Ignite Creation Date:
2025-12-25 @ 2:15 AM
Ignite Modification Date:
2025-12-31 @ 2:36 PM
Study NCT ID:
NCT00443560
Status:
COMPLETED
Last Update Posted:
2014-04-14
First Post:
2007-03-02
Is NOT Gene Therapy:
True
Has Adverse Events:
True
Brief Title:
The Association Between Decreasing Labor Analgesia Epidural Infusion and Forceps Delivery
Sponsor:
Organization:
Raw JSON
{'hasResults': True, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D048949', 'term': 'Labor Pain'}], 'ancestors': [{'id': 'D010146', 'term': 'Pain'}, {'id': 'D009461', 'term': 'Neurologic Manifestations'}, {'id': 'D012816', 'term': 'Signs and Symptoms'}, {'id': 'D013568', 'term': 'Pathological Conditions, Signs and Symptoms'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'D002045', 'term': 'Bupivacaine'}, {'id': 'D005283', 'term': 'Fentanyl'}], 'ancestors': [{'id': 'D000813', 'term': 'Anilides'}, {'id': 'D000577', 'term': 'Amides'}, {'id': 'D009930', 'term': 'Organic Chemicals'}, {'id': 'D000814', 'term': 'Aniline Compounds'}, {'id': 'D000588', 'term': 'Amines'}, {'id': 'D010880', 'term': 'Piperidines'}, {'id': 'D006573', 'term': 'Heterocyclic Compounds, 1-Ring'}, {'id': 'D006571', 'term': 'Heterocyclic Compounds'}]}}, 'resultsSection': {'moreInfoModule': {'pointOfContact': {'email': 'r-mccarthy@northwestern.edu', 'phone': '312-926-9015', 'title': 'Dr. Robert J. McCarthy, PharmD', 'organization': 'Northwestern University Feinberg School of Medicine'}, 'certainAgreement': {'piSponsorEmployee': True}, 'limitationsAndCaveats': {'description': 'The retrospective design incurs the risk of unrecorded or unobserved data. The sample selected included all patients with neuraxial analgesia who underwent IVD, but a limited sample of SVD.'}}, 'adverseEventsModule': {'description': 'Adverse events were not extracted from charts reviewed in this study', 'eventGroups': [{'id': 'EG000', 'title': 'Instrumental Vaginal Delivery (IVD)', 'description': 'Instrumental vaginal delivery (IVD) is attempted to prevent fetal hypoxia if the second stage of labor is prolonged. It includes forceps and vacuum extractions.', 'otherNumAtRisk': 0, 'otherNumAffected': 0, 'seriousNumAtRisk': 0, 'seriousNumAffected': 0}, {'id': 'EG001', 'title': 'Spontaneous Vaginal Delivery (SVD)', 'description': 'The control group consisted of parturients who had a spontaneous vaginal delivery (SVD)in the same 24 hour period who were case-matched for gravidity and parity.', 'otherNumAtRisk': 0, 'otherNumAffected': 0, 'seriousNumAtRisk': 0, 'seriousNumAffected': 0}], 'frequencyThreshold': '0'}, 'outcomeMeasuresModule': {'outcomeMeasures': [{'type': 'PRIMARY', 'title': 'Number of Parturients With a Decrease in the Infusion of Epidural Analgesia During Second Stage of Labor', 'denoms': [{'units': 'Participants', 'counts': [{'value': '1021', 'groupId': 'OG000'}, {'value': '1051', 'groupId': 'OG001'}]}], 'groups': [{'id': 'OG000', 'title': 'Instrumental Vaginal Delivery (IVD)', 'description': 'Instrumental vaginal delivery (IVD) is attempted to prevent fetal hypoxia if the second stage of labor is prolonged. It includes forceps and vacuum extractions.'}, {'id': 'OG001', 'title': 'Spontaneous Vaginal Delivery (SVD)', 'description': 'The control group consisted of parturients who had a spontaneous vaginal delivery (SVD)in the same 24 hour period who were case-matched for gravidity and parity.'