Use of on-line medical command to randomize patients in a prehospital research study

Bartholomew J. Tortella, Robert F. Lavery, Mark Quadrel, Ronald P. Cody, Greg Heyt

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective: To describe the efficiency of using on-line medical command (OLMC) to conduct a prospective, randomized clinical trial addressing safety and patient enrollment.Design, Setting, and Participants: Prospective design using OLMC to randomize adult asthmatics into one of three treatment groups. After verifying inclusion and exclusion criteria, OLMC physicians removed a covering label on study sheets and ordered the treatment specified underneath the label that had been assigned in a random sequence.Results: A total of 204 patients were seen with dyspnea and wheezing during the three-month study. Of these, 68 (33%) were excluded from the study. Of the 136 (67%) patients who were eligible for study, 87 were enrolled (enrollment efficiency 64%), with 79 fully evaluable (evaluable efficiency 91%). The study safety was 100% because no enrolled patients met any exclusion criteria.Conclusions: The design was random and prospective, with patient entry blinded, using paramedics to enroll patients and OLMC physicians as gatekeepers, thus ensuring appropriate patient eligibility and study-arm assignment. Use of OLMC physicians to perform prospective randomized studies is safe and efficient, and results in a high yield of evaluable patients.

Original languageEnglish (US)
Pages (from-to)55-58
Number of pages4
JournalPrehospital and Disaster Medicine
Volume11
Issue number1
DOIs
StatePublished - 1996
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency

Keywords

  • emergency medical services
  • on-line medical control
  • paramedics
  • prehospital care
  • research design

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