DeliriumNCT02258386
Assessment of Delirium in Hospitalized Patients
An observational study of Delirium, run by University of Arizona at 1 site in United States.
Trial summary
The aim of the present study is to implement a novel body-worn sensor, the ZephyrTM BioModule (the registered name for the wearable sensor device used in our study), for assessing physical activity and physiological measures in a clinical setting together with other clinical routine assessments. Read more about this study
- Who is it for?
- Ages 70 years and older
- Conditions the study is for
- Delirium
- How many people
- 0 participants
- Where
- 1 siteUnited States
- Study dates
- Apr 2015to Sep 2017
- 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 70 years and older
- All sexes
- No healthy volunteers
- Older adult
Study population: Age 70 and older; hospitalized in ICU at high-risk of delirium.
Who may be able to join
- Cognitive impairment,
- UTI (urinary tract infection)
- Pneumonia,
- Status post hip fracture or trauma,
- ->5 medications,
- Previous hospitalization in past 6 months
Who cannot join
- Refusal to participate
- Terminally ill
- On ventilator
- Delirium based on CAM-ICU
Trial locations and contacts
1 site in 1 country.
United States1 site
Banner University Hospital, 3 Diamond West
Tucson, Arizona, 85724
About this study
Official title: Objective Assessment of Delirium in Hospitalized Patients
The aim of the present study is to implement a novel body-worn sensor, the ZephyrTM BioModule (the registered name for the wearable sensor device used in our study), for assessing physical activity and physiological measures in a clinical setting together with other clinical routine assessments. Investigators' specific aim is to explore whether and how specific physical activity pattern and physiological measures are associated with delirium in hospital inpatient. The ultimate goal is early detection and intervention of delirium, and better management through monitoring of activity pattern and physiological information. The ZephyrTM a U.S. FDA-approved wireless, ambulatory physiological monitoring device that consists of a data logger and transmitter unit which is attached at the location of the 5th intercostal space using a specifically designed patch (BioPatchTM) and standard ECG electrodes. The ZephyrTM is designed for long-term measurement of a patient's physical activity and physiological measures. By using the physical activity parameters and physiological measures, a specific delirium risk profile will be computed for each patient. Finally, the association of this delirium risk profile with CAM-ICU questionnaire as a gold standard will be assessed.
Read the detailed description
After obtaining written informed consent and Protected Health Information (PHI) consent, CAM-ICU (Confusion Assessment Method for the ICU) will be measured routinely by unit nurses each shift. Results will be available in the medical record. Investigators will then measure physical activity and physiological measures (e.g. ECG, heart rate, respiration rate, and body temperature) using an unobtrusive body worn sensor. This sensor will be attached to the 5th intercostal space using a specifically designed patch (BioPatchTM) to allow quantification of physical activity such as walking, standing, sitting, lying, as well as measurement of other physiological parameters. These measurements will only be available to the research team and will not be available to the nurses on the inpatient study unit. Medical history (from clinic chart) and demographic information will be obtained, such as age, gender, weight, and height as well as details (e.g. injuries, fall score and number of falls) which happened during hospital stay. The research tests consist of one core measurements and one ancillary measurements (as required) as listed below (Note - ancillary measurement may not be required for everyone).
Core measurements Assessment of physical activity and physiological measures: Patients will be asked to wear the Zephyr BioModule for a period of 24 hours to maximum stay in the hospital. The Zephyr BioModule will be attached to the patients to the 5th intercostal space using a specifically designed patch (BioPatchTM).
Ancillary Measurements Upper Extremity Test: A validated body worn sensors (LEGSys™, Biosensics LLC) will be used to evaluate upper extremity kinematics (angular velocities). This is a simple test where the patient flexes and extends their arm for 20 seconds on each arm.
