Clinical Trial: Comparison of Adenoma Detection Rate Among Water, Carbon Dioxide and Air Methods of Minimal Sedation Colonoscopy

Study Status: Terminated
Recruit Status: Terminated
Study Type: Interventional

Official Title: Water Infusion and Carbon Dioxide Insufflation Versus Air Insufflation Versus Air Insufflation Techniques in Screening Colonoscopies in the United States: A Comparative Study Evaluating Safety, Effica

Brief Summary:

The purpose of this study is to determine which of the methods of colonoscopy viz. water insufflation or air insufflation or carbon dioxide insufflation is better in detecting the adenomas in colon and also which of these methods is best tolerated by patients.

Hypothesis: the investigators hypothesize that in patients undergoing first time screening colonoscopy a higher Adenoma Detection Rate will be found in the proximal colon in the group randomized to the water method compared to those randomized to the air or CO2 insufflation methods


Detailed Summary:

Significance:

ADR is an independent predictor of risk of post screening colonoscopy colon cancer. A simple method solely controlled by the colonoscopist that enhances proximal ADR holds the promise of rectifying some of the unresolved shortcomings of screening colonoscopy in failing to reduce the occurrence of post screening incident cancers in the proximal colon and the associated cancer mortality.

Hypotheses & Specific Aims:

Primary Hypothesis:

In patients undergoing first time screening a higher ADR will be found in the proximal colon in those randomized to the water method compared to those randomized to the air method or CO2 method.

Secondary Hypotheses:

The examination method but not co-variables, procedure-related or patient-centered outcomes, is an independent predictor of proximal colon ADR.

Specific Aims:

This is a prospective, randomized, single-blinded controlled study to compare the study (water) and control 1 (air) method and control 2 (CO2 method) to aid insertion of the colonoscope. The proximal colon ADR, total ADR, co-variables, procedure-related and patient-centered outcomes and adverse event during and within 30 days of colonoscopy will be recorded and compared between the study and control methods.


Sponsor: Loma Linda University

Current Primary Outcome: Adenoma Detection Rate, proximal colon and total [ Time Frame: Day 1, At time of colonoscopy ]

The number of adenomas detected in proximal colon and total number of adenomas detected during the procedure will be compared between the three methods


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Pain scores [ Time Frame: during and immediately after colonoscopy on day 1 ]
    Visual Analog Scales will be used to calculate the pain scores based on the discomfort/pain experienced by the patient
  • Sedation requirements [ Time Frame: Collected at Day 1, during the procedure ]
    The amount of sedation required to complete the patient's colonoscopy.


Original Secondary Outcome: Pain scores [ Time Frame: during and immediately after colonoscopy on day 1 ]

Visual Analog Scales will be used to calculate the pain scores based on the discomfort/pain experienced by the patient


Information By: Loma Linda University

Dates:
Date Received: January 27, 2013
Date Started: February 2013
Date Completion:
Last Updated: January 28, 2016
Last Verified: September 2014