}], 'classes': [{'categories': [{'measurements': [{'value': '146', 'groupId': 'OG000'}, {'value': '51', 'groupId': 'OG001'}]}]}], 'analyses': [{'pValue': '<0.01', 'groupIds': ['OG000', 'OG001'], 'paramType': 'Odds Ratio (OR)', 'ciPctValue': '95', 'paramValue': '3.3', 'ciLowerLimit': '2.3', 'ciUpperLimit': '4.5', 'statisticalMethod': 'Chi-squared, Corrected', 'nonInferiorityType': 'SUPERIORITY_OR_OTHER', 'testedNonInferiority': False}], 'paramType': 'NUMBER', 'timeFrame': 'Second stage of labor up to 3 hours', 'description': 'At the request of the obstetric provider, second stage analgesia density was decreased by decreasing the basal infusion rate if there was dissatisfaction with the progress of labor or a perceived inability to push. The basal infusion was never totally discontinued.', 'unitOfMeasure': 'participants', 'reportingStatus': 'POSTED', 'populationDescription': 'Analysis was per protocal'}, {'type': 'SECONDARY', 'title': 'Number of Participants With Breakthrough Pain in the First Stage of Labor', 'denoms': [{'units': 'Participants', 'counts': [{'value': '1021', 'groupId': 'OG000'}, {'value': '1051', 'groupId': 'OG001'}]}], 'groups': [{'id': 'OG000', 'title': 'Instrumental Vaginal Delivery (IVD)', 'description': 'Instrumental vaginal delivery (IVD) is attempted to prevent fetal hypoxia if the second stage of labor is prolonged. It includes forceps and vacuum extractions.'}, {'id': 'OG001', 'title': 'Spontaneous Vaginal Delivery (SVD)', 'description': 'The control group consisted of parturients who had a spontaneous vaginal delivery (SVD)in the same 24 hour period who were case-matched for gravidity and parity.'}], 'classes': [{'title': 'Supplemental bolus', 'categories': [{'measurements': [{'value': '802', 'groupId': 'OG000'}, {'value': '243', 'groupId': 'OG001'}]}]}, {'title': 'Infusion increase', 'categories': [{'measurements': [{'value': '149', 'groupId': 'OG000'}, {'value': '87', 'groupId': 'OG001'}]}]}, {'title': 'Concentration increase', 'categories': [{'measurements': [{'value': '32', 'groupId': 'OG000'}, {'value': '19', 'groupId': 'OG001'}]}]}], 'analyses': [{'pValue': '<0.01', 'groupIds': ['OG000', 'OG001'], 'paramType': 'Odds Ratio (OR)', 'ciPctValue': '95', 'paramValue': '12.2', 'ciLowerLimit': '9.9', 'ciUpperLimit': '15.0', 'statisticalMethod': 'Chi-squared, Corrected', 'nonInferiorityType': 'SUPERIORITY_OR_OTHER', 'testedNonInferiority': False}], 'paramType': 'NUMBER', 'timeFrame': 'Supplemental analgesia in first stage of labor (<24 hours)', 'description': 'Pain not responding to epidural analgesia in the first stage of labor was treated with bolus dose of bupivacaine 1.25 mg/mL or lidocaine 10 mg/mL, 10 to 15 mL. If pain relief was obtained the infusion concentration was increased. If the patient had no pain relief following the bolus injection, the epidural catheter was replaced.', 'unitOfMeasure': 'participants', 'reportingStatus': 'POSTED', 'populationDescription': 'Analysis was per protocol'}, {'type': 'SECONDARY', 'title': 'Duration of Labor Analgesia', 'denoms': [{'units': 'Participants', 'counts': [{'value': '1021', 'groupId': 'OG000'}, {'value': '1051', 'groupId': 'OG001'}]}], 'groups': [{'id': 'OG000', 'title': 'Instrumental Vaginal Delivery (IVD)', 'description': 'Instrumental vaginal delivery (IVD) is attempted to prevent fetal hypoxia if the second stage of labor is prolonged. It includes forceps and vacuum extractions.'}, {'id': 'OG001', 'title': 'Spontaneous Vaginal Delivery (SVD)', 'description': 'The control group consisted of parturients who had a spontaneous vaginal delivery (SVD)in the same 24 hour period who were case-matched for gravidity and parity.'