Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Trials
Published in: Trials 1/2014

Open Access 01-12-2014 | Study protocol

Population screening for colorectal cancer by flexible sigmoidoscopy or CT colonography: study protocol for a multicenter randomized trial

Authors: Daniele Regge, Gabriella Iussich, Carlo Senore, Loredana Correale, Cesare Hassan, Alberto Bert, Stefania Montemezzi, Nereo Segnan

Published in: Trials | Issue 1/2014

Login to get access

Abstract

Background

Colorectal cancer (CRC) is the second most prevalent type of cancer in Europe. A single flexible sigmoidoscopy (FS) screening at around the age of 60 years prevents about one-third of CRC cases. However, FS screens only the distal colon, and thus mortality from proximal CRC is unaffected. Computed tomography colonography (CTC) is a highly accurate examination that allows assessment of the entire colon. However, the benefit of CTC testing as a CRC screening test is uncertain. We designed a randomized trial to compare participation rate, detection rates, and costs between CTC (with computer-aided detection) and FS as primary tests for population-based screening.

Methods/Design

An invitation letter to participate in a randomized screening trial comparing CTC versus FS will be mailed to a sample of 20,000 people aged 58 or 60 years, living in the Piedmont region and the Verona district of Italy. Individuals with a history of CRC, adenomas, inflammatory bowel disease, or recent colonoscopy, or with two first-degree relatives with CRC will be excluded from the study by their general practitioners. Individuals responding positively to the invitation letter will be then randomized to the intervention group (CTC) or control group (FS), and scheduled for the screening procedure. The primary outcome parameter of this part of the trial is the difference in advanced neoplasia detection between the two screening tests. Secondary outcomes are cost-effectiveness analysis, referral rates for colonoscopy induced by CTC versus FS, and the expected and perceived burden of the procedures. To compare participation rates for CTC versus FS, 2,000 additional eligible subjects will be randomly assigned to receive an invitation for screening with CTC or FS. In the CTC arm, non-responders will be offered fecal occult blood test (FOBT) as alternative screening test, while in the FS arm, non-responders will receive an invitation letter to undergo screening with either FOBT or CTC. Data on reasons for participation and non-participation will also be collected.

Discussion

This study will provide reliable information concerning benefits and risks of the adoption of CTC as a mass screening intervention in comparison with FS. The trial will also evaluate the role of computer-aided detection in a screening setting.

