Finspang

Researchers are evaluating an artificial intelligence AI decision support system called Dermalyser to help primary care physicians distinguish between skin cancer and benign skin lesions. This multicenter randomized controlled trial is conducted at about 30 primary care centers across Sweden, Germany, Scotland, the Netherlands, and Australia. The study aims to assess the accuracy, reliability, and clinical usefulness of Dermalyser in real clinical settings where most patients with skin lesions are managed. Participants will be assessed at primary care centers randomized to either use Dermalyser as a complementary diagnostic tool or follow the standard clinical procedure without AI support. After reaching half of the planned enrollment, centers switch from one phase to the other. Physicians can choose to use Dermalyser when they find it indicated, but the final clinical decision about lesion management remains with the physician. Both groups will be followed for up to five years to track tumor diagnoses, proportions of skin cancer versus benign lesions, and related health outcomes. During the study, participants will have their skin lesions evaluated according to either the AI-supported or standard procedure. The primary outcome measure is the proportion of skin cancers detected within six months of enrollment. Researchers will monitor morbidity and mortality related to skin cancer and compare differences between the groups. Participation may last up to five years with follow-up to assess diagnostic outcomes and safety. The study is sponsored by Linkping University.

Researchers are evaluating the effect of spironolactone combined with standard care compared to standard care alone in patients with Heart Failure with Preserved Ejection Fraction HFPEF. This condition is common and serious, but currently lacks effective treatment. The trial is a phase 3 Registry-Randomized Clinical Trial RRCT involving patients from the Swedish Heart Failure Registry and the US. HFPEF is defined by heart failure symptoms, elevated NT-proBNP levels, and an ejection fraction of 40% or higher. Participants will be randomly assigned to receive either spironolactone added to their usual care or usual care alone. Spironolactone will be given as 25 mg tablets, starting at 25 mg per day with a possible increase to 50 mg daily if tolerated. If spironolactone is not tolerated, eplerenone may be prescribed instead. The control group will continue with their standard care without spironolactone. The study duration is planned for 9 years, with enrollment lasting 7 years. During the study, researchers will collect data on cardiovascular death and hospitalizations due to heart failure as the primary outcomes. Secondary outcomes include hospitalizations for various causes, adverse events, and treatment adherence. In Sweden, outcomes will be obtained by linking national registries, while in the US, sites and call centers will report outcomes. The trial aims to enroll approximately 2000 patients, with follow-up continuing for at least 5 years after study start to monitor these outcomes.