}], 'classes': [{'categories': [{'measurements': [{'value': '420', 'groupId': 'OG000', 'lowerLimit': '300', 'upperLimit': '570'}, {'value': '300', 'groupId': 'OG001', 'lowerLimit': '210', 'upperLimit': '420'}]}]}], 'analyses': [{'pValue': '<0.01', 'groupIds': ['OG000', 'OG001'], 'ciPctValue': '95', 'statisticalMethod': 'Wilcoxon (Mann-Whitney)', 'nonInferiorityType': 'SUPERIORITY_OR_OTHER', 'testedNonInferiority': False}], 'paramType': 'MEDIAN', 'timeFrame': 'Time form initiation of labor analgesia to delivery (up to 24 hours)', 'description': 'Time in minutes from initiation of labor analgesia until delivery of the infant', 'unitOfMeasure': 'minutes', 'dispersionType': 'Inter-Quartile Range', 'reportingStatus': 'POSTED', 'populationDescription': 'Analysis was per protocal'}]}, 'participantFlowModule': {'groups': [{'id': 'FG000', 'title': 'Instrumental Vaginal Delivery (IVD)', 'description': 'Instrumental vaginal delivery (IVD) is attempted to prevent fetal hypoxia if the second stage of labor is prolonged. It includes forceps and vacuum extractions.'}, {'id': 'FG001', 'title': 'Spontaneous Vaginal Delivery (SVD)', 'description': 'The control group consisted of parturients who had a spontaneous vaginal delivery (SVD)in the same 24 hour period who were case-matched for gravidity and parity.'}], 'periods': [{'title': 'Overall Study', 'milestones': [{'type': 'STARTED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '1081'}, {'groupId': 'FG001', 'numSubjects': '1081'}]}, {'type': 'COMPLETED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '1021'}, {'groupId': 'FG001', 'numSubjects': '1051'}]}, {'type': 'NOT COMPLETED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '60'}, {'groupId': 'FG001', 'numSubjects': '30'}]}], 'dropWithdraws': [{'type': 'No intrathecal dose', 'reasons': [{'groupId': 'FG000', 'numSubjects': '58'}, {'groupId': 'FG001', 'numSubjects': '26'}]}, {'type': 'Multiple pregnancies or fetal demise', 'reasons': [{'groupId': 'FG000', 'numSubjects': '2'}, {'groupId': 'FG001', 'numSubjects': '4'}]}]}], 'recruitmentDetails': "The Obstetric Anesthesiology Database was used to identify parturients from the Labor and Delivery Unit of Prentice Women's Hospital of Northwestern Memorial Hospital who qualified for the study between January 2004 and October 2005."}, 'baselineCharacteristicsModule': {'denoms': [{'units': 'Participants', 'counts': [{'value': '1081', 'groupId': 'BG000'}, {'value': '1081', 'groupId': 'BG001'}, {'value': '2162', 'groupId': 'BG002'}]}], 'groups': [{'id': 'BG000', 'title': 'Instrumental Vaginal Delivery (IVD)', 'description': 'Instrumental vaginal delivery (IVD) is attempted to prevent fetal hypoxia if the second stage of labor is prolonged. It includes forceps and vacuum extractions.'}, {'id': 'BG001', 'title': 'Spontaneous Vaginal Delivery (SVD)', 'description': 'The control group consisted of parturients who had a spontaneous vaginal delivery (SVD)in the same 24 hour period who were case-matched for gravidity and parity.'}, {'id': 'BG002', 'title': 'Total', 'description': 'Total of all reporting groups'}], 'measures': [{'title': 'Age, Categorical', 'classes': [{'categories': [{'title': '<=18 years', 'measurements': [{'value': '0', 'groupId': 'BG000'}, {'value': '0', 'groupId': 'BG001'}, {'value': '0', 'groupId': 'BG002'}]}, {'title': 'Between 18 and 65 years', 'measurements': [{'value': '1081', 'groupId': 'BG000'}, {'value': '1081', 'groupId': 'BG001'}, {'value': '2162', 'groupId': 'BG002'}]}, {'title': '>=65 years', 'measurements': [{'value': '0', 'groupId': 'BG000'}, {'value': '0', 'groupId': 'BG001'}, {'value': '0', 'groupId': 'BG002'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'unitOfMeasure': 'Participants'}, {'title': 