Nausea and Vomiting, PostoperativeNCT06356623
A Risk Prediction Model of Postoperative Nausea and Vomiting in Patients With Liver Cancer
An observational study of Nausea and Vomiting, Postoperative and Liver Cancer, run by Shanghai Zhongshan Hospital.
Trial summary
PONV management has been recommended as a necessary part of enhanced recovery protocols during the perioperative period, and PONV risk assessment is, therefore, a necessary first step in determining the number of medications or strategies for prophylaxis and treatment by considering the number of modifiable and… Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Nausea and Vomiting, Postoperative, Liver Cancer
- What is being tested?
- 1
- How many people
- 476 participants
- Where
- No sites listed yet
- Study dates
- 5 May 2024to 6 Aug 2024
- Phase
- Observational
- 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 18 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients who are diagnosed with liver cancer and underwent hepatectomy will be eligible.
Who may be able to join
- Patients who are diagnosed with liver cancer and underwent hepatectomy
- Patients who are older than 18 years
- Patients who have planned admissions and elective surgery, and stay at least 24 hours in the surgical unit.
Who cannot join
- Patients with cognitive impairment
- Patients with nausea and vomiting related to other existing diseases, such as gastroesophageal reflux disease.
- Patients with severe postoperative complications, including massive abdominal hemorrhage, hepatic encephalopathy and portal vein thrombosis.
Trial locations and contacts
No sites are listed yet.
About this study
Official title: Development and Validation of a Machine Learning Model for Postoperative Nausea and Vomiting in Patients With Liver Cancer
PONV management has been recommended as a necessary part of enhanced recovery protocols during the perioperative period, and PONV risk assessment is, therefore, a necessary first step in determining the number of medications or strategies for prophylaxis and treatment by considering the number of modifiable and non-modifiable risk factors. However, the external validity of two commonly-used PONV prediction models for patients undergoing liver surgery is unsatisfied, and need to be updated for liver cancer populations to better inform personalized perioperative care regime and individualized decision-making in clinical practice.
Read the detailed description
- Study design This is a multi-centre, prospective cohort study performed at two tertiary teaching hospitals in Shanghai, China.
- Settings and participants The study will be conducted in the liver disease department in Fudan University Zhongshan Hospital and Shanghai cancer center. Patients will be prospectively consecutively recruited between may 2024 and August 2024. Patients who are diagnosed with liver cancer and underwent hepatectomy will be eligible. Inclusion criteria are age older than 18 years, planned admissions and elective surgery, and staying at least 24 hours in the surgical unit. We exclude patients with cognitive impairment and patients who had nausea and vomiting related to other existing diseases, such as gastroesophageal reflux disease. We also exclude patients who had severe postoperative complications, including massive abdominal hemorrhage, hepatic encephalopathy and portal vein thrombosis. Our study aims to develop PONV prediction model. The rule of thumb in logistic modelling is that there should be a minimum of 10 events per predictor variable (EPV). According to a previous study, the incidence of PONV is 48.3% [22] and there are a total of 20 predictor variables, therefore, the required minimum sample size is 414. Considering 15% of the sample loss, we would target to recruit 476 to minimize the limitation of a small number of events of PONV.
- Data collection PONV risk factor assessments All enrolled patients will receive preoperative PONV risk assessments by the second author and the third author 1 day before surgery. The baseline demographic data and medical history will be recorded. The potential predictors include female sex, nonsmoking history, history of motion sickness or PONV, age, sex, history of smoking, history of motion sickness, history of PONV, duration of surgery, the use of postoperative opioids, the style of surgery and type of surgery, the numbers and time of portal vein occlusion and the use of postoperative opioids. We defined smoking history as nicotine use before surgery, history of motion sickness as nausea or vomiting when travelling in a car/boat/train/plane, and use of postoperative opioids as the use of opioids within the 24 hours after surgery. Nonsmoking history and history of motion sickness or PONV were collected by interviewing patients and family members, while the use of postoperative opioids will be determined by checking the hospital information system to review records and anaesthetic protocols. Outcome measures Postoperative nausea and vomiting will be assessed every hour during the first two hours, every two hours for the following four hours and every four hours until the 24th hour by the first and the second authors to ensure high-quality data collection. PONV will be evaluated on a four-grade scale from 0 (no nausea and no vomiting), 1 (having nausea but no vomiting), 2 (having vomiting without stomach contents) to 3 (having vomiting with stomach contents). A patient will be considered to have had PONV if his or her PONV grade is 2 or more within the first 24 postoperative hours. PONV will be assessed by the first author, who is blinded to the results of PONV risk assessments.