Trial registration

ClinicalTrials.gov Identifier: NCT01739608
Appendix
Available only for authorised users
Literature
1.
Ferlay J, Parkin D, Steliarova-Foucher E: Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer. 2010, 46: 765-781. 10.1016/j.ejca.2009.12.014.CrossRefPubMed
2.
Crocetti E, Buzzoni C, AIRTUM Working Group: New incidence and mortality data, 2003-2005. Epidemiol Prev. 2009, 33 (Suppl 1-2): e1-3-e5-26
3.
Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF, Ackroyd F, Shike M, Kurtz RC, Hornsby-Lewis L, Gerdes H, Stewart ET: Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993, 329: 1977-1981. 10.1056/NEJM199312303292701.CrossRefPubMed
4.
Hardcastle JD, Chamberlain JO, Robinson MH, Moss SM, Amar SS, Balfour TW, James PD, Mangham CM: Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet. 1996, 348: 1472-1477. 10.1016/S0140-6736(96)03386-7.CrossRefPubMed
5.
Kronborg O, Fenger C, Olsen J, Jørgensen OD, Søndergaard O: Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet. 1996, 348: 1467-1471. 10.1016/S0140-6736(96)03430-7.CrossRefPubMed
6.
Selby JV, Friedman GD, Quesenberry CP, Weiss NS: A case control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med. 1992, 326: 653-657. 10.1056/NEJM199203053261001.CrossRefPubMed
7.
Newcomb PA, Norfleet RG, Storer BE, Surawicz TS, Marcus PM: Screening sigmoidoscopy and colorectal cancer mortality. J Natl Cancer Inst. 1992, 84: 1572-1575. 10.1093/jnci/84.20.1572.CrossRefPubMed
8.
Mandel JS, Bond JH, Church TR, Snover DC, Bradley GM, Schuman LM, Ederer F: Reducing Mortality from Colorectal Cancer by Screening for Fecal Occult Blood. N Engl J Med. 1993, 328: 1365-1371. 10.1056/NEJM199305133281901.CrossRefPubMed
9.
Segnan N, Armaroli P, Bonelli L, Risio M, Sciallero S, Zappa M, Andreoni B, Arrigoni A, Bisanti L, Casella C, Crosta C, Falcini F, Ferrero F, Giacomin A, Giuliani O, Santarelli A, Visioli CB, Zanetti R, Atkin WS, Senore C, the SCORE Working Group: Once-Only Sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian randomized controlled trial, GSCORE. J Natl Cancer Inst. 2011, 103: 1310-1322. 10.1093/jnci/djr284.CrossRefPubMed
10.
Lansdorp-Vogelaar I, Van Ballegooijen M, Zauber AG, Habbema JDF, Kuipers EJ: Effect of rising chemotherapy costs on the cost savings of colorectal cancer screening. J Natl Cancer Inst. 2009, 101: 1412-1422. 10.1093/jnci/djp319.CrossRefPubMedPubMedCentral
11.
Mandel JS, Church TR, Ederer F, Bond JH: Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood. J Natl Cancer Inst. 1999, 91: 434-437. 10.1093/jnci/91.5.434.CrossRefPubMed
12.
13.
Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JM, Parkin DM, Wardle J, Duffy SW, Cuzick J: Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010, 375: 1624-1633. 10.1016/S0140-6736(10)60551-X.CrossRefPubMed
14.
Schoen RE, Pinsky PF, Weissfeld JL, Yokochi LA, Church T, Laiyemo AO, Bresalier R, Andriole GL, Buys SS, Crawford ED, Fouad MN, Isaacs C, Johnson CC, Reding DJ, O’Brien B, Carrick DM, Wright P, Riley TL, Purdue MP, Izmirlian G, Kramer BS, Miller AB, Gohagan JK, Prorok PC, Berg CD: Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy. N Engl J Med. 2012, 366: 2345-2357. 10.1056/NEJMoa1114635.CrossRefPubMedPubMedCentral
15.
Hoff G, Grotmol T, Skovlund E, Bretthauer M, Norwegian Colorectal Cancer Prevention Study Group: Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomised controlled trial. BMJ. 2009, 338: b1846-10.1136/bmj.b1846.CrossRefPubMedPubMedCentral
16.
Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, Dash C, Giardiello FM, Glick S, Johnson D, Johnson CD, Levin TR, Pickhardt PJ, Rex DK, Smith RA, Thorson A, Winawer SJ, Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps: A joint guideline from the American cancer society, the US Multi-society task force on colorectal cancer, and the American college of radiology. Gastroenterology. 2008, 134: 1570-1595. 10.1053/j.gastro.2008.02.002.CrossRefPubMed
17.
Lieberman DA, Harford WV, Ahnen DJ, Provenzale D, Sontag SJ, Schnell TG, Chejfec G, Campbell DR, Durbin TE, Bond JH, Nelson DB, Ewing SL, Triadafilopoulos G, Ramirez FC, Lee JG, Collins JF, Fennerty MB, Johnston TK, Corless CL, McQuaid KR, Garewal H, Sampliner RE, Morales TG, Fass R, Smith RE, Maheshwari Y, Weiss DG: One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon. N Engl J Med. 2001, 345: 555-560. 10.1056/NEJMoa010328.CrossRefPubMed
18.
Sung JJ, Chan FK, Leung WK, Wu JC, Lau JY, Ching J, To KF, Lee YT, Luk YW, Kung NN, Kwok SP, Li MK, Chung S: Screening for colorectal cancer in Chinese: Comparison of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. Gastroenterology. 2003, 124: 608-614. 10.1053/gast.2003.50090.CrossRefPubMed
19.
Anderson WF, Guyton KZ, Hiatt RA, Vernon SW, Levin B, Hawk E: Colorectal cancer screening for persons at average risk. J Natl Cancer Inst. 2002, 94: 1126-1133. 10.1093/jnci/94.15.1126.CrossRefPubMed
20.
Brenner H, Chang-Claude J, Seiler CM, Sturmer T, Hoffmeister M: Potential for colorectal cancer prevention of sigmoidoscopy versus colonoscopy: population-based case control study. Cancer Epidemiol Biomarkers Prev. 2007, 16: 494-499. 10.1158/1055-9965.EPI-06-0460.CrossRefPubMed
21.
Rabeneck L, Lewis JD, Paszat LF, Saskin R, Stukel TA: Risk of proximal and distal colorectal cancer following flexible sigmoidoscopy: a population-based cohort study. Am J Gastroenterol. 2008, 103: 2075-2082. 10.1111/j.1572-0241.2008.01932.x.CrossRefPubMed
22.
Pickhardt PJ, Hassan C, Halligan S, Marmo R: Colorectal cancer: CT Colonography and colonoscopy for detection-systematic review and meta-analysis. Radiology. 2011, 259: 393-405. 10.1148/radiol.11101887.CrossRefPubMedPubMedCentral
23.
Pickhardt PJ, Choi JR, Hwang I, Butler JA, Puckett ML, Hildebrandt HA, Wong RK, Nugent PA, Mysliwiec PA, Schindler WR: Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med. 2003, 349: 2191-2200. 10.1056/NEJMoa031618.CrossRefPubMed
24.
Johnson CD, Chen MH, Toledano AY, Heiken JP, Dachman A, Kuo MD, Menias CO, Siewert B, Cheema JI, Obregon RG, Fidler JL, Zimmerman P, Horton KM, Coakley K, Iyer RB, Hara AK, Halvorsen RA, Casola G, Yee J, Herman BA, Burgart LJ, Limburg PJ: Accuracy of CT Colonography for detection of large adenomas and cancers. N Engl J Med. 2008, 359: 1207-1217. 10.1056/NEJMoa0800996.CrossRefPubMedPubMedCentral
25.
Stoop EM, De Haan MC, De Wijkerslooth TR, Bossuyt PM, Van Ballegooijen M, Nio CY, van de Vijver MJ, Biermann K, Thomeer M, Van Leerdam ME, Fockens P, Stoker J, Kuipers EJ, Dekker E: Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trial. Lancet Oncol. 2012, 13: 55-64. 10.1016/S1470-2045(11)70283-2.CrossRefPubMed
26.
Liedenbaum M, Vries A, Rijn A, Dekker H, Willemssen F, Leerdam M, Marrewijk C, Fockens P, Bipat S, Bossuyt P, Dekker E, Stoker J: CT colonography with limited bowel preparation for the detection of colorectal neoplasia in an FOBT positive screening population. Abdom Imaging. 2010, 35: 661-668. 10.1007/s00261-009-9586-8.CrossRefPubMed
27.
