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Pediatric CancerNCT05012917

Parent/Child Dyad Approach to Symptom Screening for Children With Cancer

A study testing Patient/Proxy-SSPedi and Co-SSPedi in people with Pediatric Cancer and Quality of Life, run by The Hospital for Sick Children at 1 site in Canada.

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

Symptoms are common and often severely bothersome in pediatric patients receiving cancer treatments. In order to measure the extent of bothersome symptoms, the Symptom Screening in Pediatrics Tool (SSPedi) was developed. Read more about this study

Who is it for?
Ages 4 to 18 years
What is being tested?
Patient/Proxy-SSPedi and Co-SSPedi
Could I receive a placebo?
No, everyone receives an active treatment
How many people
420 participants
Where
1 siteCanada
Study dates
19 Aug 2021to 3 Aug 2023
Phase
Interventional
Are there results?
None posted in the registry

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 4 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Child and guardian both understand English
  • Child is 4 to 18 years of age
  • Child has diagnosis of cancer or is a hematopoietic stem cell transplant (HSCT) recipient
  • Child is inpatient or outpatient

Who cannot join

  • Participants who have illness severity,
  • cognitive disability, or
  • visual impairment that preclude utilization of co-SSPedi, SSPedi/mini-SSPedi or proxy SSPedi according to the primary healthcare team

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • The Hospital for Sick Children

    Toronto, Ontario, M5G 1X8

Other trials in Canada

About this study

Official title: A Randomized Controlled Trial a Dyad Approach to Symptom Screening (Co-SSPedi) vs. Proxy-report (Proxy-SSPedi) and Self-report (SSPedi or Mini-SSPedi) for Pediatric Patients Receiving Cancer Treatments

Symptoms are common and often severely bothersome in pediatric patients receiving cancer treatments. In order to measure the extent of bothersome symptoms, the Symptom Screening in Pediatrics Tool (SSPedi) was developed. It is reliable, valid and responsive to change in pediatric patients aged 8-18 years receiving cancer treatments. Mini-SSPedi was developed for children 4-7 years and exhibits face and content validity. These instruments were developed to address the lack of appropriate symptom screening tools for this population. They are available in both self-report and proxy-report formats.

Differences between child self-report and parent proxy-report quality of life (QoL) scores have been well described in pediatric populations. There has been increasing recognition that each reporter may have unique and valid perspectives. This has led to a suggestion to collect both child and parent report when possible.

Read more

When used in clinical care, obtaining both child and parent report will commonly not be feasible. There are settings in which children will not be willing to independently report symptoms, such as when they are very ill. Unfortunately, it is particularly in this setting that obtaining symptoms reports is crucial. While young children may be able to independently report symptoms on a single occasion in the context of a carefully conducted research study, they are less likely to be able to repeatedly and independently report their symptoms. Finally, the burden and logistical complexity of separate child and parent reporting would be associated with considerable challenges for clinical implementation.

In considering how routine symptom screening could be implemented into clinical practice, we hypothesized that a dyad approach, where SSPedi is completed by both the child and parent together, may be one way to address these challenges. Consequently, we developed and finalized the approach to co-SSPedi administration, with instruction that is easy to understand, resulting in dyads completing co-SSPedi correctly.

To understand the relationships between the available forms of SSPedi (co-SSPedi, proxy-SSPedi and SSPedi), outstanding questions are how co-SSPedi scores compare to either proxy-report or self-report SSPedi and whether the co-SSPedi administration approach increases or decreases score variability. This study is designed to address these questions.

Read the detailed description

The overall goal of this randomized, cross-over study is to describe the distribution of co-SSPedi scores when compared to proxy-report and self-report SSPedi or mini-SSPedi scores. We hypothesize co-SSPedi would be significantly different than proxy-report and self-report SSPedi with respect to score distribution, and would have decreased symptom score variability.

Aim 1: To compare the mean co-SSPedi scores vs. proxy-SSPedi for pediatric patients with cancer or HSCT recipients who are 4-18 years of age.

Aim 2: To compare the mean co-SSPedi scores vs. self-report SSPedi/mini-SSPedi scores for pediatric patients with cancer or HSCT recipients who are 4-18 years of age.

Aim 3: To describe differences in interquartile range, standard deviation and range between co-SSPedi scores vs. proxy-report or self-report SSPedi/mini-SSPedi scores.

Aim 4: To obtain qualitative feedback about the experience of completing symptom screening together vs. separately from pediatric patients and their parents

Overall Strategy

This study is a randomized cross-over study that involves a single interview where the primary analysis will involve the first period only. This study will be conducted at a single center, The Hospital for Sick Children (SickKids) in Toronto. The study population will comprise participants across all oncology and HSCT sections within the Division of Haematology/Oncology.

Research Methods

Eligibility: This study will enroll child-parent dyads. We will include English-speaking dyads of a child and a guardian, where the child is between 4-18 years of age and has a diagnosis of cancer or is a hematopoietic stem cell transplant (HSCT) recipient. Exclusion criteria will be illness severity, cognitive disability or other impairment that precludes completion of co-SSPedi, SSPedi/mini-SSPedi or proxy SSPedi according to the primary healthcare team. Both inpatients and outpatients will be eligible.

Procedures: The instruments will be administered on an electronic platform. Each dyad will complete both co-SSPedi as one "period" and then self-report SSPedi/mini-SSPedi and proxy-SSPedi as a second "period". Both "periods" will occur during the same dyad encounter. The order of periods will be randomized, resulting in two groups based upon the approach used in the first period. The allocation sequence will be computer generated and will be concealed from all participants, healthcare providers and research team members. Consenting participants will be randomized 1:1 to co-SSPedi administration first vs. self-report/proxy-report first using permuted block sizes and stratified by relapse status (yes vs. no), age (4-7, 8-10, 11-14 and 15-18 years) and outpatient/ inpatient at time of interview as our previous data suggested that these factors were the most strongly associated with higher total SSPedi scores.

