Airway ManagementVIDIGLOVNCT07355608
Videolaryngoscopic Difficult ıntubation and Glottic View Score: A Multicentre Prospective Study
An observational study of Airway Management, run by Diskapi Teaching and Research Hospital at 2 sites in Turkey (Türkiye).
Trial summary
Background: Videolaryngoscopy has improved glottic visualization and facilitated tracheal intubation. However, difficulties-including failed intubation-still occur. At present, no prospectively derived classification system exists to assess the difficulty of videolaryngoscopic (VL) intubation across both normal and… Read more about this study
- Who is it for?
- Ages 18 to 100 years
- Conditions the study is for
- Airway Management
- How many people
- 4,977 participants
- Where
- 2 sitesTurkey (Türkiye)
- Study dates
- 1 Oct 2026to 1 Feb 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
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 100 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Adults, both with normal or predicted difficult airways, undergoing orotracheal intubation with a videolarygoscope, for a case mix of surgeries
Who may be able to join
- Adults
- Both with normal or predicted difficult airways
- Undergoing orotracheal intubation with a videolarygoscope
Who cannot join
- Rapid sequence intubation
- Double lumen tube intubation
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)2 sites
Etlik City Hospital
Ankara, 06170
Dilek Unal yazıcıoğlu, Professor, +905336957855, dilekunalmd@gmail.com
Emel Gündüz, +905444341719, drgunduz@hotmai.com
Akdeniz University Medical Faculty
Antalya
About this study
Official title: Prediction of Difficult Videolaryngoscopic Intubation and Development of a Dedicated Glottic View Score: A Multicentre Prospective Study
Background:
Videolaryngoscopy has improved glottic visualization and facilitated tracheal intubation. However, difficulties-including failed intubation-still occur. At present, no prospectively derived classification system exists to assess the difficulty of videolaryngoscopic (VL) intubation across both normal and anticipated difficult airways. Additionally, current glottic view grading systems, designed for direct laryngoscopy, may not adequately capture the specific challenges of VL intubation.
Read more
Objectives:
This study aims to:
- Develop a predictive model for difficult VL intubation in surgical patients with both normal and anticipated difficult airways.
- Create a glottic view scoring system specifically tailored to videolaryngoscopy.
- Compare the predictive accuracy of the new scoring system with existing laryngeal view grades in forecasting difficult VL intubation.
Read the detailed description
Background:
Videolaryngoscopy has improved glottic visualization and facilitated tracheal intubation. However, difficulties-including failed intubation-still occur. At present, no prospectively derived classification system exists to assess the difficulty of videolaryngoscopic (VL) intubation across both normal and anticipated difficult airways. Additionally, current glottic view grading systems, designed for direct laryngoscopy, may not adequately capture the specific challenges of VL intubation.
Objectives:
This study aims to:
- Develop a predictive model for difficult VL intubation in surgical patients with both normal and anticipated difficult airways.
- Create a glottic view scoring system specifically tailored to videolaryngoscopy.
- Compare the predictive accuracy of the new scoring system with existing laryngeal view grades in forecasting difficult VL intubation.
Methods:
A prospective cohort of 4,977 patients will be enrolled. Patient and intubation related variables-including VL findings, airway features, clinical parameters, device, and procedural details-will be analyzed. Binary logistic regression will be employed to build the initial predictive model. In parallel, machine learning techniques (Random Forest, Support Vector Machine, XGBoost, LightGBM, etc.) will be applied to evaluate predictive performance. Comparative analysis will be conducted between the machine learning models and the logistic regression baseline.
Expected Impact:
The development of a robust predictive tool and an associated VL-specific glottic view score could enhance clinical decision making, particularly in identifying patients at risk of difficult or failed VL intubation. This may support early consideration of awake tracheal intubation, and use of standardized terminology and reduce complications associated with difficult airway management
- Conditions
- Airway Management
- Keywords
- Airway management, Videolaryngoscope, Difficult airway
What is being measured
The primary outcome is the main question the study is designed to answer.
