Evidence map›Paper›PMID 25850463›Full record

Trial reportAllergy2015

Patients' ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial.

T Umasunthar, A Procktor, M Hodes, J G Smith, C Gore, H E Cox, T Marrs, H Hanna, K Phillips, C Pinto and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Allergy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Review
  4. Alternatives to Injectable Adrenaline for Treating Anaphylaxis.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2025
    Review
  5. Adrenaline Auto-Injectors for Preventing Fatal Anaphylaxis.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2025
    Review
  6. Review
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. How incorrect is the use of adrenaline auto-injectors?Internal and emergency medicine · 2015
    Article
  13. Article
  14. Article
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

T UmasuntharSection of Paediatrics, Imperial College London, London, UK.
A ProcktorSection of Paediatrics, Imperial College London, London, UK.
M HodesImperial College Healthcare NHS Trust, St. Mary's Hospital, London, UK.
J G SmithPopulation Health Research Institute, St. George's, University of London, London, UK.
C GoreSection of Paediatrics, Imperial College London, London, UK.
H E CoxSection of Paediatrics, Imperial College London, London, UK.
T MarrsDepartment of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.
H HannaSection of Paediatrics, Imperial College London, London, UK.
K PhillipsSection of Paediatrics, Imperial College London, London, UK.
C PintoSection of Paediatrics, Imperial College London, London, UK.
P J TurnerSection of Paediatrics, Imperial College London, London, UK.
J O WarnerSection of Paediatrics, Imperial College London, London, UK.
R J BoyleSection of Paediatrics, Imperial College London, London, UK.

Funding

Medical Research Council MR/K010468/1
6 · The paper itself

Abstract

backgroundPrevious work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices.

methodsWe allocated mothers of food-allergic children prescribed an AAI for the first time to Anapen or EpiPen using a computer-generated randomization list, with optimal training according to manufacturer's instructions. After one year, participants were randomly allocated a new device (EpiPen, Anapen, new EpiPen, JEXT or Auvi-Q), without device-specific training. We assessed ability to deliver adrenaline using their AAI in a simulated anaphylaxis scenario six weeks and one year after initial training, and following device switch. Primary outcome was successful adrenaline administration at six weeks, assessed by an independent expert. Secondary outcomes were success at one year, success after switching device, and adverse events.

resultsWe randomized 158 participants. At six weeks, 30 of 71 (42%) participants allocated to Anapen and 31 of 73 (43%) participants allocated to EpiPen were successful - RR 1.00 (95% CI 0.68-1.46). Success rates at one year were also similar, but digital injection was more common at one year with EpiPen (8/59, 14%) than Anapen (0/51, 0%, P = 0.007). When switched to a new device without specific training, success rates were higher with Auvi-Q (26/28, 93%) than other devices (39/80, 49%; P < 0.001).

conclusionsAAI device design is a major determinant of successful adrenaline administration. Success rates were low with several devices, but were high using the audio-prompt device Auvi-Q.

Indexed as

alpha-AmylasesAnaphylaxisChildChild, PreschoolEpinephrineFemaleFood HypersensitivityHumansInfantInjectionsMaleSalivary alpha-AmylasesSalivary GlandsSelf AdministrationTreatment OutcomeVasoconstrictor Agentsalpha-AmylasesEpinephrineSalivary alpha-AmylasesVasoconstrictor Agentsadrenalineanaphylaxisautoinjectorfood allergyhuman factors research

Identifiers

PMID25850463
PMCPMC4654245

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.