Pickhardt PJ: Incidence of colonic perforation at CT Colonography: review of existing data and implications for screening of asymptomatic adults. Radiology. 2006, 239: 313-316. 10.1148/radiol.2392052002.CrossRefPubMed
28.
Burling D, Halligan S, Slater A, Noakes MJ, Taylor SA: Potentially Serious Adverse Events at CT Colonography in Symptomatic Patients: National Survey of the United Kingdom. Radiology. 2006, 239: 464-471. 10.1148/radiol.2392051101.CrossRefPubMed
29.
Sosna J, Blachar A, Amitai M, Barmeir E, Peled N, Goldberg SN, Bar-Ziv J: Colonic Perforation at CT colonography: assessment of risk in a multicenter large cohort. Radiology. 2006, 239: 457-463. 10.1148/radiol.2392050287.CrossRefPubMed
30.
Iafrate F, Iussich G, Correale L, Hassan C, Regge D, Neri E, Baldassari P, Ciolina M, Pichi A, Iannitti M, Diacinti D, Laghi A: Adverse events of computed tomography colonography: an Italian national survey. Dig Liver Dis. 2013, 35: 661-668.
31.
Florie J, Gelder R, Schutter M, Randen A, Venema H, Jager S, Hulst V, Prent A, Bipat S, Bossuyt P, Baak L, Stoker J: Feasibility study of computed tomography colonography using limited bowel preparation at normal and low-dose levels study. Eur Radiol. 2007, 17: 3112-3122. 10.1007/s00330-007-0668-0.CrossRefPubMedPubMedCentral
32.
Jensch S, Bipat S, Peringa J, Vries A, Heutinck A, Dekker E, Baak L, Montauban Van Swijndregt A, Stoker J: CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation. Eur Radiol. 2010, 20: 146-156. 10.1007/s00330-009-1517-0.CrossRefPubMed
33.
Pickhardt PJ, Hassan C, Laghi A, Zullo A, Kim DH, Morini S: Cost-effectiveness of colorectal cancer screening with computed tomography colonography. Cancer. 2007, 109: 2213-2221. 10.1002/cncr.22668.CrossRefPubMed
34.
Hassan C, Zullo A, Laghi A, Reitano I, Taggi F, Cerro P, Iafrate F, Giustini M, Winn S, Morini S: Colon cancer prevention in Italy: Cost-effectiveness analysis with CT colonography and endoscopy. Dig Liver Dis. 2007, 39: 242-250. 10.1016/j.dld.2006.09.016.CrossRefPubMed
35.
Hassan C, Pickhardt PJ: Cost-effectiveness of CT colonography. Radiol Clin North Am. 2013, 51: 89-97. 10.1016/j.rcl.2012.09.006.CrossRefPubMed
36.
Pickhardt PJ, Taylor AJ: Extracolonic findings identified in asymptomatic adults at screening CT colonography. AJR Am J Roentgenol. 2006, 186: 718-728. 10.2214/AJR.04.1748.CrossRefPubMed
37.
Zalis ME, Barish MA, Choi JR, Dachman AH, Fenlon HM, Ferrucci JT, Glick SN, Laghi A, Macari M, McFarland EG, Morrin MM, Pickhardt PJ, Soto J, Yee J, the Working Group on Virtual Colonoscopy F: CT Colonography Reporting and Data System: a consensus proposal. Radiology. 2005, 236: 3-9. 10.1148/radiol.2361041926.CrossRefPubMed
38.
Hassan C, Pickhardt PL, Laghi A, Kim DH, Zullo A, Iafrate F, Di Giulio L, Morini S: Computed tomographic colonography to screen for colorectal cancer, extracolonic cancer, and aortic aneurysm: Model simulation with cost-effectiveness analysis. Arch Intern Med. 2008, 168: 696-705. 10.1001/archinte.168.7.696.CrossRefPubMed
39.
Pickhardt PJ, Hanson ME, Vanness DJ, Lo JY, Kim DH, Taylor AJ, Winter TC, Hinshaw JL: Unsuspected extracolonic findings at screening CT colonography: clinical and economic impact. Radiology. 2008, 249: 151-159. 10.1148/radiol.2491072148.CrossRefPubMed
40.
Sali L, Grazzini G, Carozzi F, Castiglione G, Falchini M, Mallardi B, Mantellini P, Ventura L, Regge D, Zappa M, Mascalchi M, Milani S: Screening for colorectal cancer with FOBT, virtual colonoscopy and optical colonoscopy: study protocol for a randomized controlled trial in the Florence district (SAVE study). Trials. 2013, 14: 74-10.1186/1745-6215-14-74.CrossRefPubMedPubMedCentral
