Evidence map›Paper›PMID 29078810›Full record

Trial reportTrials2017

Improving oxygen therapy for children and neonates in secondary hospitals in Nigeria: study protocol for a stepped-wedge cluster randomised trial.

Hamish R Graham, Adejumoke I Ayede, Ayobami A Bakare, Oladapo B Oyewole, David Peel, Amy Gray, Barbara McPake, Eleanor Neal, Shamim Qazi, Rasa Izadnegahdar and 2 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Trials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% of its field
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

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Article
  8. Using intermittent pulse oximetry to guide neonatal oxygen therapy in a low-resource context.Archives of disease in childhood. Fetal and neonatal edition · 2020
    Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. 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

12 authors at 4 institutions in 4 countries.

Hamish R GrahamCentre for International Child Health, University of Melbourne, MCRI, Royal Children's Hospital, Level 2 East, 50 Flemington Road, Parkville, VIC, 3052, Australia. Hamish.Graham@rch.org.au.
Adejumoke I AyedeDepartment of Paediatrics, University College Hospital, Ibadan, Nigeria.
Ayobami A BakareDepartment of Paediatrics, University College Hospital, Ibadan, Nigeria.
Oladapo B OyewoleDepartment of Paediatrics, University College Hospital, Ibadan, Nigeria.
David PeelAshdown Consultants, Hartfield, England.
Amy GrayCentre for International Child Health, University of Melbourne, MCRI, Royal Children's Hospital, Level 2 East, 50 Flemington Road, Parkville, VIC, 3052, Australia.
Barbara McPakeNossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia.
Eleanor NealCentre for International Child Health, University of Melbourne, MCRI, Royal Children's Hospital, Level 2 East, 50 Flemington Road, Parkville, VIC, 3052, Australia.
Shamim QaziDepartment of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland.
Rasa IzadnegahdarBill and Melinda Gates Foundation, Seattle, WA, USA.
Adegoke G FaladeDepartment of Paediatrics, University College Hospital, Ibadan, Nigeria.
Trevor DukeCentre for International Child Health, University of Melbourne, MCRI, Royal Children's Hospital, Level 2 East, 50 Flemington Road, Parkville, VIC, 3052, Australia.
University of Melbourne · AUUniversity College Hospital, Ibadan · NGBill & Melinda Gates Foundation · USWorld Health Organization · CH

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundOxygen is a life-saving, essential medicine that is important for the treatment of many common childhood conditions. Improved oxygen systems can reduce childhood pneumonia mortality substantially. However, providing oxygen to children is challenging, especially in small hospitals with weak infrastructure and low human resource capacity. METHODS/

designThis trial will evaluate the implementation of improved oxygen systems at secondary-level hospitals in southwest Nigeria. The improved oxygen system includes: a standardised equipment package; training of clinical and technical staff; infrastructure support (including improved power supply); and quality improvement activities such as supportive supervision. Phase 1 will involve the introduction of pulse oximetry alone; phase 2 will involve the introduction of the full, improved oxygen system package. We have based the intervention design on a theory-based analysis of previous oxygen projects, and used quality improvement principles, evidence-based teaching methods, and behaviour-change strategies. We are using a stepped-wedge cluster randomised design with participating hospitals randomised to receive an improved oxygen system at 4-month steps (three hospitals per step). Our mixed-methods evaluation will evaluate effectiveness, impact, sustainability, process and fidelity. Our primary outcome measures are childhood pneumonia case fatality rate and inpatient neonatal mortality rate. Secondary outcome measures include a range of clinical, quality of care, technical, and health systems outcomes. The planned study duration is from 2015 to 2018. DISCUSSION: Our study will provide quality evidence on the effectiveness of improved oxygen systems, and how to better implement and scale-up oxygen systems in resource-limited settings. Our results should have important implications for policy-makers, hospital administrators, and child health organisations in Africa and globally.

trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12617000341325 . Retrospectively registered on 6 March 2017.

Indexed as

Delivery of Health Care, IntegratedDeveloping CountriesOxygen Inhalation TherapyPatient Care TeamSecondary Care CentersAdolescentAllied Health PersonnelChildChild MortalityChild, PreschoolClinical ProtocolsElectric Power SuppliesFemaleHospital MortalityHumansInfantChildDeveloping countriesInfantOximetryPneumoniaQuality improvementSolar energyStepped-wedge designTheory-based evaluation

Identifiers

PMID29078810
PMCPMC5659007
OpenAlexW2765449558

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.