CClinicalTrials.gg
CompletedNCT04631237Updated Apr 27, 2026Results posted

Developing a Down Syndrome Health Instrument

An observational study in Down Syndrome and Health, Subjective, sponsored by Massachusetts General Hospital. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-27.

Sponsored by Massachusetts General Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
758
Ages
18 Years and older
Sex
All
01

Study summary

Although over 200,000 individuals with DS live in the United States, studies to date have focused on outcomes apart from health. The foundation for this proposal is based on the need to accurately measure health of all individuals - specifically, with DS - and the dearth of available tools for this population. Creating such an instrument will provide a barometer of the current state of health for DS and hold use in future research. In this project, I propose to create an instrument that directly assesses health in DS - the Down syndrome Health Instrument (DHI). More specifically, the aims of this proposal are: 1. To conduct focus groups among caregivers, individuals with DS, panels of experts on DS and primary care physicians, and cognitive interviews to refine a conceptual model of health for DS and create an item pool, 2. To administer the DHI and establish internal validity, reliability, and external validity of the DHI for use in clinical research, and 3. To test the usability of the DHI in two pilot settings: research and clinical. This instrument will measure patient-reported health in DS for the first time and allow measurement of health as an outcome which is not currently possible in this population. This can identify gaps in care, then direct and optimize interventions that will improve care.

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Conditions studied

  • Down Syndrome
  • Health, Subjective

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Keywords

  • health status
03

In context

Down Syndrome

432 studies on the registry are indexed under Down Syndrome; 100 are open to participants now.

This study's enrollment of 758 is above the median of 150 across 141 observational studies indexed under Down Syndrome.

Browse Down Syndrome studies →

Lead sponsor

Massachusetts General Hospital is the lead sponsor of 2,536 studies on the registry; 446 are open to participants now.

Of its 214 completed or terminated interventional studies of FDA-regulated products, 161 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Primary caregivers and individuals with DS

Inclusion criteria

  • Primary caregiver of an individual with DS (individual with DS age: \<22 years)
  • Caregiver age: ≥18 years
  • Fluent in written and spoken English
  • Able to read and provide informed consent

Exclusion criteria

Exclusion Criteria:

  • Physical or mental condition of caregiver that would prohibit self-administration of questionnaire
  • Mosaic Down syndrome: based on medical record review. If caregiver is uncertain or mosaicism is unknown, we will request additional records.
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
758 participants (actual)
Patient registry
No

Groups and cohorts

  • Focus Groups

    N=52

    Other: Observational, no intervention

  • Cognitive Interviews

    N=24

    Other: Observational, no intervention

  • Survey

    N=542

    Other: Observational, no intervention

Interventions

  • OtherObservational, no intervention

    No intervention involved

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What researchers measure

Primary outcomes

  1. Number of Completed Surveys for Validation Analysis

    Local and national survey results, cognitive interviews and validation of Down syndrome health measure (DSHM) using psychometric analysis and factor analysis

    Time frame: At the time of survey completion

Secondary outcomes

  1. Number of Focus Group Participants Who Participated to Make the Conceptual Model

    Descriptive focus group results regarding health views. Outline of the preliminary conceptual model

    Time frame: At the time of focus group completion

  2. Number of Completed Cognitive Interviews

    Time frame: At the time of cognitive interview

07

Results

Posted Apr 27, 2026

Participant flow

Participant flow — Overall Study
MilestoneFocus GroupsCognitive InterviewsSurvey
Started2842688
Completed2842542
Not completed00146

Outcome measures

PrimaryNumber of Completed Surveys for Validation Analysis

Local and national survey results, cognitive interviews and validation of Down syndrome health measure (DSHM) using psychometric analysis and factor analysis

Time frame:
At the time of survey completion
Reported as:
Count of participants · Participants
Number of Completed Surveys for Validation Analysis
ParticipantsFocus GroupsCognitive InterviewsSurvey
Number of Completed Surveys for Validation Analysis00542
SecondaryNumber of Focus Group Participants Who Participated to Make the Conceptual Model

Descriptive focus group results regarding health views. Outline of the preliminary conceptual model

Time frame:
At the time of focus group completion
Reported as:
Count of participants · Participants
Number of Focus Group Participants Who Participated to Make the Conceptual Model
ParticipantsFocus GroupsCognitive InterviewsSurvey
Number of Focus Group Participants Who Participated to Make the Conceptual Model2800
SecondaryNumber of Completed Cognitive Interviews
Time frame:
At the time of cognitive interview
Reported as:
Count of participants · Participants
Number of Completed Cognitive Interviews
ParticipantsFocus GroupsCognitive InterviewsSurvey
Number of Completed Cognitive Interviews0420

Adverse events

Collected over 1 year. Non-serious events are listed at a 1% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Focus Groups0/28 (0%)0/28 (0%)0/28 (0%)
Cognitive Interviews0/42 (0%)0/42 (0%)0/42 (0%)
Survey0/542 (0%)0/542 (0%)0/542 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Focus GroupsCognitive InterviewsSurveyTotal
<=18 years4004
Between 18 and 65 years2442688754
>=65 years0000
Sex: Female, Male
Sex: Female, Male(Participants)Focus GroupsCognitive InterviewsSurveyTotal
Female2336462521
Male565667
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Focus GroupsCognitive InterviewsSurveyTotal
Hispanic or Latino062733
Not Hispanic or Latino036510546
Unknown or Not Reported280151179
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Focus GroupsCognitive InterviewsSurveyTotal
American Indian or Alaska Native1113
Asian101314
Native Hawaiian or Other Pacific Islander0044
Black or African American141823
White2536485546
More than one race011011
Unknown or Not Reported00157157
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Study locations

