lips, genitalia, nails, on/around the eyes, inside the ear

Trial locations and contacts

1 site in 1 country.

United States1 site
  • NYU Langone Health

    New York, New York, 10016

Other trials in United States

About this study

The overall goal of this research is to develop a platform that can increase patient access to expert skin cancer diagnostic services via telemedicine. This is especially important for medically underserved areas where melanoma outcomes are worse than in areas with greater access to in-person evaluations. If successful, the widespread availability of such services would be combined with public education efforts to encourage individuals with changing skin lesions to seek evaluation. With decreased travel times to high quality diagnostic services, such efforts may decrease the diagnosis of more advanced melanomas (with a concomitant increase in the diagnosis of earlier stage tumors), and potentially decrease melanoma mortality.

Read the detailed description

This is a prospective pilot study of a store-and-forward telemedicine diagnostic assessment of participant-selected skin lesions concerning for skin cancer, controlled against an in-person dermatologist assessment (gold standard evaluation). The study will be a single arm design with each participant undergoing telemedicine data acquisition (i.e. clinical and dermoscopic imaging and Nevisense measurement), immediately followed by the in-person dermatologist assessment. The in-person dermatologist will be blinded to the Nevisense score at the time of the visit. Using the telemedicine data, the teledermatology team will render a biopsy/no-biopsy recommendation within 3 business days of the participant evaluation. They will be blinded to the results of the in-person dermatologist's diagnostic evaluation.

Conditions
Skin Cancer
Being tested
Nevisense 3.0, Dermlite Cam, Skin biopsy, Barco Demetra
Medical subject headings
Skin Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Nevisense 3.0Device

    Nevisense, an AI-based point-of-care system for the non-invasive evaluation of irregular moles remains the only FDA approved system available for melanoma detection in the US. Nevisense 3.0 will be used as a one-time exposure of <8 seconds per lesion. Disposable electrodes that contact the participant are 5mm x 5mm in size. Nevisense 3.0 measures electrical impedance of skin lesions and provides an output called the electrical impedence spectroscopy (EIS) score. Electrical impedance is a measure of a material's overall resistance to the flow of alternating electric currents of various frequencies. The principle is that electrical impedance is different in normal versus abnormal tissue.

  • Dermlite CamDevice

    Dermlite Cam is a digital camera that captures images of the skin under cross-polarized and non-polarized light and is 510(k) exempt. The DermLite Cam device appears as a single piece camera with a charging cable and USB computer cable. As part of the camera unit, an extensor arm exists to allow for the capture of standardized clinical images. The DermLite Cam will be used to acquire 3 images of <5 seconds per lesion (one clinical, one polarized dermoscopic, and one non-polarized dermoscopic). NOTE - for the purposes of this study, teledermatology images (dermoscopic and clinical - at approximately 6 inches, 12 inches, and 18 inches) were taken using the Barco Demetra after technical issues arose that prohibited the continued use of the Dermlite Cam.

  • Skin biopsyProcedure or surgery

    A skin biopsy is a small procedure that removes a sample of skin from the surface of the body. The method utilized will be either a shave or punch technique. The maximum size of a punch biopsy will be 6mm and these wounds are generally closed with no more than 2-3 sutures. A skin biopsy takes <15 minutes including preparation time, administration of intradermal anesthesia using lidocaine 1% with epinephrine 1:100,000, removal of the skin sample, achievement of hemostasis, dressing the wound, and providing instructions for home care. Samples will be placed formalin for routine processing.

  • Barco DemetraDevice

    Barco Demetra is a non-invasive skin imaging system, which acquires multispectral and white light dermoscopic images and clinical photographs of the skin which can then be stored, retrieved, displayed, and reviewed by medical practitioners. The Barco Demetra received 510(k) Premarket approval (K192829). The system involves a hardware imaging device and a stand-alone software application. The hardware device is a portable, battery-powered medical device for acquiring and visualizing images of the skin and uploads all images to cloud storage. The software application is cloud software with an associated web application; it can be used to visualize images and related data and can generate consultation reports. For the purposes of this study, teledermatology images (dermoscopic and clinical - at approximately 6 inches, 12 inches, and 18 inches) were taken using the Barco Demetra after technical issues arose that prohibited the continued use of the Dermlite Cam.

Study groups in NCT04411810
Study groupRoleWhat they receive
Participants with skin lesionsExperimentalParticipants who have up to 3 concerning skin lesions will be evaluated by both an in-person dermatologist and a team of three teledermatologists(board-certified dermatologists). The teledermatoogy team will deliver a consensus recommendation. If either the in-person dermatologist or teledermatologists are concerned that the skin spot(s) may be a skin cancer, a biopsy will be recommended and can be performed at no charge. Or if both agree that the spot(s) are not concerning for skin cancer, no biopsy will be needed.
Receives: Device: Nevisense 3.0; Device: Dermlite Cam; Procedure: Skin biopsy; Device: Barco Demetra

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Accuracy of Skin Cancer Diagnosis: In-Person Assessment

    To compare the accuracy of skin cancer diagnoses between in-person recommendation and the telemedicine (tele) recommendation, the number of "positive" evaluations (i.e. recommended for biopsy) that were truly skin cancer plus the number of "negative" evaluations (i.e. not recommended for biopsy) that were truly non-cancerous divided by the total number of skin lesions evaluated is calculated.

    Measured: End of the study (4 weeks)

  2. Accuracy of Skin Cancer Diagnosis: Telemedicine Without Nevisense

    To compare the accuracy of skin cancer diagnoses between in-person recommendation and the telemedicine (tele) recommendation, the number of "positive" evaluations (i.e. recommended for biopsy) that were truly skin cancer plus the number of "negative" evaluations (i.e. not recommended for biopsy) that were truly non-cancerous divided by the total number of skin lesions evaluated is calculated.