- Statistical analysis The statistical analysis will be performed using SPSS 25.0 and Pyhthon software version 4.0.1. Continuous variables were analysed by using descriptive statistics (median, interquartile range, or mean [SD]); categorical data were analyzed as proportions (number, percentage). According to the ratio of 8:2, the data will be divided into training sets and validation sets, and the prediction model of the random forest algorithm will be constructed, the hyperparameter optimization will be carried out, and the importance of each predictor in the random forest model will be calculated by Gini coefficient. The differentiation of the prediction model will be evaluated based on the ROC curve, the calibration curve evaluated the calibration degree of the model, and the prediction performance of the model for PONV will be evaluated. A P value of less than .05 will be considered statistically significant.
- Conditions
- Nausea and Vomiting, Postoperative, Liver Cancer
- Being tested
- 1
- Keywords
- liver cancer, Nausea and Vomiting, Postoperative, risk score
- Medical subject headings
- Postoperative Nausea and Vomiting, Liver Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
1Other
this is not an intervention study
| Study group | Role | What they receive |
|---|---|---|
| patients with PONV | Not described Receives: Other: 1 | |
| patients without PONV | Not described |
What is being measured
The primary outcome is the main question the study is designed to answer.
Postoperative nausea and vomiting
PONV will be evaluated on a four-grade scale from 0 (no nausea and no vomiting), 1 (having nausea but no vomiting), 2 (having vomiting without stomach contents) to 3 (having vomiting with stomach contents).
Measured: Postoperative nausea and vomiting will be assessed every hour during the first two hours, every two hours for the following four hours and every four hours until the 24th hour
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Apr 2024
- Study start5 May 2024 (estimated)
- Primary completion5 Aug 2024 (estimated)
- Study completion6 Aug 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Nausea and Vomiting, PostoperativeStudies of the same condition, open and under way.
- More trials run by Shanghai Zhongshan HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- 476 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Shanghai Zhongshan Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06356623
- Sponsor's protocol ID
- SHDC2202020401
- Status last verified
- Apr 2024
- First submitted
- 5 Apr 2024
- Last updated
- 10 Apr 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 10 Apr 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Development and Validation of a Machine Learning Model for Postoperative Nausea and Vomiting in Patients With Liver Cancer
- ClinicalTrials.gov ID
- NCT06356623
- Acronym / sponsor ID
- SHDC2202020401
- Conditions
- Nausea and Vomiting, Postoperative, Liver Cancer
- Keywords
- liver cancer, Nausea and Vomiting, Postoperative, risk score
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 476 participants (estimated)
- Lead sponsor
- Shanghai Zhongshan HospitalUniversity, hospital or other
- Study start
- 5 May 2024 (estimated)
- Primary completion
- 5 Aug 2024 (estimated)
- Study completion
- 6 Aug 2024 (estimated)
- First posted
- 10 Apr 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
PONV management has been recommended as a necessary part of enhanced recovery protocols during the perioperative period, and PONV risk assessment is, therefore, a necessary first step in determining the number of medications or strategies for prophylaxis and treatment by considering the number of modifiable and non-modifiable risk factors. However, the external validity of two commonly-used PONV prediction models for patients undergoing liver surgery is unsatisfied, and need to be updated for liver cancer populations to better inform personalized perioperative care regime and individualized decision-making in clinical practice.
Detailed description
- Study design This is a multi-centre, prospective cohort study performed at two tertiary teaching hospitals in Shanghai, China.
- Settings and participants The study will be conducted in the liver disease department in Fudan University Zhongshan Hospital and Shanghai cancer center. Patients will be prospectively consecutively recruited between may 2024 and August 2024. Patients who are diagnosed with liver cancer and underwent hepatectomy will be eligible. Inclusion criteria are age older than 18 years, planned admissions and elective surgery, and staying at least 24 hours in the surgical unit. We exclude patients with cognitive impairment and patients who had nausea and vomiting related to other existing diseases, such as gastroesophageal reflux disease. We also exclude patients who had severe postoperative complications, including massive abdominal hemorrhage, hepatic encephalopathy and portal vein thrombosis. Our study aims to develop PONV prediction model. The rule of thumb in logistic modelling is that there should be a minimum of 10 events per predictor variable (EPV). According to a previous study, the incidence of PONV is 48.3% [22] and there are a total of 20 predictor variables, therefore, the required minimum sample size is 414. Considering 15% of the sample loss, we would target to recruit 476 to minimize the limitation of a small number of events of PONV.