1 site
  • Massachusetts General Hospital
    Boston, Massachusetts 02114, United States
09

References and documents

Publications

  • Santoro SL, Peters MLB. K Awards: The Journey of a Thousand Steps. Ann Intern Med. 2021 Dec;174(12):1735-1737. doi: 10.7326/M21-2692. Epub 2021 Nov 16. No abstract available. PubMed 34781710 ↗
  • Santoro SL, Donelan K, Constantine M. Proxy-report in individuals with intellectual disability: A scoping review. J Appl Res Intellect Disabil. 2022 Sep;35(5):1088-1108. doi: 10.1111/jar.13013. Epub 2022 Jun 8. PubMed 35676858 ↗
  • Santoro SL, Cabrera MJ, Haugen K, Krell K, Merker VL. Indicators of health in Down syndrome: A virtual focus group study with patients and their parents. J Appl Res Intellect Disabil. 2023 Mar;36(2):354-365. doi: 10.1111/jar.13065. Epub 2023 Jan 9. PubMed 36624557 ↗
  • Santoro SL, Cabrera MJ, Co JPT, Constantine M, Haugen K, Krell K, Skotko BG, Winickoff JP, Donelan K. Health in Down syndrome: creating a conceptual model. J Intellect Disabil Res. 2023 Apr;67(4):323-351. doi: 10.1111/jir.13007. Epub 2023 Jan 17. PubMed 36650105 ↗
  • Santoro SL, Haugen K, Donelan K, Skotko BG. Global health measures from a National Down Syndrome Registry. Am J Med Genet A. 2023 Aug;191(8):2092-2099. doi: 10.1002/ajmg.a.63243. Epub 2023 May 14. PubMed 37183579 ↗
  • Shaffer M, Co JPT, Donelan K, Skotko BG, Torres A, Winickoff JP, Santoro SL. Successful (and Unsuccessful) Recruitment Approaches and Participant Loss in a Down Syndrome Survey. Am J Intellect Dev Disabil. 2025 Mar 1;130(2):131-145. doi: 10.1352/1944-7558-130.2.131. PubMed 39999870 ↗
  • Witt M, Shaffer M, Torres A, Santoro SL. Research Letter: Recruiting a Diverse Cohort in Genetics Research-Reflecting on Demographic Representation in a Down Syndrome Survey. Am J Med Genet A. 2025 Oct;197(10):e64111. doi: 10.1002/ajmg.a.64111. Epub 2025 May 20. No abstract available. PubMed 40391503 ↗
  • Witt M, Palumbo M, Santoro SL. Bothersome and Impactful Health Conditions in Children and Adolescents with Down Syndrome. J Pediatr. 2025 Dec;287:114748. doi: 10.1016/j.jpeds.2025.114748. Epub 2025 Jul 23. PubMed 40712746 ↗
  • Witt M, Krell K, Santoro SL. Caregiver Interviews Regarding Health in Down Syndrome. Am J Med Genet A. 2026 Feb;200(2):300-307. doi: 10.1002/ajmg.a.64253. Epub 2025 Sep 12. PubMed 40937636 ↗
  • Santoro SL, Nichols D, Witt M, Oreskovic NM. Daily Activities, Exercise and Endurance in Down Syndrome. Am J Med Genet A. 2026 Mar;200(3):592-605. doi: 10.1002/ajmg.a.64283. Epub 2025 Oct 16. PubMed 41098034 ↗
  • Witt ME, Zeng C, Santoro SL. The Prevalence of Co-Occurring Conditions and an Exploration of Social Factors Influencing Health in Down Syndrome. Am J Med Genet A. 2026 Jun 8. doi: 10.1002/ajmg.a.70219. Online ahead of print. PubMed 42260322 ↗
  • Krell K, Witt M, Santoro SL. Caregivers' Perspectives on Medical Management and Its Helpfulness in Down Syndrome. Am J Med Genet A. 2026 Apr;200(4):835-845. doi: 10.1002/ajmga.70006. Epub 2025 Nov 27. PubMed 41306073 ↗
  • Santoro SL, Campbell A, Cabrera M, Co JPT, Donelan K, Haugen K, Krell K, Shaffer M, Skotko BG, Winickoff JP, Witt M, Constantine M. Development and Validation of a Health Measure for Down Syndrome. J Pediatr. 2026 Feb;289:114888. doi: 10.1016/j.jpeds.2025.114888. Epub 2025 Nov 4. PubMed 41192789 ↗

Study documents

  • Study protocol · Jan 4, 2024
  • Statistical analysis plan · Dec 16, 2024
  • Informed consent form · Jan 17, 2024
  • Informed consent form · Nov 1, 2024

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

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04631237
Lead sponsor
Massachusetts General Hospital
Collaborators
National Institutes of Health (NIH)
Responsible party
Stephanie Santoro (Assistant Professor of Pediatrics, Clinical Geneticist, Massachusetts General Hospital) — Principal investigator
First posted
Nov 17, 2020
Start date
Apr 3, 2020
Primary completion
Mar 31, 2025
Completion
Mar 31, 2025
Results posted
Apr 27, 2026
Last update
Apr 27, 2026

Study contacts

STEPHANIE L SANTORO, MD
principal investigator · MGH

Oversight

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

Not currently enrolling

This study is completed, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.

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