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TerminatedNCT03809117Updated Dec 20, 2022Results posted

Film Array Gastrointestinal Panel Compared to Usual Care for ED Evaluation of Infectious Diarrhea

An interventional study of Biofire Film Array Gastrointestinal Panel in Infectious Diarrhea, sponsored by Andrew Meltzer. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-12-20.

Sponsored by Andrew Meltzer · Not applicable, Interventional, and Treatment

Why this study was terminated
Study was halted due to obstacles faced in executing clinical procedures as a result of the COVID-19 pandemic.
Phase
Not applicable
Study type
Interventional
Enrollment
74
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This research study will test a laboratory test called Film-Array Gastrointestinal (GI) Panel. This GI Panel is a test that can identify the bacteria or viruses that may cause diarrhea. This test will enable the ED doctor to better understand the cause of diarrhea to try to determine the best treatment.

The primary objective of this study is to determine if testing ED patients who complain of diarrhea will lead to more optimal use of antibiotics. Optimal use of antibiotics is defined as the most appropriate antibiotic to treat a specified pathogen.

02

Conditions studied

03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Presumed infectious diarrhea (3 or more loose stools in past 24 hours)
  • Must have one of the 3 following features or symptoms lasting more than 7 days.

    1. Symptoms greater than 24 hours;
    2. Dehydration (defined as the need for intravenous fluid or per clinician's judgement ((based on the general appearance and alertness of the patient, the pulse, the blood pressure, the presence or absence of postural hypotension, the mucous membranes and tears, sunken eyes, skin turgor, capillary refill, and jugular venous pressure.))
    3. Inflammation (defined as fever (greater than 100.1), blood in stool per patient, DRE, or tenesmus.)

Exclusion criteria

Exclusion Criteria:

  • Chronic Symptoms (>14 days)
  • Inability to Follow- Up (i.e. no telephone)
  • Prisoner
  • Likely non-infectious cause of diarrhea (Crohn's disease, radiation colitis, irritable bowel syndrome, or celiac disease)
  • Confirmed C. Diff Diarrhea
  • Unable to provide written consent
  • Non- English speaker
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
74 participants (actual)

Study arms

  • Experimental
    Experimental

    Gastrointestinal Polymerase Chain Reaction test performed and results communicated to treatment provider. Followed by usual care per treating physician.

    Diagnostic Test: Biofire Film Array Gastrointestinal Panel

  • Active comparator
    Control

    Gastrointestinal Polymerase Chain Reaction test performed at the conclusion of the study. Clinician will not be informed of results. Usual Care performed per treating physician.

    Diagnostic Test: Biofire Film Array Gastrointestinal Panel

Interventions

  • Diagnostic testBiofire Film Array Gastrointestinal Panel

    The 22-target FilmArray® GI Panel allows a syndromic approach to the diagnosis of infectious diarrhea as it includes bacteria, viruses and parasites in one test. Results are typically available within two hours of collection.

05

What researchers measure

Primary outcomes

  1. Number of Participants With Optimal Antibiotic Chosen

    Optimal use of antibiotics is defined as the most appropriate antibiotic to treat a specified pathogen. Designated physicians on study staff will retrospectively examine charts of enrolled subjects will evaluate whether the antibiotic chosen by treating clinician was appropriate given GI PCR results.

    Time frame: 30 Days post ED Discharge

Secondary outcomes

  1. ED Length of Stay

    Time from patient arrival to time when patient is officially discharged or admitted

    Time frame: 30 Days post ED Discharge

  2. Hospital Admission Rate

    Time frame: 30 Days post ED Discharge

  3. Rate of Abdominal/Pelvic CT Scans

    Time frame: 30 Days post ED Discharge

06

Results

Posted Dec 20, 2022
Limitations and caveats
Early termination leading to small numbers of subjects analyzed

Participant flow

Participant flow — Overall Study
MilestoneExperimentalControl
Started3836
Completed3836
Not completed00

Outcome measures

PrimaryNumber of Participants With Optimal Antibiotic Chosen

Optimal use of antibiotics is defined as the most appropriate antibiotic to treat a specified pathogen. Designated physicians on study staff will retrospectively examine charts of enrolled subjects will evaluate whether the antibiotic chosen by treating clinician was appropriate given GI PCR results.

Time frame:
30 Days post ED Discharge
Reported as:
Count of participants · Participants
Number of Participants With Optimal Antibiotic Chosen
ParticipantsExperimentalControl
Number of Participants With Optimal Antibiotic Chosen138
SecondaryED Length of Stay

Time from patient arrival to time when patient is officially discharged or admitted

Time frame:
30 Days post ED Discharge
Reported as:
Median · hours
ED Length of Stay
hoursExperimentalControl
ED Length of Stay7.68 (6.43 to 10.67)8.15 (5.90 to 11.23)
SecondaryHospital Admission Rate
Time frame:
30 Days post ED Discharge
Reported as:
Count of participants · Participants
Hospital Admission Rate
ParticipantsExperimentalControl
Hospital Admission Rate73
SecondaryRate of Abdominal/Pelvic CT Scans
Time frame:
30 Days post ED Discharge
Reported as:
Count of participants · Participants
Rate of Abdominal/Pelvic CT Scans
ParticipantsExperimentalControl
Rate of Abdominal/Pelvic CT Scans88

Adverse events

Collected over Day 7 and Day 30. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Experimental0/38 (0%)0/38 (0%)0/38 (0%)
Control0/36 (0%)0/36 (0%)0/36 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)ExperimentalControlTotal
Median34 (26 to 51.25)33 (25.75 to 52.25)34 (26 to 52.75)
Sex: Female, Male
Sex: Female, Male(Participants)ExperimentalControlTotal
Female231942
Male151732
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)ExperimentalControlTotal
Race — Black212142
Race — White10919
Race — Asian, Native American, Other, Unknown7613
07

Study locations

1 site
  • The George Washington University, Department of Emergency Medicine
    Washington, District of Columbia 20037, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Sep 9, 2020
  • Informed consent form · Mar 9, 2020

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03809117
Lead sponsor
Andrew Meltzer
Collaborators
BioFire Diagnostics, LLC
Responsible party
Andrew Meltzer (Associate Professor of Emergency Medicine, George Washington University) — Sponsor-investigator
First posted
Jan 18, 2019
Start date
Nov 19, 2018
Primary completion
Mar 15, 2020
Completion
Sep 7, 2020
Results posted
Dec 20, 2022
Last update
Dec 20, 2022

Study contacts

Andrew Meltzer, MD, MS
principal investigator · The George Washington University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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