Failed first intubation attempt
Failed to intubate at firtst attempt
Measured: 2 minutes after anesthesia induction
Difficult intubation
Failed to intubate at 1-2 attempts and/or intubation duration longer than 120 second
Measured: 2 minutes after anesthesia induction
Failed intubation
Not able to intubate the patient
Measured: 2 minutes after anesthesia induction
Intubation duration
Time elapsed from entring the blade between the teeth to detecting an entidal carbondioxide trace
Measured: 2 minutes after anesthesia induction
Glottic view description
Vocal cords are fully visible Vocal cords are partially separately Vocal cords are not visible Cords are adducted Epiglottis is visible Epiglottis is large Epiglottis is small Epiglottis is edematous Epiglottis mass is present Arytenoids are visible Arytenoid luxation or subluxation Arytenoid edema Valecula problem (edema, Coffee grounds, etc., unable to insert a blade) Aryepiglottic plica pathology (edema, Coffee grounds scar) Laryngeal structures should be formed Glottic stenosis Laryngospasm
Measured: 2 minutes after anesthesia induction
Secondary outcomes (2)
Percentil of glottic opening score
the percentage of glottic opening seen, defined by the linear span from the anterior commissure to the inter-arytenoid notch
Measured: 2 minutes after anesthesia induction
Cormack lehanne score
grade 1 being a full view of the glottis, grade 2 being a partial view, grade 3 being only a view of the epiglottis, and grade 4 being an absent view of the glottis and epiglottis
Measured: 2 minutes after anesthesia induction
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Jan 2026
- Study start1 Oct 2026 (estimated)
- Primary completion1 Feb 2027 (estimated)
- Study completion1 Feb 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Airway ManagementStudies of the same condition, open and under way.
- 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
- Other
- Time perspective
- Prospective
- Enrolment
- 4,977 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Diskapi Teaching and Research Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, DILEK YAZICIOGLU, Diskapi Teaching and Research Hospital
- Investigators
- Dilek Yazıcıoğlu Ünal, professor, Principal investigator, Ankara Etlik City Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07355608
- Sponsor's protocol ID
- Etlik City Hospital
- Acronym
- VIDIGLOV
- Status last verified
- Aug 2026
- First submitted
- 2 Dec 2025
- Last updated
- 11 Aug 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Xia M, Jin C, Zheng Y, Wang J, Zhao M, Cao S, Xu T, Pei B, Irwin MG, Lin Z, Jiang H. Deep learning-based facial analysis for predicting difficult videolaryngoscopy: a feasibility study. Anaesthesia. 2024 Apr;79(4):399-409. doi: 10.1111/anae.16194. Epub 2023 Dec 13.
PubMed 38093485O'Loughlin EJ, Swann AD, English JD, Ramadas R. Accuracy, intra- and inter-rater reliability of three scoring systems for the glottic view at videolaryngoscopy. Anaesthesia. 2017 Jul;72(7):835-839. doi: 10.1111/anae.13837. Epub 2017 Mar 24.
PubMed 28337769
Study at a glance
From the registry record, last updated by the sponsor on 11 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Prediction of Difficult Videolaryngoscopic Intubation and Development of a Dedicated Glottic View Score: A Multicentre Prospective Study
- ClinicalTrials.gov ID
- NCT07355608
- Acronym / sponsor ID
- VIDIGLOV / Etlik City Hospital
- Conditions
- Airway Management
- Keywords
- Airway management, Videolaryngoscope, Difficult airway
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 4,977 participants (estimated)
- Lead sponsor
- Diskapi Teaching and Research HospitalUniversity, hospital or other
- Study start
- 1 Oct 2026 (estimated)
- Primary completion
- 1 Feb 2027 (estimated)
- Study completion
- 1 Feb 2027 (estimated)
- First posted
- 21 Jan 2026 (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.
Background:
Videolaryngoscopy has improved glottic visualization and facilitated tracheal intubation. However, difficulties-including failed intubation-still occur. At present, no prospectively derived classification system exists to assess the difficulty of videolaryngoscopic (VL) intubation across both normal and anticipated difficult airways. Additionally, current glottic view grading systems, designed for direct laryngoscopy, may not adequately capture the specific challenges of VL intubation.
Objectives:
This study aims to:
- Develop a predictive model for difficult VL intubation in surgical patients with both normal and anticipated difficult airways.
- Create a glottic view scoring system specifically tailored to videolaryngoscopy.
- Compare the predictive accuracy of the new scoring system with existing laryngeal view grades in forecasting difficult VL intubation.