Analysis plan:
To predict the risk of delirium using physical activity and physiological data, each patient participating in the study will be categorized as to presence of delirium based on CAM-ICU questionnaire. Logistic regression analysis will be used to examine the relation between each physical activity variable (e.g. lying time) and physiological measures (e.g. heart rate) with delirium risk. Firstly, univariate logistic regression, using presence of delirium as the dependent variable, will be employed to investigate the relationship of the test variables. The Odd Ratios (OR) and coefficient of determination (R2) will be calculated for each explanatory variable. Then multivariate logistic regression using stepwise-automated methods will be performed to investigate the independent effects of the physical activity variables and physiological measures in predicting delirium. Sensitivities, specificities, positive and negative predictive values of different cut-off values will be calculated for any non-categorical variable shown to have an independent effect on predicting delirium. A two-sided P-value ≤0.05 will be considered to be statistically significant. Statistical analysis will be performed using SPSS (Statistical Package for the Social Sciences) statistics 22.0 (IBM, Armonk (name of town), NY (New York), USA).
- Conditions
- Delirium
- Medical subject headings
- Delirium
What is being measured
The primary outcome is the main question the study is designed to answer.
Objective Assessment of Delirium in Hospitalized Patients
To identify biodata (physiological measurement) patterns indicative of the 3 subtypes of delirium (hypoactive, hyperactive and mixed). To build an algorithm sensitive and specific to the diagnosis of each of the three subtypes of delirium for future integration into a delirium monitoring system capable of objective delirium diagnosis, concentrating on those patterns indicative of early identification.
Measured: 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Oct 2014 (estimated)
- Study startApr 2015
- Primary completionSep 2017 (estimated)
- Study completionSep 2017 (estimated)
Why it stopped: No participants enrolled. The study may be reopened at a later date.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for DeliriumStudies of the same condition, open and under way.
- More trials run by University of ArizonaThe 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
- Other
- Time perspective
- Prospective
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Arizona
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jane Mohler, PhD, Principal investigator, University of Arizona
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02258386
- Sponsor's protocol ID
- IRB #1409472204
- Status last verified
- May 2016
- First submitted
- 2 Oct 2014
- Last updated
- 22 Aug 2024
- Results posted
- No
- Data monitoring committee
- No
Publications
Cole MG. Delirium in elderly patients. Am J Geriatr Psychiatry. 2004 Jan-Feb;12(1):7-21.
PubMed 14729554Gleason OC. Delirium. Am Fam Physician. 2003 Mar 1;67(5):1027-34.
PubMed 12643363Foreman MD, Wakefield B, Culp K, Milisen K. Delirium in elderly patients: an overview of the state of the science. J Gerontol Nurs. 2001 Apr;27(4):12-20. doi: 10.3928/0098-9134-20010401-06.
PubMed 11915152Inouye SK. The dilemma of delirium: clinical and research controversies regarding diagnosis and evaluation of delirium in hospitalized elderly medical patients. Am J Med. 1994 Sep;97(3):278-88. doi: 10.1016/0002-9343(94)90011-6.
PubMed 8092177Francis J. Delirium in older patients. J Am Geriatr Soc. 1992 Aug;40(8):829-38. doi: 10.1111/j.1532-5415.1992.tb01859.x. No abstract available.
PubMed 1634729Albert MS, Levkoff SE, Reilly C, Liptzin B, Pilgrim D, Cleary PD, Evans D, Rowe JW. The delirium symptom interview: an interview for the detection of delirium symptoms in hospitalized patients. J Geriatr Psychiatry Neurol. 1992 Jan-Mar;5(1):14-21. doi: 10.1177/002383099200500103.
PubMed 1571069Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatry Res. 1988 Jan;23(1):89-97. doi: 10.1016/0165-1781(88)90037-6.
PubMed 3363018Leslie DL, Zhang Y, Holford TR, Bogardus ST, Leo-Summers LS, Inouye SK. Premature death associated with delirium at 1-year follow-up. Arch Intern Med. 2005 Jul 25;165(14):1657-62. doi: 10.1001/archinte.165.14.1657.
PubMed 16043686McCusker J, Cole M, Dendukuri N, Belzile E, Primeau F. Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study. CMAJ. 2001 Sep 4;165(5):575-83.