- Data collection PONV risk factor assessments All enrolled patients will receive preoperative PONV risk assessments by the second author and the third author 1 day before surgery. The baseline demographic data and medical history will be recorded. The potential predictors include female sex, nonsmoking history, history of motion sickness or PONV, age, sex, history of smoking, history of motion sickness, history of PONV, duration of surgery, the use of postoperative opioids, the style of surgery and type of surgery, the numbers and time of portal vein occlusion and the use of postoperative opioids. We defined smoking history as nicotine use before surgery, history of motion sickness as nausea or vomiting when travelling in a car/boat/train/plane, and use of postoperative opioids as the use of opioids within the 24 hours after surgery. Nonsmoking history and history of motion sickness or PONV were collected by interviewing patients and family members, while the use of postoperative opioids will be determined by checking the hospital information system to review records and anaesthetic protocols. Outcome measures Postoperative nausea and vomiting will be assessed every hour during the first two hours, every two hours for the following four hours and every four hours until the 24th hour by the first and the second authors to ensure high-quality data collection. PONV will be evaluated on a four-grade scale from 0 (no nausea and no vomiting), 1 (having nausea but no vomiting), 2 (having vomiting without stomach contents) to 3 (having vomiting with stomach contents). A patient will be considered to have had PONV if his or her PONV grade is 2 or more within the first 24 postoperative hours. PONV will be assessed by the first author, who is blinded to the results of PONV risk assessments.
- Statistical analysis The statistical analysis will be performed using SPSS 25.0 and Pyhthon software version 4.0.1. Continuous variables were analysed by using descriptive statistics (median, interquartile range, or mean [SD]); categorical data were analyzed as proportions (number, percentage). According to the ratio of 8:2, the data will be divided into training sets and validation sets, and the prediction model of the random forest algorithm will be constructed, the hyperparameter optimization will be carried out, and the importance of each predictor in the random forest model will be calculated by Gini coefficient. The differentiation of the prediction model will be evaluated based on the ROC curve, the calibration curve evaluated the calibration degree of the model, and the prediction performance of the model for PONV will be evaluated. A P value of less than .05 will be considered statistically significant.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| patients with PONV | – | Other: 1 |
| patients without PONV | – | – |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients who are diagnosed with liver cancer and underwent hepatectomy will be eligible.
Key inclusion criteria (3 listed)
- Patients who are diagnosed with liver cancer and underwent hepatectomy
- Patients who are older than 18 years
- Patients who have planned admissions and elective surgery, and stay at least 24 hours in the surgical unit.
Key exclusion criteria (3 listed)
- Patients with cognitive impairment
- Patients with nausea and vomiting related to other existing diseases, such as gastroesophageal reflux disease.
- Patients with severe postoperative complications, including massive abdominal hemorrhage, hepatic encephalopathy and portal vein thrombosis.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| 1this is not an intervention study | Other | patients with PONV |
Primary outcome
Postoperative nausea and vomiting
Time frame: Postoperative nausea and vomiting will be assessed every hour during the first two hours, every two hours for the following four hours and every four hours until the 24th hour
PONV will be evaluated on a four-grade scale from 0 (no nausea and no vomiting), 1 (having nausea but no vomiting), 2 (having vomiting without stomach contents) to 3 (having vomiting with stomach contents).
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Apr 2024.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Questions about this trial
What is this clinical trial studying?
An observational study of Nausea and Vomiting, Postoperative and Liver Cancer, run by Shanghai Zhongshan Hospital.
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 3 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: status not confirmed, as of the sponsor's last update on 10 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.
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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Yuxia Zhang, Ph.D (13816881925, zhang.yx@aliyun.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Postoperative nausea and vomiting (time frame: Postoperative nausea and vomiting will be assessed every hour during the first two hours, every two hours for the following four hours and every four hours until the 24th hour). 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 10 Apr 2024; AzTrials last refreshed its copy on 7 Nov 2026.