'Age, Continuous', 'classes': [{'categories': [{'measurements': [{'value': '32', 'spread': '3', 'groupId': 'BG000'}, {'value': '31', 'spread': '3', 'groupId': 'BG001'}, {'value': '31', 'spread': '3', 'groupId': 'BG002'}]}]}], 'paramType': 'MEAN', 'unitOfMeasure': 'years', 'dispersionType': 'STANDARD_DEVIATION'}, {'title': 'Sex: Female, Male', 'classes': [{'categories': [{'title': 'Female', 'measurements': [{'value': '1081', 'groupId': 'BG000'}, {'value': '1081', 'groupId': 'BG001'}, {'value': '2162', 'groupId': 'BG002'}]}, {'title': 'Male', 'measurements': [{'value': '0', 'groupId': 'BG000'}, {'value': '0', 'groupId': 'BG001'}, {'value': '0', 'groupId': 'BG002'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'unitOfMeasure': 'Participants'}, {'title': 'Region of Enrollment', 'classes': [{'title': 'United States', 'categories': [{'measurements': [{'value': '1081', 'groupId': 'BG000'}, {'value': '1081', 'groupId': 'BG001'}, {'value': '2162', 'groupId': 'BG002'}]}]}], 'paramType': 'NUMBER', 'unitOfMeasure': 'participants'}]}}, 'protocolSection': {'designModule': {'studyType': 'OBSERVATIONAL', 'designInfo': {'timePerspective': 'RETROSPECTIVE', 'observationalModel': 'CASE_CONTROL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 2162}}, 'statusModule': {'overallStatus': 'COMPLETED', 'startDateStruct': {'date': '2006-01'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2014-03', 'completionDateStruct': {'date': '2006-03', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2014-03-17', 'studyFirstSubmitDate': '2007-03-02', 'resultsFirstSubmitDate': '2011-05-09', 'studyFirstSubmitQcDate': '2007-03-05', 'lastUpdatePostDateStruct': {'date': '2014-04-14', 'type': 'ESTIMATED'}, 'resultsFirstSubmitQcDate': '2011-06-22', 'studyFirstPostDateStruct': {'date': '2007-03-06', 'type': 'ESTIMATED'}, 'resultsFirstPostDateStruct': {'date': '2011-07-21', 'type': 'ESTIMATED'}, 'primaryCompletionDateStruct': {'date': '2006-03', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Number of Parturients With a Decrease in the Infusion of Epidural Analgesia During Second Stage of Labor', 'timeFrame': 'Second stage of labor up to 3 hours', 'description': 'At the request of the obstetric provider, second stage analgesia density was decreased by decreasing the basal infusion rate if there was dissatisfaction with the progress of labor or a perceived inability to push. The basal infusion was never totally discontinued.'}], 'secondaryOutcomes': [{'measure': 'Number of Participants With Breakthrough Pain in the First Stage of Labor', 'timeFrame': 'Supplemental analgesia in first stage of labor (<24 hours)', 'description': 'Pain not responding to epidural analgesia in the first stage of labor was treated with bolus dose of bupivacaine 1.25 mg/mL or lidocaine 10 mg/mL, 10 to 15 mL. If pain relief was obtained the infusion concentration was increased. If the patient had no pain relief following the bolus injection, the epidural catheter was replaced.'}, {'measure': 'Duration of Labor Analgesia', 'timeFrame': 'Time form initiation of labor analgesia to delivery (up to 24 hours)', 'description': 'Time in minutes from initiation of labor analgesia until delivery of the infant'}]}, 'oversightModule': {'oversightHasDmc': False}, 'conditionsModule': {'keywords': ['Labor', 'Epidural Analgesia', 'delivery', 'vacuum extraction', 'obstetrical Forceps'], 'conditions': ['Labor Pain', 'Pregnancy']}, 'referencesModule': {'references': [{'pmid': '11707657', 'type': 'BACKGROUND', 'citation': 'Murphy DJ. Failure to progress in the second stage of labour. Curr Opin Obstet Gynecol. 