PubMed 11563209O'Keeffe S, Lavan J. The prognostic significance of delirium in older hospital patients. J Am Geriatr Soc. 1997 Feb;45(2):174-8. doi: 10.1111/j.1532-5415.1997.tb04503.x.
PubMed 9033515
Study at a glance
From the registry record, last updated by the sponsor on 22 Aug 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Objective Assessment of Delirium in Hospitalized Patients
- ClinicalTrials.gov ID
- NCT02258386
- Acronym / sponsor ID
- IRB #1409472204
- Conditions
- Delirium
- Study type
- Observational
- Recruitment status
- WithdrawnReason stopped: No participants enrolled. The study may be reopened at a later date.
- Enrolment
- 0 participants (actual)
- Lead sponsor
- University of ArizonaUniversity, hospital or other
- Study start
- Apr 2015
- Primary completion
- Sep 2017 (estimated)
- Study completion
- Sep 2017 (estimated)
- First posted
- 7 Oct 2014 (estimated)
- 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.
The aim of the present study is to implement a novel body-worn sensor, the ZephyrTM BioModule (the registered name for the wearable sensor device used in our study), for assessing physical activity and physiological measures in a clinical setting together with other clinical routine assessments. Investigators' specific aim is to explore whether and how specific physical activity pattern and physiological measures are associated with delirium in hospital inpatient. The ultimate goal is early detection and intervention of delirium, and better management through monitoring of activity pattern and physiological information. The ZephyrTM a U.S. FDA-approved wireless, ambulatory physiological monitoring device that consists of a data logger and transmitter unit which is attached at the location of the 5th intercostal space using a specifically designed patch (BioPatchTM) and standard ECG electrodes. The ZephyrTM is designed for long-term measurement of a patient's physical activity and physiological measures. By using the physical activity parameters and physiological measures, a specific delirium risk profile will be computed for each patient. Finally, the association of this delirium risk profile with CAM-ICU questionnaire as a gold standard will be assessed.
Detailed description
After obtaining written informed consent and Protected Health Information (PHI) consent, CAM-ICU (Confusion Assessment Method for the ICU) will be measured routinely by unit nurses each shift. Results will be available in the medical record. Investigators will then measure physical activity and physiological measures (e.g. ECG, heart rate, respiration rate, and body temperature) using an unobtrusive body worn sensor. This sensor will be attached to the 5th intercostal space using a specifically designed patch (BioPatchTM) to allow quantification of physical activity such as walking, standing, sitting, lying, as well as measurement of other physiological parameters. These measurements will only be available to the research team and will not be available to the nurses on the inpatient study unit. Medical history (from clinic chart) and demographic information will be obtained, such as age, gender, weight, and height as well as details (e.g. injuries, fall score and number of falls) which happened during hospital stay. The research tests consist of one core measurements and one ancillary measurements (as required) as listed below (Note - ancillary measurement may not be required for everyone).
Core measurements Assessment of physical activity and physiological measures: Patients will be asked to wear the Zephyr BioModule for a period of 24 hours to maximum stay in the hospital. The Zephyr BioModule will be attached to the patients to the 5th intercostal space using a specifically designed patch (BioPatchTM).
Ancillary Measurements Upper Extremity Test: A validated body worn sensors (LEGSys™, Biosensics LLC) will be used to evaluate upper extremity kinematics (angular velocities). This is a simple test where the patient flexes and extends their arm for 20 seconds on each arm.
Analysis plan:
To predict the risk of delirium using physical activity and physiological data, each patient participating in the study will be categorized as to presence of delirium based on CAM-ICU questionnaire. Logistic regression analysis will be used to examine the relation between each physical activity variable (e.g. lying time) and physiological measures (e.g. heart rate) with delirium risk. Firstly, univariate logistic regression, using presence of delirium as the dependent variable, will be employed to investigate the relationship of the test variables. The Odd Ratios (OR) and coefficient of determination (R2) will be calculated for each explanatory variable. Then multivariate logistic regression using stepwise-automated methods will be performed to investigate the independent effects of the physical activity variables and physiological measures in predicting delirium. Sensitivities, specificities, positive and negative predictive values of different cut-off values will be calculated for any non-categorical variable shown to have an independent effect on predicting delirium. A two-sided P-value ≤0.05 will be considered to be statistically significant. Statistical analysis will be performed using SPSS (Statistical Package for the Social Sciences) statistics 22.0 (IBM, Armonk (name of town), NY (New York), USA).
