Screening

Researchers are addressing racial disparities in colorectal cancer CRC by focusing on African Americans aged 45 to 75, who face higher CRC incidence and mortality and lower screening rates. The study aims to improve CRC screening by partnering with the Department of Motor Vehicles DMV to recruit 1,200 African American participants during their DMV visits. The research compares two approaches to increase screening on-site distribution of Fecal Immunochemical Test FIT kits and on-site distribution combined with targeted social media advertising. Participants will receive a free FIT kit with a prepaid return envelope, a culturally tailored educational brochure, reminder text messages, and phone calls. The social media group will see targeted ads on Facebook, Instagram, and YouTube from August to October 2024. Participants return kits to a Nebraska Medicine lab, and results are mailed within 14 to 21 days. For those with positive results or lacking insurance or a primary care provider, a health navigator provides help with scheduling follow-up colonoscopies and accessing financial support. Throughout the study, participants provide demographic and screening information via surveys. Researchers measure FIT kit return rates, positive test rates, and follow-up colonoscopy completion rates, comparing the two groups while considering factors like age, gender, income, and health beliefs. Participants perceptions about screening are also gathered through an online survey. The study runs until October 2026, with ongoing monitoring of screening completion and follow-up outcomes.

Researchers are studying a new approach to reduce unnecessary screening mammograms in women aged 75 and older. This trial focuses on decreasing overuse of mammography, which may cause more harm than benefit in older women due to factors like shorter life expectancy and risks from follow-up procedures. The study aims to test a multilevel strategy involving patients, providers, and healthcare organizations to better align mammography use with current guidelines and patient needs. The study compares two groups one receiving enhanced usual care with organizational support such as provider education and consensus-building task forces, and another receiving this plus additional provider and patient interventions. Providers in the intervention group receive educational newsletters, and patients receive a brochure encouraging discussions with their providers about the appropriateness of continuing mammograms. Organizational components apply to all participants across selected clinics. Participants will be monitored for 18 months to assess screening mammography overuse, provider ordering behavior, and mammography screening discussions. Data will be collected through scheduled primary care visits and healthcare records. The study involves a cluster randomized controlled design at the provider level and includes diverse older women. Safety and study outcomes will be tracked throughout the trial period.

Gastrointestinal cancers cause significant health challenges worldwide due to the lack of effective and accessible early screening methods. Current diagnostic tools like endoscopy and imaging are invasive or not sensitive enough for early detection, leading to diagnoses at advanced stages with limited treatment options. Researchers aim to develop a noninvasive blood test using circulating microRNAs miRNAs that may help detect multiple types of gastrointestinal cancers early, improving possible outcomes. This study collects retrospective blood samples from participants with major gastrointestinal cancers, including hepatocellular carcinoma, cholangiocarcinoma, pancreatic ductal adenocarcinoma, esophageal squamous cell carcinoma, gastric cancer, and colorectal cancer, as well as from non-cancer controls. Small RNA sequencing will measure circulating miRNA levels. Using machine learning, investigators will identify a minimal panel of miRNAs that can distinguish cancer from non-cancer and differentiate among cancer types across diverse cohorts and geographic regions. Participants blood samples and clinical data will be analyzed to develop and validate this miRNA signature. The study evaluates the accuracy of the miRNA panel for cancer detection using measures like area under the receiver operating characteristic curve and sensitivity. This observational study uses existing samples and data and involves no active treatment. The research aims to create a scalable, cost-effective screening tool to support earlier diagnosis of gastrointestinal cancers.

Researchers are conducting a study to systematically screen newborns in the Normandy region for lysosomal storage diseases such as Mucopolysaccharidosis type I and Pompe disease. This observational study aims to evaluate the occurrence and epidemiology of these diseases using dried blood samples collected from newborns. The study is based on previous pilot work and seeks to include about 100,000 newborns over a period of three years. All newborns born in Normandy maternity hospitals who are participating in the national neonatal screening program will have additional blood samples collected on blotting paper for this study. The screening occurs within the first few days after birth, typically from day 2 to day 4. The study will continue until the target number of participants is reached. Participants will have blood samples collected as part of routine neonatal screening, with extra samples taken specifically for this research. The main outcome measured is the number of newborns screened relative to the number of samples collected. Secondary outcomes include the number of positive cases detected for Mucopolysaccharidosis type I and Pompe disease. The study involves parental consent and monitors newborns during these early days, with no further intervention or long-term follow-up described.

Researchers are evaluating whether an online mindfulness program can reduce and prevent mood and anxiety symptoms in adolescents who are at risk due to high levels of trait negative affect, a tendency to experience frequent and intense negative emotions. This randomized clinical trial compares the mindfulness program to a supportive comparison group and a no-intervention control group. The study focuses on reducing momentary negative emotions and internalizing problems in youth aged 12 to 17 years old. Participants are randomly assigned to one of three groups the Mindfulness Program, the Supportive Active Comparison, or a Control group. The Mindfulness Program involves nine weekly 30-minute online sessions with a coach teaching mindfulness skills like calm breathing and gratitude. The Supportive Active group also meets weekly online with a coach to discuss personal thoughts and feelings, using active listening and expressive writing. The Control group completes assessments only at the same time points as the other groups. Participants will be assessed before the intervention, after the 9-week program, and again at a six-month follow-up. Assessments include measures of momentary negative affect and internalizing symptoms using ecological momentary assessment and diagnostic evaluations. The study aims to understand how mindfulness training affects emotional regulation and the development of anxiety and depression symptoms in vulnerable youth over time.

