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Cerebral AneurysmNCT04583163

Variability in Transcranial Doppler Technique in Neuro-Critical Care Patients

An observational study of Cerebral Aneurysm and Stroke, run by Hackensack Meridian Health at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This study aims to determine the inter- and intra-variability of Transcranial Doppler (TCD) ultrasound in neuro-critical care patients who are planned for consecutive daily TCD evaluations. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cerebral Aneurysm, Stroke, Vasospasm, Cerebral
What is being tested?
Transcranial Doppler
How many people
3 participants
Where
1 siteUnited States
Study dates
22 Sep 2020to 12 Aug 2022
Phase
Observational
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 years and older
  • All sexes
  • Adult, Older adult

Study population: Neuro-critical care patients

Who may be able to join

  • Adults 18 years of age or older
  • Current hospitalization for a neurologic issue and admitted to the surgical intensive care unit.
  • Undergoing daily transcranial Doppler imaging No
  • English speaking patients and/or legally authorized representative (LAR)

Who cannot join

  • Less than 18 years of age
  • Patient is unable to obtain consent and no LAR is identified to provide consent
  • Non-English speaking patient or LAR
  • Unable to perform the study due to lack of availability of TCD technologists

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Hackensack University Medical Center

    Hackensack, New Jersey, 07601

Other trials in United States

About this study

Official title: Inter- and Intra-Observer Variability in Transcranial Doppler (TCD) Technique in Neurocritical Care Patients

This study aims to determine the inter- and intra-variability of Transcranial Doppler (TCD) ultrasound in neuro-critical care patients who are planned for consecutive daily TCD evaluations.

Read the detailed description

Patients enrolled in the study are recruited from the pool of neuro-critical care patients admitted to the surgical intensive care unit (SICU). When the patients are admitted in the surgical ICU, the study staff will determine eligibility based on the protocol inclusion criteria. Due to the nature of the disease, there is a high likelihood that patients are either unconscious, of limited mental capacity and/or have been intubated therefore when appropriate the legally authorized representative will be utilized to obtain research consent.

To meet study inclusion, transcranial Doppler (TCD) testing will be ordered as part of the standard of care for these patients. The test will not be ordered solely for research purposes. There are no known side effects from the non-invasive measurement of cerebral blood flow using ultrasound

Three different TCD technicians will do triplicate readings on 3 consecutive days on up to 12 patients already undergoing TCD as ordered by their treating team. Standard of care on specific neuro critical care patients (such as cerebral aneurysms) is to undergo daily TCD monitoring to assess for possible vasospasm. Patients will be in the supine position while measurements are obtained. The probe will be placed in the preauricular region of the temporal window

Being tested
Transcranial Doppler
Keywords
Transcranial Doppler, TCD, Interrater Variability, Intrarater Variability, Transcranial Doppler Ultrasound, Neurocritical Care, DCI, Delayed Cerebral Ischemia, MCA, PCA, Mean Flow Velocity
Medical subject headings
Intracranial Aneurysm, Stroke, Vasospasm, Intracranial, Subarachnoid Hemorrhage, Brain Ischemia

What participants receive

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

  • Transcranial DopplerDiagnostic test

    Also called TCD, TCD Ultrasound, Transcranial Doppler Ultrasound, Transcranial Neurovascular Exam

    Transcranial Doppler is a non-invasive, painless, ultrasound technique that uses high frequency sound waves to measure the rate and direction of blood flow vessels in the brain.