Study design
- Observational model
- Other
- Time perspective
- Prospective
Who may qualify
- Ages
- 70 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Older adult
- Study population
- Age 70 and older; hospitalized in ICU at high-risk of delirium.
Key inclusion criteria (6 listed)
- Cognitive impairment,
- UTI (urinary tract infection)
- Pneumonia,
- Status post hip fracture or trauma,
- ->5 medications,
Key exclusion criteria (4 listed)
- Refusal to participate
- Terminally ill
- On ventilator
- Delirium based on CAM-ICU
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
Objective Assessment of Delirium in Hospitalized Patients
Time frame: 3 years
To identify biodata (physiological measurement) patterns indicative of the 3 subtypes of delirium (hypoactive, hyperactive and mixed). To build an algorithm sensitive and specific to the diagnosis of each of the three subtypes of delirium for future integration into a delirium monitoring system capable of objective delirium diagnosis, concentrating on those patterns indicative of early identification.
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Aug 2024.
- Background: PubMed 14729554Cole MG. Delirium in elderly patients. Am J Geriatr Psychiatry. 2004 Jan-Feb;12(1):7-21.
- Background: PubMed 12643363Gleason OC. Delirium. Am Fam Physician. 2003 Mar 1;67(5):1027-34.
- Background: PubMed 11915152Foreman MD, Wakefield B, Culp K, Milisen K. Delirium in elderly patients: an overview of the state of the science. J Gerontol Nurs. 2001 Apr;27(4):12-20. doi: 10.3928/0098-9134-20010401-06.
- Background: PubMed 8092177Inouye SK. The dilemma of delirium: clinical and research controversies regarding diagnosis and evaluation of delirium in hospitalized elderly medical patients. Am J Med. 1994 Sep;97(3):278-88. doi: 10.1016/0002-9343(94)90011-6.
- Background: PubMed 1634729Francis J. Delirium in older patients. J Am Geriatr Soc. 1992 Aug;40(8):829-38. doi: 10.1111/j.1532-5415.1992.tb01859.x. No abstract available.
- Background: PubMed 1571069Albert MS, Levkoff SE, Reilly C, Liptzin B, Pilgrim D, Cleary PD, Evans D, Rowe JW. The delirium symptom interview: an interview for the detection of delirium symptoms in hospitalized patients. J Geriatr Psychiatry Neurol. 1992 Jan-Mar;5(1):14-21. doi: 10.1177/002383099200500103.
- Background: PubMed 3363018Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatry Res. 1988 Jan;23(1):89-97. doi: 10.1016/0165-1781(88)90037-6.
- Background: PubMed 16043686Leslie DL, Zhang Y, Holford TR, Bogardus ST, Leo-Summers LS, Inouye SK. Premature death associated with delirium at 1-year follow-up. Arch Intern Med. 2005 Jul 25;165(14):1657-62. doi: 10.1001/archinte.165.14.1657.
- Background: PubMed 11563209McCusker J, Cole M, Dendukuri N, Belzile E, Primeau F. Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study. CMAJ. 2001 Sep 4;165(5):575-83.
- Background: PubMed 9033515O'Keeffe S, Lavan J. The prognostic significance of delirium in older hospital patients. J Am Geriatr Soc. 1997 Feb;45(2):174-8. doi: 10.1111/j.1532-5415.1997.tb04503.x.
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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.
Jane Mohler, PhD principal investigator
University of Arizona
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Delirium, run by University of Arizona 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 6 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: withdrawn, as of the sponsor's last update on 22 Aug 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?
The study was withdrawn before enrolling participants, so there are no results.
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?
Objective Assessment of Delirium in Hospitalized Patients (time frame: 3 years). 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 NCT02258386, which also lists 10 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 22 Aug 2024.