Researchers are investigating whether people aged 50 to 80 who experience unexplained weight loss and undergo lung cancer screening are more likely to have or develop lung cancer than those without unexplained weight loss. The study focuses on using low-dose computed tomography LDCT scans, which produce detailed lung images with minimal radiation, to detect tumors. Additionally, researchers will analyze blood samples to explore the potential for blood tests to aid in diagnosing lung cancer. All participants will receive annual LDCT scans to monitor their lungs, with imaging performed at the start of the study and again after one year. At these same time points, blood samples will be collected for later analysis of circulating tumor DNA ctDNA. Participants will also complete a screening questionnaire at baseline and one year after enrollment to collect relevant health information. Throughout the study, participants will be monitored for lung cancer incidence over two years. Researchers will evaluate the occurrence of lung cancer in those with unexplained weight loss. The study involves regular imaging, blood draws, and questionnaires to gather data. Participants are expected to comply with study procedures and will be followed to assess outcomes and safety during the study period.

Researchers are conducting a randomized controlled trial to compare the outcomes of screening mammography exams interpreted with and without the help of an FDA-cleared artificial intelligence AI decision-support tool in real-world U.S. settings. The study aims to determine if using AI improves breast cancer detection and recall rates during screening. This trial includes all adult patients undergoing screening mammography and all interpreting radiologists across six regional health systems. During the trial, each 3D screening mammogram will be randomly assigned to either the intervention group, where radiologists receive assistance from the AI decision-support tool, or the usual care group, where radiologists interpret the images alone. Randomization happens at the exam level immediately after image acquisition, and patients returning for screening in the second year will be re-randomized. Radiologists will see AI information only when it is available during interpretation, but they maintain full control over their final diagnosis. Participants will undergo routine screening mammograms, with data collected on cancer detection rates within 90 days and recall rates over about one year. Additional measures include false-positive rates, interval cancer rates, and trust in AI over several years. The study plans to assess these outcomes across approximately 400,000 screening exams, with monitoring done through the participating health systems. Radiologists and patients will contribute perspectives on AI use in medical imaging during the trial period.

This research aims to evaluate a multi-component care strategy called DADA LINK to improve cervical cancer screening and treatment connection among women aged 25 to 49 years in Kenya. The highest rates of cervical cancer occur in sub-Saharan Africa, with it being the leading cause of cancer death among Kenyan women. This study focuses on overcoming barriers at the patient, provider, and facility levels by using tailored strategies based on earlier research and clinic assessments in Nairobi County. The trial compares clinics using the DADA LINK integrated care package, which includes HPV self-sampling kits, care navigation by trained non-physician staff, and use of a mobile health platform called WEMA, against clinics continuing usual care practices. Care coordinators at intervention clinics motivate staff to follow cervical cancer care guidelines, collect patient exit survey data, and manage screening and treatment tracking through the WEMA app. The study lasts 12 months, with an additional 6-month follow-up to assess costs and maintenance of the care strategies. Participants cervical cancer screening and treatment data will be collected from clinic records by study staff. Researchers will measure how many women complete screening during clinic visits and how many receive follow-up triage or treatment within 12 months. The WEMA system also supports communication with patients via text messages to improve attendance. This comprehensive monitoring aims to assess both the implementation and effectiveness of the care package over the study period.

This research aims to develop a universal method for adapting speech audiometry tests into different languages, focusing on children. Speech audiometry is commonly used to assess hearing in children, but many languages lack suitable test materials. This study introduces the first comprehensive protocol that systematically addresses linguistic, phonological, and audiological factors to adapt and standardize the Mainzer Audiometric Test for Children MATCH for other languages. The adaptation process includes six phases selecting and validating test items for recognizability among children, ensuring linguistic accuracy by comparing phoneme distributions, recording speech materials in a sound-treated environment following ISO standards, equalizing item intelligibility through adult speech recognition tests, standardizing the test on normal-hearing children aged 3 to 6 years, and evaluating diagnostic validity by comparing speech recognition thresholds with pure-tone audiometry in clinical samples. The study also uses ROC analysis to determine sensitivity, specificity, and optimal cutoffs for detecting hearing loss. Participants include children aged 2 to 7 years with either normal hearing or stable sensorineural hearing loss, divided into age groups for testing. The study involves assessments such as speech recognition testing, pure-tone audiometry, and tympanometry. Researchers monitor test-retest reliability and diagnostic performance over about one year. The primary outcome is the correlation between adapted MATCH speech recognition thresholds and pure-tone audiometry thresholds. Secondary outcomes include diagnostic accuracy and test consistency.

Postoperative nausea and vomiting PONV are common and distressing complications following surgery, especially in patients at high risk. They can affect up to 80% of these patients without preventive treatment and often continue after patients return home, impacting recovery and satisfaction. This research aims to evaluate whether adding a 40 mg dose of aprepitant to a standard multimodal prevention strategy improves outcomes in high-risk patients undergoing outpatient surgery. Participants will receive either a single oral capsule of 40 mg aprepitant or a placebo just before being taken to the operating room. Both groups will also receive the usual antiemetic preventive care. This randomized, triple-blind study compares the effects of aprepitant plus standard treatment versus placebo plus standard treatment in preventing PONV after outpatient surgery. During the study, researchers will monitor the absence of nausea, vomiting, or the need for rescue treatment within 48 hours after surgery as the primary outcome. Additional assessments include the severity and frequency of nausea and vomiting at recovery room discharge, 24 hours, and 48 hours post-surgery. The study will also track medical costs, recovery quality, side effects, patient satisfaction, and pain medication use. Participants involvement will last through these monitoring periods to capture relevant data on PONV outcomes and safety.