Study groups in NCT04583163
Study groupRoleWhat they receive
Neuro-critical Care PatientsUp to 12 subjects will be recruited over a 1 year period. Patients enrolled in the study are recruited from the pool of neuro-critical care patients admitted to the surgical intensive care unit (SICU). To meet study inclusion, TransCranial Doppler (TCD) testing will be ordered as part of the standard of care for these patients. The test will not be ordered solely for research purposes. There are no known side effects from the non-invasive measurement of cerebral blood flow using ultrasound. Three different TCD technicians will perform triplicate readings on 3 consecutive days on up to 12 patients already undergoing TCD as ordered by their treating team. Standard of care on specific neuro critical care patients (such as cerebral aneurysms) is to undergo daily TCD monitoring to assess for possible vasospasm. Patients will be in the supine position while measurements are obtained. The probe will be placed in the preauricular region of the temporal window.
Receives: Diagnostic Test: Transcranial Doppler

What is being measured

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

  1. Determine the Inter-variability of TCD Ultrasound - EDV Measurement

    The inter-variability (agreement among 3 TCD technicians) was measured by using the intraclass correlation coefficient (ICC).

    Three technicians took measurements from the same patient at three different visits. The ICC is calculated based on the readings from the same visit of a patient by different technician as the index for the interrater reliability or agreement among the three technicians. Based on the suggestion from Koo and Li (2016), the interpretation of the agreement by using the ICC is defined as: below 0.50 = poor, 0.50-0.75 = moderate, 0.76-0.90 = good, above 090 = excellent.

    Measured: 3 consecutive days

  2. Determine the Inter-variability of TCD Ultrasound - PFV Measurement

    The inter-variability (agreement among 3 TCD technicians) was measured by using the intraclass correlation coefficient (ICC).

    Three technicians took measurements from the same patient at three different visits. The ICC is calculated based on the readings from the same visit of a patient by different technician as the index for the interrater reliability or agreement among the three technicians. Based on the suggestion from Koo and Li (2016), the interpretation of the agreement by using the ICC is defined as: below 0.50 = poor, 0.50-0.75 = moderate, 0.76-0.90 = good, above 090 = excellent.

    Measured: 3 consecutive days

  3. Determine the Inter-variability of TCD Ultrasound - Depth Measurement

    The inter-variability (agreement among 3 TCD technicians) was measured by using the intraclass correlation coefficient (ICC).

    Three technicians took measurements from the same patient at three different visits. The ICC is calculated based on the readings from the same visit of a patient by different technician as the index for the interrater reliability or agreement among the three technicians. Based on the suggestion from Koo and Li (2016), the interpretation of the agreement by using the ICC is defined as: below 0.50 = poor, 0.50-0.75 = moderate, 0.76-0.90 = good, above 090 = excellent.

    Measured: 3 consecutive days

  4. Determine the Intra-variability of TCD Ultrasound - EDV Measurement

    The intra-variability (reliability or consistency within each TCD technician) was measured by using the intraclass correlation coefficient (ICC).

    Three technicians took measurements from the same patient at three different visits. The ICC is calculated for each technician based on the readings from the same patient.

    Based on the suggestion from Koo and Li (2016), the interpretation of the reliability by using the ICC is defined as: below 0.50 = poor, 0.50-0.75 = moderate, 0.76-0.90 = good, above 090 = excellent.

    Measured: 3 Consecutive Days

  5. Determine the Intra-variability of TCD Ultrasound - PFV Measurement

    The intra-variability (reliability or consistency within each TCD technician) was measured by using the intraclass correlation coefficient (ICC).

    Three technicians took measurements from the same patient at three different visits. The ICC is calculated for each technician based on the readings from the same patient.

    Based on the suggestion from Koo and Li (2016), the interpretation of the reliability by using the ICC is defined as: below 0.50 = poor, 0.50-0.75 = moderate, 0.76-0.90 = good, above 090 = excellent.

    Measured: 3 Consecutive Days

  6. Determine the Intra-variability of TCD Ultrasound - Depth Measurment

    The intra-variability (reliability or consistency within each TCD technician) was measured by using the intraclass correlation coefficient (ICC).

    Three technicians took measurements from the same patient at three different visits. The ICC is calculated for each technician based on the readings from the same patient.

    Based on the suggestion from Koo and Li (2016), the interpretation of the reliability by using the ICC is defined as: below 0.50 = poor, 0.50-0.75 = moderate, 0.76-0.90 = good, above 090 = excellent.