2001 Dec;13(6):557-61. doi: 10.1097/00001703-200112000-00002.'}, {'pmid': '11454372', 'type': 'BACKGROUND', 'citation': 'Comparative Obstetric Mobile Epidural Trial (COMET) Study Group UK. Effect of low-dose mobile versus traditional epidural techniques on mode of delivery: a randomised controlled trial. Lancet. 2001 Jul 7;358(9275):19-23. doi: 10.1016/S0140-6736(00)05251-X.'}, {'pmid': '15495111', 'type': 'BACKGROUND', 'citation': 'Torvaldsen S, Roberts CL, Bell JC, Raynes-Greenow CH. Discontinuation of epidural analgesia late in labour for reducing the adverse delivery outcomes associated with epidural analgesia. Cochrane Database Syst Rev. 2004 Oct 18;2004(4):CD004457. doi: 10.1002/14651858.CD004457.pub2.'}, {'pmid': '10735793', 'type': 'BACKGROUND', 'citation': 'Hess PE, Pratt SD, Soni AK, Sarna MC, Oriol NE. An association between severe labor pain and cesarean delivery. Anesth Analg. 2000 Apr;90(4):881-6. doi: 10.1097/00000539-200004000-00020.'}, {'pmid': '10691224', 'type': 'BACKGROUND', 'citation': 'Cohen SE, Yeh JY, Riley ET, Vogel TM. Walking with labor epidural analgesia: the impact of bupivacaine concentration and a lidocaine-epinephrine test dose. Anesthesiology. 2000 Feb;92(2):387-92. doi: 10.1097/00000542-200002000-00019.'}, {'pmid': '12657859', 'type': 'BACKGROUND', 'citation': 'Panni MK, Segal S. Local anesthetic requirements are greater in dystocia than in normal labor. Anesthesiology. 2003 Apr;98(4):957-63. doi: 10.1097/00000542-200304000-00024.'}, {'pmid': '11275036', 'type': 'BACKGROUND', 'citation': 'Yancey MK, Zhang J, Schweitzer DL, Schwarz J, Klebanoff MA. Epidural analgesia and fetal head malposition at vaginal delivery. Obstet Gynecol. 2001 Apr;97(4):608-12. doi: 10.1016/s0029-7844(00)01230-8.'}, {'pmid': '15716559', 'type': 'BACKGROUND', 'citation': 'Wong CA, Scavone BM, Peaceman AM, McCarthy RJ, Sullivan JT, Diaz NT, Yaghmour E, Marcus RJ, Sherwani SS, Sproviero MT, Yilmaz M, Patel R, Robles C, Grouper S. The risk of cesarean delivery with neuraxial analgesia given early versus late in labor. N Engl J Med. 2005 Feb 17;352(7):655-65. doi: 10.1056/NEJMoa042573.'}, {'type': 'BACKGROUND', 'citation': '9. Wong CA, Scavone BM, Sullivan JT, Ebarvia MJ, McCarthy RJ. The risk of cesarean delivery with early neuraxial analgesia in nulliparous induction of labor. http://www.asa-abstracts.com 2007:A1204.'}, {'pmid': '17826432', 'type': 'BACKGROUND', 'citation': 'Ben-Haroush A, Melamed N, Kaplan B, Yogev Y. Predictors of failed operative vaginal delivery: a single-center experience. Am J Obstet Gynecol. 2007 Sep;197(3):308.e1-5. doi: 10.1016/j.ajog.2007.06.051.'}, {'pmid': '11327090', 'type': 'BACKGROUND', 'citation': 'Ziadeh S, Yahaya A. Pregnancy outcome at age 40 and older. Arch Gynecol Obstet. 2001 Mar;265(1):30-3. doi: 10.1007/s004040000122.'}]}, 'descriptionModule': {'briefSummary': 'The objective of this study will be to compare epidural infusion management, specifically looking at infusion rate changes, in patients who receive forceps deliveries versus normal spontaneous vaginal deliveries. We will match patients based on time and date of delivery, as well as parity, in order to eliminate these variables as potential con-founders.\n\nWe hypothesize patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of forceps delivery.', 'detailedDescription': 'The obstetrical anesthesia database will be queried for all forceps deliveries between the dates of January 2004-October 2005. To minimize the influence of different anesthetic and obstetric care providers, the control group consisted of parturients who has spontaneous vaginal deliveries (SVD) in the same 24 hour period who were case-matched for gravidity and parity. Parturients with twin deliveries and fetal demise were not selected for either group.