41.
Doshi T, Rusinak D, Halvorsen RA, Rockey DC, Suzuki K, Dachman AH: CT colonography: false-negative interpretations. Radiology. 2007, 244: 165-173. 10.1148/radiol.2441061122.CrossRefPubMed
42.
Heresbach D, Djabbari M, Riou F, Marcus C, Le Sidaner A, Pierredon-Foulogne MA, Ponchon T, Boudiaf M, Seyrig JA, Laumonier H, Luet D, Giraud-Cohen M, Pelletier AL, Charachon A, Ramaholimihaso F, Bouillet P, Veyrac M, Ficarelli S, Vahedi K, Keruhel J, Lamouliatte H, Ridereau-Zins C, Bouhnik Y, Tissier M, Diris B, Zagdanski AM, Josselin JM, Hamonic S, Gandon Y: Accuracy of computed tomographic colonography in a nationwide multicentre trial, and its relation to radiologist expertise. Gut. 2011, 60: 658-665. 10.1136/gut.2010.225623.CrossRefPubMed
43.
Regge D, Hassan C, Pickhardt PJ, Laghi A, Zullo A, Kim DH, Iafrate F, Morini S: Impact of computer-aided detection on the cost-effectiveness of CT colonography. Radiology. 2009, 250: 488-497. 10.1148/radiol.2502080685.CrossRefPubMed
44.
Regge D, Monica PD, Galatola G, Laudi C, Zambon A, Correale L, Asnaghi R, Barbaro B, Borghi C, Campanella D, Cassinis MC, Ferrari R, Ferraris A, Hassan C, Iafrate F, Iussich G, Laghi A, Massara R, Neri E, Sali L, Venturini S, Gandini G: Efficacy of computer-aided detection as a second reader for 6-9 mm lesions at CT colonography: multicenter prospective trial. Radiology. 2013, 266: 168-176. 10.1148/radiol.12120376.CrossRefPubMed
45.
Halligan S, Mallett S, Altman DG, McQuillan J, Proud M, Beddoe G, Honeyfield L, Taylor SA: Incremental benefit of computer-aided detection when used as a second and concurrent reader of CT colonographic data: multiobserver study. Radiology. 2011, 258: 469-476. 10.1148/radiol.10100354.CrossRefPubMed
46.
Dachman AH, Obuchowski NA, Hoffmeister JW, Hinshaw JL, Frew MI, Winter TC, Van Uitert RL, Periaswamy S, Summers RM, Hillman BJ: Effect of Computer-aided Detection for CT Colonography in a Multireader, Multicase Trial. Radiology. 2010, 256: 827-835. 10.1148/radiol.10091890.CrossRefPubMedPubMedCentral
47.
Taylor SA, Charman SC, Lefere P, McFarland EG, Paulson EK, Yee J, Aslam R, Barlow JM, Gupta A, Kim DH, Miller CM, Halligan S: CT colonography: investigation of the optimum reader paradigm by using computer-aided detection software. Radiology. 2008, 246: 463-471. 10.1148/radiol.2461070190.CrossRefPubMed
48.
Mani A, Napel S, Paik D, Jeffrey R, Yee J, Olcott E, Prokesch R, Davila M, Schraedley-Desmond P, Beaulieu C: Computed tomography colonography: feasibility of computer-aided polyp detection in a first-reader paradigm. J Comput Assist Tomogr. 2004, 28: 318-332. 10.1097/00004728-200405000-00003.CrossRefPubMed
49.
Robinson C, Halligan S, Iinuma G, Topping W, Punwani S, Honeyfield L, Taylor SA: CT colonography: computer-assisted detection of colorectal cancer. Br J Radiol. 2011, 84: 435-440. 10.1259/bjr/17848340.CrossRefPubMedPubMedCentral
50.
Iussich G, Correale L, Senore C, Segnan N, Laghi A, Iafrate F, Campanella D, Neri E, Cerri F, Hassan C, Regge D: CT colonography: preliminary assessment of a double-read paradigm that uses computer-aided detection as the first reader. Radiology. 2013, 268: 743-751. 10.1148/radiol.13121192.CrossRefPubMed
51.
Iussich G, Correale L, Senore C, Segnan N, Campanella D, Galatola G, Laudi C, Regge D: Computer Aided Detection (CAD) for CT Colonography Screening: a Prospective Comparison of a Double Reading Paradigm with First Reader CAD Against Second Reader CAD. Invest Radiol. in press