    Measured: 3 Consecutive Days

Secondary outcomes (1)
  1. Change in Velocity Prompting Clinical Intervention

    Describe the change in velocity that prompts clinical intervention in symptomatic and asymptomatic vasospasm in neuro-critical care patients.

    Measured: 3 Consecutive Days

Timeline

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

  1. First posted12 Oct 2020
  2. Study start22 Sep 2020
  3. Primary completion12 Aug 2022
  4. Study completion12 Aug 2022

Why it stopped: Study was terminated due to resource limitations

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
3 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04583163
Sponsor's protocol ID
2019-0945
Status last verified
Apr 2025
First submitted
5 Oct 2020
Last updated
15 Apr 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided

Publications

  • Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307-10.

    PubMed 2868172
  • Oyama K, Criddle L. Vasospasm after aneurysmal subarachnoid hemorrhage. Crit Care Nurse. 2004 Oct;24(5):58-60, 62, 64-7.

    PubMed 15526491
  • Kumar G, Shahripour RB, Harrigan MR. Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. J Neurosurg. 2016 May;124(5):1257-64. doi: 10.3171/2015.4.JNS15428. Epub 2015 Oct 23.

    PubMed 26495942
  • Francoeur CL, Mayer SA. Management of delayed cerebral ischemia after subarachnoid hemorrhage. Crit Care. 2016 Oct 14;20(1):277. doi: 10.1186/s13054-016-1447-6.

    PubMed 27737684
  • Carrera E, Schmidt JM, Oddo M, Fernandez L, Claassen J, Seder D, Lee K, Badjatia N, Connolly ES Jr, Mayer SA. Transcranial Doppler for predicting delayed cerebral ischemia after subarachnoid hemorrhage. Neurosurgery. 2009 Aug;65(2):316-23; discussion 323-4. doi: 10.1227/01.NEU.0000349209.69973.88.

    PubMed 19625911
  • Rigamonti A, Ackery A, Baker AJ. Transcranial Doppler monitoring in subarachnoid hemorrhage: a critical tool in critical care. Can J Anaesth. 2008 Feb;55(2):112-23. doi: 10.1007/BF03016323.

    PubMed 18245071
  • Maeda H, Etani H, Handa N, Tagaya M, Oku N, Kim BH, Naka M, Kinoshita N, Nukada T, Fukunaga R, et al. A validation study on the reproducibility of transcranial Doppler velocimetry. Ultrasound Med Biol. 1990;16(1):9-14. doi: 10.1016/0301-5629(90)90080-v.

    PubMed 2181766
  • Baumgartner RW, Mathis J, Sturzenegger M, Mattle HP. A validation study on the intraobserver reproducibility of transcranial color-coded duplex sonography velocity measurements. Ultrasound Med Biol. 1994;20(3):233-7. doi: 10.1016/0301-5629(94)90063-9.

    PubMed 7914715
  • Totaro R, Marini C, Cannarsa C, Prencipe M. Reproducibility of transcranial Dopplersonography: a validation study. Ultrasound Med Biol. 1992;18(2):173-7. doi: 10.1016/0301-5629(92)90128-w.

    PubMed 1580013
  • Shen Q, Stuart J, Venkatesh B, Wallace J, Lipman J. Inter observer variability of the transcranial Doppler ultrasound technique: impact of lack of practice on the accuracy of measurement. J Clin Monit Comput. 1999 May;15(3-4):179-84. doi: 10.1023/a:1009925811965.

    PubMed 12568169
  • Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979 Mar;86(2):420-8. doi: 10.1037//0033-2909.86.2.420.

    PubMed 18839484

Questions about this trial

What is this clinical trial studying?

An observational study of Cerebral Aneurysm and Stroke, run by Hackensack Meridian 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 4 inclusion and 4 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: stopped early, as of the sponsor's last update on 15 Apr 2025. 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 15 Apr 2025). 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?

Determine the Inter-variability of TCD Ultrasound - EDV Measurement (time frame: 3 consecutive days). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04583163, which also lists 11 linked publications.

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 15 Apr 2025.

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