\n\nThe database will be queried for the following: maternal age, parity, gestational age, type of analgesia, changes in epidural infusion rate and/or concentration, and supplemental bolus doses of local anesthesia. The data will be stripped of identification by the database manager and entered into a secured computer which is password protected and maintained in the Department of Anesthesiology. The primary endpoint is to evaluate if decreasing the epidural infusion rate was associated with a forceps delivery.'}, 'eligibilityModule': {'sex': 'FEMALE', 'stdAges': ['ADULT'], 'maximumAge': '60 Years', 'minimumAge': '18 Years', 'samplingMethod': 'PROBABILITY_SAMPLE', 'studyPopulation': 'Pregnant Women', 'healthyVolunteers': True, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Singletons\n* Viable fetal vaginal deliveries between January 2004-October 2005\n\nExclusion Criteria:\n\n* Outside specified time frame\n* Multiparity\n* Fetal demise'}, 'identificationModule': {'nctId': 'NCT00443560', 'briefTitle': 'The Association Between Decreasing Labor Analgesia Epidural Infusion and Forceps Delivery', 'organization': {'class': 'OTHER', 'fullName': 'Northwestern University'}, 'officialTitle': 'A Retrospective Case-controlled Study of the Association Between Request to Discontinue Second Stage Labor Epidural Analgesia and Risk of Instrumental Vaginal Delivery', 'orgStudyIdInfo': {'id': '0524-028'}}, 'armsInterventionsModule': {'armGroups': [{'label': 'Instrumental Vaginal Delivery (IVD)', 'description': 'Instrumental vaginal delivery (IVD) is attempted to prevent fetal hypoxia if the second stage of labor is prolonged. It includes forceps and vacuum extractions.', 'interventionNames': ['Other: Case controlled analysis of epidural labor analgesia patterns']}, {'label': 'Spontaneous Vaginal Delivery (SVD)', 'description': 'The control group consisted of parturients who had a spontaneous vaginal delivery (SVD)in the same 24 hour period who were case-matched for gravidity and parity.', 'interventionNames': ['Other: Case controlled analysis of epidural labor analgesia patterns']}], 'interventions': [{'name': 'Case controlled analysis of epidural labor analgesia patterns', 'type': 'OTHER', 'otherNames': ['combined spinal epidural analgesia', 'epidural labor analgesia', 'bupivacaine', 'fentanyl'], 'description': 'A retrospective study utilizing the Obstetric Anesthesiology Database to identify parturients who received neuraxial labor analgesia initiated with a combined spinal epidural (CSE) technique and maintained with a continuous epidural infusion with patient controlled epidural analgesia boluses', 'armGroupLabels': ['Instrumental Vaginal Delivery (IVD)', 'Spontaneous Vaginal Delivery (SVD)']}]}, 'contactsLocationsModule': {'locations': [{'zip': '60611', 'city': 'Chicago', 'state': 'Illinois', 'country': 'United States', 'facility': 'Northwestern University', 'geoPoint': {'lat': 41.85003, 'lon': -87.65005}}], 'overallOfficials': [{'name': 'Cynthia A Wong, M.D.', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'Northwestern University'}]}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'Northwestern University', 'class': 'OTHER'}, 'responsibleParty': {'type': 'PRINCIPAL_INVESTIGATOR', 'investigatorTitle': 'Professor of Anesthesiology', 'investigatorFullName': 'Cynthia Wong', 'investigatorAffiliation': 'Northwestern University'}}}}