The dyad will complete the randomized approach first and then will proceed to the alternate approach. After the second period, qualitative feedback will be elicited using a semi-structured interview.

Being tested
Patient/Proxy-SSPedi, Co-SSPedi
Keywords
Pediatric Oncology, Randomized Controlled Trial, Symptom Screening, Quality of Life
Medical subject headings
Neoplasms

What participants receive

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

  • Patient/Proxy-SSPediOther

    SSPedi and Mini-SSPedi: SSPedi is a symptom assessment scale for children 8-18 years of age that includes 15 symptoms considered most important by children receiving cancer treatment or HSCT, their parents and healthcare professionals. Each symptom is rated on a 5-point Likert scale consisting of 0="not at all bothered", 1="a little", 2="medium", 3="a lot" and 4="extremely bothered". The recall period is yesterday or today.

    Mini-SSPedi was developed for children 4-7 years of age and is comprised of the same 15 symptoms. Mini-SSPedi has a recall period of today with a 3-point Likert scale consisting of 0="not at all bothered", 2="medium" and 4="extremely bothered'. So, the anchors and mid-point are identical to SSPedi. A faces-type scale accompanies the response options and the symptom descriptions are simplified.

    Proxy-SSPedi: Proxy-SSPedi is identical to SSPedi except that the leading question refers to "your child" rather than "you". It is designed for children 2-18 years of age.

  • Co-SSPediOther

    Co-SSPedi: Co-SSPedi is based upon either SSPedi (age 8-18) or mini-SSPedi (age 4-7).

    Co-SSPedi is meant to be completed by both child and parent together. The format and wording is identical to self-report SSPedi and mini-SSPedi (depending on child age) to maximize the ability of the child to participate in symptom reporting.

    The approach uses written instruction that asks the dyad who will hold the device and enter the agreed-upon scores. The instruction then asks one member to read the leading question, each symptom and response options out loud. The child answers how bothered they are by that symptom out loud. The parent then states if they agree or they can offer a different answer. If the answer is different, the instruction asks the dyad to discuss until they agree upon an answer. The agreed-upon answer is then entered into co-SSPedi. This process is repeated for the remaining 14 symptoms.

Study groups in NCT05012917
Study groupRoleWhat they receive
Patient/Proxy-SSPedi Administered FirstOtherParent/child dyads will complete self-report SSPedi/mini-SSPedi and proxy-SSPedi as the first "period" and then co-SSPedi as a second "period".
Receives: Other: Patient/Proxy-SSPedi; Other: Co-SSPedi
Co-SSPedi Administered FirstOtherParent/child dyads will complete co-SSPedi as the first "period" and then self-report SSPedi/mini-SSPedi and proxy-SSPedi as a second "period".
Receives: Other: Patient/Proxy-SSPedi; Other: Co-SSPedi

What is being measured

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

  1. Symptom Screening in Pediatrics Tool (SSPedi) total score

    The total SSPedi score is a measure that reflects the total burden of bothersome symptoms experienced.

    Total unweighted scores will be calculated for co-SSPedi, SSPedi/mini-SSPedi and proxy-SSPedi. The scoring for all instruments is identical. Each item's Likert score ranges from 0 (no bother) to 4 (worst bother); Likert scores are summed for a total score that ranges from 0 (none) to 60 (worst possible).

    Measured: Immediately after the intervention

Timeline

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

  1. First posted19 Aug 2021
  2. Study start19 Aug 2021
  3. Primary completion3 Aug 2023
  4. Study completion3 Aug 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
Supportive care
Allocation
Randomised
Intervention model
Crossover
Model description
This is a randomized cross-over study that involves a single interview where the primary analysis will involve the first period only.
Masking
None (open label)
Enrolment
420 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05012917
Sponsor's protocol ID
1000076793
Status last verified
Sep 2023
First submitted
4 Aug 2021
Last updated
26 Sep 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Dupuis LL, Johnston DL, Baggott C, Hyslop S, Tomlinson D, Gibson P, Orsey A, Dix D, Price V, Vanan M, Portwine C, Kuczynski S, Spiegler B, Tomlinson GA, Sung L. Validation of the Symptom Screening in Pediatrics Tool in Children Receiving Cancer Treatments. J Natl Cancer Inst. 2018 Jun 1;110(6):661-668. doi: 10.1093/jnci/djx250.

    PubMed 29272441
  • Hyslop S, Dupuis LL, Baggott C, Dix D, Gibson P, Kuczynski S, Johnston DL, Orsey A, Portwine C, Price V, Spiegler B, Tomlinson D, Vanan M, Tomlinson GA, Sung L. Validation of the Proxy Version of Symptom Screening in Pediatrics Tool in Children Receiving Cancer Treatments. J Pain Symptom Manage. 2018 Jul;56(1):107-112. doi: 10.1016/j.jpainsymman.2018.03.025. Epub 2018 Apr 6.

    PubMed 29630923

Questions about this trial

What is this clinical trial studying?

A study testing Patient/Proxy-SSPedi and Co-SSPedi in people with Pediatric Cancer and Quality of Life, run by The Hospital for Sick Children at 1 site in Canada.

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 3 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 26 Sep 2023. 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 Canada. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Symptom Screening in Pediatrics Tool (SSPedi) total score (time frame: Immediately after the intervention). 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 NCT05012917, which also lists 2 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 26 Sep 2023.

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