52.
Campanella D, Morra L, Delsanto S, Tartaglia V, Asnaghi R, Bert A, Neri E, Regge D: Comparison of three different iodine-based bowel regimens for CT colonography. Eur Radiol. 2010, 20: 348-358. 10.1007/s00330-009-1553-9.CrossRefPubMed
53.
Segnan N, Senore C, Andreoni B, Azzoni A, Bisanti L, Cardelli A, Castiglione G, Crosta C, Ederle A, Fantin A, Ferrari A, Fracchia M, Ferrero F, Gasperoni S, Recchia S, Risio M, Rubeca T, Saracco G, Zappa M: Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. Gastroenterology. 2007, 132: 2304-2312. 10.1053/j.gastro.2007.03.030.CrossRefPubMed
54.
Jass JR, Sobin LH: Histological typing of intestinal tumors. 1989, New York: Springer-Verlag, secondCrossRef
55.
Senore C, Ederle A, Fantin A, Andreoni B, Bisanti L, Grazzini G, Zappa M, Ferrero F, Marutti A, Giuliani O, Armaroli P, Segnan N: Acceptability and side-effects of colonoscopy and sigmoidoscopy in a screening setting. J Med Screen. 2011, 18: 128-134. 10.1258/jms.2011.010135.CrossRefPubMed
56.
Senore C, Armaroli P, Silvani M, Andreoni B, Bisanti L, Castiglione G, Grazzini G, Taddei S, Gasperoni S, Giuliani O, Malfitana G, Marutti A, Genta G, Segnan N: Comparing Different strategies for colorectal cancer screening in Italy: predictors of patients’ participation. Am J Gastroenterol. 2009, 105: 188-198.CrossRefPubMed
57.
Zorzi M, Falcini F, Grazzini G, De’Bianchi P, Senore C, Vettorazzi M, Visioli C, Zappa M: Screening for colorectal cancer in Italy: 2006 survey. Epidemiol Prev. 2006, 32: 55-68.
58.
Prentice RL: Surrogate endpoints in clinical trials: Definition and operational criteria. Stat Med. 1989, 8: 431-440. 10.1002/sim.4780080407.CrossRefPubMed
59.
Hassan C, Pickhardt P, Marmo R, Choi J: Impact of lifestyle factors on colorectal polyp detection in the screening setting. Dis Colon Rectum. 2010, 53: 1328-1333. 10.1007/DCR.0b013e3181e10daa.CrossRefPubMed
60.
Wilmink A, Quick C, Hubbard C, Day N: Effectiveness and cost of screening for abdominal aortic aneurysm: results of a population screening program. J Vasc Surg. 2003, 38: 72-77. 10.1016/S0741-5214(03)00135-6.CrossRefPubMed
Metadata
Title
Population screening for colorectal cancer by flexible sigmoidoscopy or CT colonography: study protocol for a multicenter randomized trial
Authors
Daniele Regge
Gabriella Iussich
Carlo Senore
Loredana Correale
Cesare Hassan
Alberto Bert
Stefania Montemezzi
Nereo Segnan
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Trials / Issue 1/2014
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-15-97

Other articles of this Issue 1/2014

Trials 1/2014 Go to the issue

Study protocol

Low-dose intravenous immunoglobulin treatment for complex regional pain syndrome (LIPS): study protocol for a randomized controlled trial

Study protocol

Combining motivational and volitional strategies to promote unsupervised walking in patients with fibromyalgia: study protocol for a randomized controlled trial

Study protocol

Acupuncture for functional dyspepsia: study protocol for a two-center, randomized controlled trial

Study protocol

Screening uptake rates and the clinical and cost effectiveness of screening for gestational diabetes mellitus in primary versus secondary care: study protocol for a randomised controlled trial

Study protocol

Improving coronary heart disease self-management using mobile technologies (Text4Heart): a randomised controlled trial protocol

Study protocol

Stoma-Const - the technical aspects of stoma construction: study protocol for a randomised controlled trial