Detailed description
Background:
Videolaryngoscopy has improved glottic visualization and facilitated tracheal intubation. However, difficulties-including failed intubation-still occur. At present, no prospectively derived classification system exists to assess the difficulty of videolaryngoscopic (VL) intubation across both normal and anticipated difficult airways. Additionally, current glottic view grading systems, designed for direct laryngoscopy, may not adequately capture the specific challenges of VL intubation.
Objectives:
This study aims to:
- Develop a predictive model for difficult VL intubation in surgical patients with both normal and anticipated difficult airways.
- Create a glottic view scoring system specifically tailored to videolaryngoscopy.
- Compare the predictive accuracy of the new scoring system with existing laryngeal view grades in forecasting difficult VL intubation.
Methods:
A prospective cohort of 4,977 patients will be enrolled. Patient and intubation related variables-including VL findings, airway features, clinical parameters, device, and procedural details-will be analyzed. Binary logistic regression will be employed to build the initial predictive model. In parallel, machine learning techniques (Random Forest, Support Vector Machine, XGBoost, LightGBM, etc.) will be applied to evaluate predictive performance. Comparative analysis will be conducted between the machine learning models and the logistic regression baseline.
Expected Impact:
The development of a robust predictive tool and an associated VL-specific glottic view score could enhance clinical decision making, particularly in identifying patients at risk of difficult or failed VL intubation. This may support early consideration of awake tracheal intubation, and use of standardized terminology and reduce complications associated with difficult airway management
Study design
- Observational model
- Other
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 to 100 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Adults, both with normal or predicted difficult airways, undergoing orotracheal intubation with a videolarygoscope, for a case mix of surgeries
Key inclusion criteria (3 listed)
- Adults
- Both with normal or predicted difficult airways
- Undergoing orotracheal intubation with a videolarygoscope
Key exclusion criteria (2 listed)
- Rapid sequence intubation
- Double lumen tube intubation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Failed first intubation attempt
Time frame: 2 minutes after anesthesia induction
Failed to intubate at firtst attempt
Difficult intubation
Time frame: 2 minutes after anesthesia induction
Failed to intubate at 1-2 attempts and/or intubation duration longer than 120 second
Failed intubation
Time frame: 2 minutes after anesthesia induction
Not able to intubate the patient
Intubation duration
Time frame: 2 minutes after anesthesia induction
Time elapsed from entring the blade between the teeth to detecting an entidal carbondioxide trace
Glottic view description
Time frame: 2 minutes after anesthesia induction
Vocal cords are fully visible Vocal cords are partially separately Vocal cords are not visible Cords are adducted Epiglottis is visible Epiglottis is large Epiglottis is small Epiglottis is edematous Epiglottis mass is present Arytenoids are visible Arytenoid luxation or subluxation Arytenoid edema Valecula problem (edema, Coffee grounds, etc., unable to insert a blade) Aryepiglottic plica pathology (edema, Coffee grounds scar) Laryngeal structures should be formed Glottic stenosis Laryngospasm
2 secondary outcomes
Percentil of glottic opening score
Time frame: 2 minutes after anesthesia induction
Cormack lehanne score
Time frame: 2 minutes after anesthesia induction
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Aug 2026.
- Background: PubMed 38093485Xia M, Jin C, Zheng Y, Wang J, Zhao M, Cao S, Xu T, Pei B, Irwin MG, Lin Z, Jiang H. Deep learning-based facial analysis for predicting difficult videolaryngoscopy: a feasibility study. Anaesthesia. 2024 Apr;79(4):399-409. doi: 10.1111/anae.16194. Epub 2023 Dec 13.
- Background: PubMed 28337769O'Loughlin EJ, Swann AD, English JD, Ramadas R. Accuracy, intra- and inter-rater reliability of three scoring systems for the glottic view at videolaryngoscopy. Anaesthesia. 2017 Jul;72(7):835-839. doi: 10.1111/anae.13837. Epub 2017 Mar 24.
- Individual participant dataSharing planned: No
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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.
Dilek Yazıcıoğlu Ünal, professor principal investigator
Ankara Etlik City Hospital
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Airway Management, run by Diskapi Teaching and Research Hospital at 2 sites in Turkey (Türkiye).
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 2 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: opening soon, as of the sponsor's last update on 11 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Turkey (Türkiye). 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Dilek Yazıcıoğlu Ünal, Professor (+90 5336957855, dilekunalmd@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Failed first intubation attempt (time frame: 2 minutes after anesthesia induction). The study lists 5 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 NCT07355608, 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 11 Aug 2026.