Liverpool Heart and Chest Hospital NHS Foundation Trust
Liverpool, Merseyside, L14 3PE, United Kingdom
NCT Number: NCT07253883
The diagnosis of either asthma or chronic obstructive pulmonary disease (COPD) is currently based on a combination of symptoms, different lung tests and sometimes a 'trial by treatment'. Both COPD and Asthma tests currently include forced breathing using a test known as spirometry which can be difficult and uncomfortable for people to perform and needs expert interpretation. Asthma can require multiple tests in sequence which can make the process of diagnosis long and inconvenient for patients. In the UK, there have been challenges providing enough testing for COPD and asthma, in part because the tests are challenging to provide in the community to everyone who needs one.
The STARDUST study aims to test and develop new ways of diagnosing asthma and COPD that are quick, accurate and easy for patient and healthcare professionals to perform. People who have been referred for routine lung testing will breathe normally in and out into a handheld device called the N-Tidal Handset for 75 seconds. This device measures how the level of carbon dioxide (CO2) changes in the breath as people breath through it. The information gathered on the N-Tidal Handsets, called breath records or capnograms, will not be used to alter the diagnosis of any participants in the study.
After the capnograms have been collected, the research team will test 'algorithms' that have been developed using artificial intelligence, to see if they can accurately identify the correct diagnosis. Information collected in the study will also be used to make improvements in these algorithms.
If confirmed to be accurate, these algorithms could be used in clinical practice to help healthcare professionals make faster, more accessible and accurate diagnoses, especially in settings like GP clinics in the community where access to specialist tests may be limited.
Trial opening soon.
Get Notified18 year–110 year
All sexes
Observational
Liverpool, Merseyside, L14 3PE, United Kingdom
COPD is one of the leading causes of disability and in the top five causes of death worldwide. Early diagnosis and treatment are essential to slow the decline of lung function and improve quality of life.
The current standard for diagnosing COPD is spirometry; an effort-dependent test that requires supervised use, by a specifically trained medical professional, in a clinic-based environment. It is estimated that up to 2/3 of cases are undiagnosed suggesting that there is a significant care gap in the ability to accurately diagnose COPD.
Asthma is a chronic respiratory disease, characterised by airway inflammation and hyper-responsiveness. In 2019 affected an estimated 262 million people. Early diagnosis and treatment are important to reduce symptoms, exacerbations and mortality and to improve overall quality of life. The confirmation of reversible airflow obstruction using pre- and post-bronchodilator (BD) spirometry is needed to confirm a diagnosis in those suspected as having asthma without evidence of inflammation in the airways or blood.
Spirometry can be challenging for patients to perform, is time consuming and can be challenging to deliver at the scale required by the population.
TidalSense have been developing respiratory diagnostic devices that could offer simpler, safe, fast, reliable and precise tests to diagnose both COPD and asthma.
It is anticipated that successfully meeting the primary objectives of this study will result in data on the diagnostic accuracy of the COPD diagnostic models and could lead to the development and improvement of all diagnostic algorithms used in the study. This may contribute to a range of future clinical benefits:
These benefits could enable quicker testing, improve patient experience (relaxed breathing instead of forced breathing), and improve patient access to testing compared to current diagnostic pathways and reduce misdiagnosis.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Partial pressure of CO2 during tidal breathing for diagnosis of asthma or COPD
Fractional exhaled nitric oxide
Other names: Fractional exhaled nitric oxide
Spirometry with or without bronchodilation (if indicated)
Time frame: At time of testing
PPV, NPV, Sensitivity, Specificity compared to clinician diagnosis of COPD
Time frame: At time of testing
Prototype asthma diagnostic algorithms (index test; PPV, NPV, Sensitivity, Specificity) trained using a combined capnogram dataset from this and previous studies, compared to clinician diagnosis of asthma
Time frame: At time of diagnosis
Diagnostic accuracy (PPV, NPV, Sensitivity, Specificity) of the N-Tidal Diagnose 1 severity algorithm in those with a confirmed diagnosis of COPD. Diagnostic accuracy (PPV, NPV, Sensitivity, Specificity) of the diagnostic algorithms embedded in NTidal Diagnose 1 v1.0 in relevant subgroups. Diagnostic accuracy (PPV, NPV, Sensitivity, Specificity) of the pre-production asthma diagnostic algorithms trained using a combined capnogram dataset from this and previous studies in relevant prespecified subgroups. Exploratory analysis of novel machine learning diagnostic algorithms for COPD and asthma.
Time frame: At time of diagnosis
Visual Analogue Score (VAS) following N-Tidal, spirometry and FeNO (ease of use and comfort for participants, ease of use only for administering healthcare professionals) in a subset of participants. Percentage of participants with a clinical suspicion of COPD with adequate N-Tidal Handset breath record capture, sufficient to generate a diagnostic output using N-Tidal Diagnose 1 v1.0 diagnostic algorithms. Percentage of participants with a clinical suspicion of asthma with adequate N-Tidal Handset breath record capture, sufficient to generate a diagnostic output using prototype asthma diagnostic algorithms.
Contact information is provided by the study sponsor or research team.
Hassan Burhan, MBChB FRCP
CONTACT
Thomas FitzMaurice, MBChB BSc PGCME MRCP(UK) PhD
CONTACT
Liverpool Heart and Chest Hospital NHS Foundation Trust
Other
A Diagnostic Accuracy Study: N-Tidal Assessment for Respiratory Diagnosis Compared to Using Standard Testing
Acronym: STARDUST
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View the official ClinicalTrials.gov record (opens in a new tab)This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.
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