    Measured: End of the study (4 weeks)

  3. Accuracy of Skin Cancer Diagnosis: Telemedicine With Nevisense

    To compare the accuracy of skin cancer diagnoses between in-person recommendation and the telemedicine (tele) recommendation, the number of "positive" evaluations (i.e. recommended for biopsy) that were truly skin cancer plus the number of "negative" evaluations (i.e. not recommended for biopsy) that were truly non-cancerous divided by the total number of skin lesions evaluated is calculated.

    Measured: End of the study (4 weeks)

Secondary outcomes (18)
  1. Sensitivity of Telemedicine Evaluation in Diagnosing Skin Cancer: Without Nevisense

    Assessment of the dermatologist's ability to designate an individual who has skin cancer as "positive" using the telemedicine platform without nevisense.

    Measured: End of the study (4 weeks)

  2. Sensitivity of Telemedicine Evaluation in Diagnosing Skin Cancer: With Nevisense

    Assessment of the dermatologist's ability to designate an individual who has skin cancer as "positive" using the telemedicine platform with nevisense.

    Measured: End of the study (4 weeks)

  3. Sensitivity of In-Person Evaluation in Diagnosing Skin Cancer

    Assessment of the dermatologist's ability to designate an individual who has skin cancer as "positive" during in-person evaluations.

    Measured: End of the study (4 weeks)

  4. Specificity of Telemedicine Evaluation in Diagnosing Skin Cancer: Without Nevisense

    Assessment of the dermatologist's ability to designate an individual who does not have skin cancer as "negative" using the telemedicine platform without nevisense.

    Measured: End of the study (4 weeks)

  5. Specificity of Telemedicine Evaluation in Diagnosing Skin Cancer: With Nevisense

    Assessment of the dermatologist's ability to designate an individual who does not have skin cancer as "negative" using the telemedicine platform with Nevisense.

    Measured: End of the study (4 weeks)

  6. Specificity of In-Person Evaluation in Diagnosing Skin Cancer

    Assessment of the dermatologist's ability to designate an individual who does not have skin cancer as "negative" during in-person evaluations.

    Measured: End of the study (4 weeks)

  7. False-Positive Rate of Telemedicine Evaluation: Without Nevisense

    The number of false-positives (i.e., diagnosing a patient with skin cancer when no skin cancer is present) out of the total number of telemedicine evaluations without Nevisense.

    Measured: End of the study (4 weeks)

  8. False-Positive Rate of Telemedicine Evaluation: With Nevisense

    The number of false-positives (i.e., diagnosing a patient with skin cancer when no skin cancer is present) out of the total number of telemedicine evaluations with Nevisense.

    Measured: End of the study (4 weeks)

  9. False-Positive Rate of In-Person Evaluation

    The number of false-positives (i.e., diagnosing a patient with skin cancer when no skin cancer is present) out of the total number of in-person evaluations.

    Measured: End of the study (4 weeks)

  10. False-Negative Rate of Telemedicine Evaluation: Without Nevisense

    The number of false-negatives (i.e., indicating a patient does not have skin cancer when skin cancer is present) out of the total number of telemedicine evaluations without Nevisense.

    Measured: End of the study (4 weeks)

  11. False-Negative Rate of Telemedicine Evaluation: With Nevisense

    The number of false-negatives (i.e., indicating a patient does not have skin cancer when skin cancer is present) out of the total number of telemedicine evaluations with Nevisense.

    Measured: End of the study (4 weeks)

  12. False-Negative Rate of In-Person Evaluation

    The number of false-negatives (i.e., indicating a patient does not have skin cancer when skin cancer is present) out of the total number of in-person evaluations.

    Measured: End of the study (4 weeks)

  13. Positive Predictive Value of Telemedicine Evaluation: Without Nevisense

    The probability that a patient with a positive (abnormal) test result via telemedicine evaluation without Nevisense actually has skin cancer.

    Measured: End of the study (4 weeks)

  14. Positive Predictive Value of Telemedicine Evaluation: With Nevisense

    The probability that a patient with a positive (abnormal) test result via telemedicine evaluation with Nevisense actually has skin cancer.

    Measured: End of the study (4 weeks)

  15. Positive Predictive Value of In-Person Evaluation

    The probability that a patient with a positive (abnormal) test result via in-person evaluation actually has skin cancer.

    Measured: End of the study (4 weeks)

  16. Negative Predictive Value of Telemedicine Evaluation: Without Nevisense

    The probability that a person with a negative (normal) test result via telemedicine evaluation without Nevisense is truly free of disease.

    Measured: End of the study (4 weeks)

  17. Negative Predictive Value of Telemedicine Evaluation: With Nevisense

    The probability that a person with a negative (normal) test result via telemedicine evaluation with Nevisense is truly free of disease.

    Measured: End of the study (4 weeks)

  18. Negative Predictive Value of In-Person Evaluation

    The probability that a person with a negative (normal) test result via in-person evaluation is truly free of disease.

    Measured: End of the study (4 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jun 2020
  2. Study start20 Aug 2020
  3. Primary completion3 Mar 2023
  4. Study completion4 Mar 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
149 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04411810
Sponsor's protocol ID
19-01242
Status last verified
Apr 2024
First submitted
28 May 2020
Last updated
8 Apr 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Yes: Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices).

Questions about this trial

What is this clinical trial studying?

A study testing Nevisense 3.0, Dermlite Cam and Skin biopsy in people with Skin Cancer, run by NYU Langone Health at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Apr 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Accuracy of Skin Cancer Diagnosis: In-Person Assessment (time frame: End of the study (4 weeks)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Apr 2024.

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