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Trial Review
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Trial registered on ANZCTR
Registration number
ACTRN12625000541404
Ethics application status
Approved
Date submitted
8/05/2025
Date registered
28/05/2025
Date last updated
28/05/2025
Date data sharing statement initially provided
28/05/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Developing a Novel Algorithm to Exclude Deep Vein Thrombosis in the Emergency Department
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Scientific title
Developing a Novel Algorithm to Exclude Deep Vein Thrombosis in the Emergency Department
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Secondary ID [1]
314232
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
DNA-DVT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
deep vein thrombosis
337138
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Condition category
Condition code
Cardiovascular
333894
333894
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Blood
333561
333561
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0
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Clotting disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
A retrospective cohort study (up to 4 years of Emergency Department (ED) presentations) reviewing historical risk factors, examination findings and d dimer levels and the ability to combine these into a simple score to accurately exclude the diagnosis of deep vein thrombosis (DVT)
Data will be reviewed from electronic medical records for patients presenting to the Emergency Departments at Royal North Shore Hospital and Hornsby Kuringgai Hospital between 1 January 2021 and 31 December 2024. Records will be assessed during a single presentation and it will be noted if the patient has re-presented within the following 14 days. A review of medical records for history and examination findings as well as investigation results of D dimer blood results and Vascular US imaging reports will be collected.
The novel algorithm will be developed using statistical analysis (both regression analysis and bootstrapping) to determine a combination of risk factors that are sufficiently sensitive to exclude DVT.
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Intervention code [1]
330843
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Early Detection / Screening
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Comparator / control treatment
No control group.
Will compare the algorithm with previous reported diagnostic tools including Well's Criteria for DVT, the Primary Care Rule, the DAYS Algorithm (by Xu et al. (2021); not an acronym) and Halestensen et al. (2024) Rule
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Control group
Active
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Outcomes
Primary outcome [1]
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Incidence of DVT diagnosis
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Assessment method [1]
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Diagnosis of DVT will be determined on review of ultrasound reports
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Timepoint [1]
341139
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Baseline
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Secondary outcome [1]
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Frequency of DVT risk factors in pregnant patients
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Assessment method [1]
446479
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Review of medical history, d dimer and ultrasound reports from electronic hospital records
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Timepoint [1]
446479
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Baseline
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Secondary outcome [2]
447885
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Frequency of unnecessary investigations
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Assessment method [2]
447885
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Frequency of ultrasounds performed in patients with no DVT risk factors or negative D dimer
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Timepoint [2]
447885
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baseline
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Secondary outcome [3]
447886
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Sensitivity and specificity of novel algorithm compared to previous algorithms and will be assessed together as a composite secondary outcome
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Assessment method [3]
447886
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To be compared to Well's Criteria for DVT, Primary Care Rule, DAY Algorithm and Halstensen et al. (2024) Rule
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Timepoint [3]
447886
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baseline
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Eligibility
Key inclusion criteria
Adult patients
Presented to Royal North Shore Hospital or Hornsby Kuringgai Hospital Emergency Department with a suspected DVT
Underwent both D dimer and Vascular ultrasound within 36 hours
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients who have not undergone both D dimer and lower limb ultrasound testing
Patients presenting with another primary concern, for example chest pain or dyspnoea
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Retrospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
2/06/2025
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
1000
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Hornsby Ku-ring-gai Hospital - Hornsby
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Recruitment hospital [2]
27893
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Royal North Shore Hospital - St Leonards
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Recruitment postcode(s) [1]
44089
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2065 - St Leonards
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Recruitment postcode(s) [2]
44090
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2077 - Hornsby
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Funding & Sponsors
Funding source category [1]
318751
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Hospital
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Name [1]
318751
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Royal North Shore Hospital
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Address [1]
318751
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Country [1]
318751
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Australia
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Primary sponsor type
Government body
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Name
Northern Sydney Local Health District
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Address
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Country
Australia
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Secondary sponsor category [1]
321191
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None
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Name [1]
321191
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Address [1]
321191
0
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Country [1]
321191
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
317363
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Northern Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [1]
317363
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https://www.nslhd.health.nsw.gov.au/Research/ResearchOffice/Pages/HREC.aspx
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Ethics committee country [1]
317363
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Australia
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Date submitted for ethics approval [1]
317363
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17/04/2025
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Approval date [1]
317363
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19/05/2025
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Ethics approval number [1]
317363
0
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Summary
Brief summary
Vascular ultrasounds are a limited resource and not always available in Emergency Departments. Similarly, current clinical decision rules are either too subjective or burdensome to result in high compliance in the Emergency Department. This study aims to derive a simple clinical decision rule to safely exclude the diagnosis of DVT and reduce the amount of vascular ultrasounds performed in the ED.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Benjamin Needham
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Address
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Royal North Shore Hospital, Reserve Road, St Leonards NSW 2065
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Country
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Australia
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Phone
140810
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+61 294632256
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Fax
140810
0
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Email
140810
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[email protected]
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Contact person for public queries
Name
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Mark Gillett
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Address
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Royal North Shore Hospital, Reserve Road, St Leonards NSW 2065
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Country
140811
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Australia
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Phone
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+61 294632228
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Fax
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Email
140811
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[email protected]
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Contact person for scientific queries
Name
140812
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Mark Gillett
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Address
140812
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Royal North Shore Hospital, Reserve Road, St Leonards NSW 2065
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Country
140812
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Australia
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Phone
140812
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+61 294632228
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Fax
140812
0
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Email
140812
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
Yes
Will there be any conditions when requesting access to individual participant data?
Persons/groups eligible to request access:
•
Researchers
Conditions for requesting access:
•
Yes, conditions apply:
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Requires review on a case-by-case basis by the trial custodian, sponsor or data sharing committee
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Requires a scientifically sound proposal or protocol
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Requires approval by an ethics committee
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Requires a data sharing agreement between data requester and trial custodian or sponsor
What individual participant data might be shared?
•
All de-identified individual participant data
What types of analyses could be done with individual participant data?
•
Studies testing whether findings can be repeated or confirmed
When can requests for individual participant data be made (start and end dates)?
From:
After publication of main results
To:
Not yet decided
Where can requests to access individual participant data be made, or data be obtained directly?
•
Email of trial custodian, sponsor or committee:
[email protected]
Are there extra considerations when requesting access to individual participant data?
Yes:
will need discussion with data custodian and local ethics committee
What supporting documents are/will be available?
No Supporting Document Provided
Type
Citation
Link
Email
Other Details
Attachment
Study protocol
UTF-8Study Protocol v1.4.docx
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF