Evidence map›Paper›PMID 34493311›Full record

Trial reportTrials2021

The future is now: our experience starting a remote clinical trial during the beginning of the COVID-19 pandemic.

Hans H Liu, Michael D Ezekowitz, Michele Columbo, Oneib Khan, Jack Martin, Judith Spahr, David Yaron, Lisa Cushinotto, Luciano Kapelusznik

Registry-linked trialOpen access · goldAbstract readLetterRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04652648 (Rapid Development and Implementation of a Remote ECG-monitored Prospective Randomized Clinical Trial During a Pandemic), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 42% 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.

NCT04652648 phase4completednot on this map

Rapid Development and Implementation of a Remote ECG-monitored Prospective Randomized Clinical Trial During a Pandemic: Hydroxychloroquine Prophylaxis in COVID-19 Household Contacts

TypeinterventionalSponsorBryn Mawr HospitalRan2020 to 2020Enrolled54ConditionsCovid19, Hydroxychloroquine, Coronavirus Infection, TransmissionArmsHydroxychloroquine
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

9 authors at 3 institutions in 2 countries.

Hans H LiuDepartment of Medicine, Bryn Mawr Hospital, Bryn Mawr, PA, USA. LIULIANG@AOL.COM.ORCID http://orcid.org/0000-0001-6511-7398
Michael D EzekowitzDepartment of Medicine, Bryn Mawr Hospital, Bryn Mawr, PA, USA.
Michele ColumboDepartment of Medicine, Bryn Mawr Hospital, Bryn Mawr, PA, USA.
Oneib KhanLankenau Internal Medicine Residency Program, Lankenau Hospital, Main Line Health System, Wynnewood, PA, USA.
Jack MartinDepartment of Medicine, Bryn Mawr Hospital, Bryn Mawr, PA, USA.
Judith Spahr, Lewes, DE, USA.
David YaronBryn Mawr Family Practice Residency, Bryn Mawr Hospital, Bryn Mawr, PA, USA.
Lisa CushinottoDepartment of Pharmacy, Bryn Mawr Hospital, Bryn Mawr, PA, USA.
Luciano KapelusznikDepartment of Medicine, Bryn Mawr Hospital, Bryn Mawr, PA, USA.
Bryn Mawr Hospital · USLewes Victoria Hospital · GBMain Line Health · US

Funding

Bryn Mawr Hospital, Bryn Mawr, PA (US) n/aMary Lane n/aSharpe-Strumia Research Foundation SSRF2020-23Wistar Morris Cotswold Foundation n/a
6 · The paper itself

Abstract

backgroundThe World Health Organization declared the outbreak of SARS-CoV-2 a pandemic on February 11, 2020. This organism causes COVID-19 disease and the rapid rise in cases and geographic spread strained healthcare systems. Clinical research trials were hindered by infection control measures discouraging physical contact and diversion of resources to meet emergent requirements. The need for effective treatment and prevention of COVID-19 prompted an untested investigational response. Trial groups adapted approaches using remote enrolment and consenting, newly developed diagnostic tests, delivery of study medications and devices to participants' homes, and remote monitoring to ensure investigator/enrollee safety while preserving ethical integrity, confidentiality, and data accuracy.

methodsClinical researchers at our community health system in the USA undertook an outpatient randomized open-label study of hydroxychloroquine (HCQ) prophylaxis versus observation of SARS-CoV-2 infection in household COVID-19 contacts. Designed in March 2020, challenges included COVID-19 infection in the research group, HCQ shortage, and lack of well-established home SARS-CoV-2 tests and remote ECG monitoring protocols in populations naive to these procedures. The study was written, funded, and received ethical committee approval in 4 months and was completed by September 2020 during a period of fluctuating infection rates and conflicting political opinions on HCQ use; results have been published. Singular methodology included the use of a new RNA PCR saliva SARS-CoV-2 home diagnostic test and a remote smartphone-based 6-lead ECG recording system.

resultsOf 483 households contacted regarding trial participation, 209 (43.3%) did not respond to telephone calls/e-mails and 90 (18.6%) declined; others were not eligible by inclusion or exclusion criteria. Ultimately, 54 individuals were enrolled and 42 completed the study. Numbers were too small to determine the efficacy of HCQ prophylaxis. No serious treatment-related adverse events were encountered.

conclusionsFlexibility in design, a multidisciplinary research team, prompt cooperation among research, funding, ethics review groups, and finding innovative study approaches enabled this work. Concerns were balancing study recruitment against unduly influencing individuals anxious for protection from the pandemic and exclusion of groups based on lack of Internet access and technology. An issue to address going forward is establishing research cooperation across community health systems before emergencies develop.

trial registrationClinicalTrials.gov NCT04652648 . Registered on December 3, 2020.

Indexed as

COVID-19PandemicsHumansHydroxychloroquineSARS-CoV-2Treatment OutcomeHydroxychloroquineCOVID-19 pandemicHydroxychloroquineProspective clinical trialRemote ECG monitoringSARS-CoV-2Trial management

Identifiers

PMID34493311
PMCPMC8422835
OpenAlexW3198163217

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.