Evidence map›Paper›PMID 35714630›Full record

Trial reportThe Lancet. Global health2022

Mobile health school screening and telemedicine referral to improve access to specialty care in rural Alaska: a cluster- randomised controlled trial.

Susan D Emmett, Alyssa Platt, Elizabeth L Turner, Joseph J Gallo, Alain B Labrique, S Meade Inglis, Cole D Jenson, Heather E Parnell, Nae-Yuh Wang, Kelli L Hicks and 5 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Lancet. Global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03309553 (Hearing Norton Sound), which is not on this map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
4.3field-weighted citation impact, top 5% 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.

NCT03309553 nacompletednot on this map

Hearing Norton Sound: A Community Randomized Trial to Address Childhood Hearing Loss in Rural Alaska

TypeinterventionalSponsorNorton Sound Health CorporationRan2017 to 2020Enrolled1,481ConditionsHearing LossArmsCurrent Primary Care Referral Process, Telemedicine Referral Process
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 38 citations in OpenAlex.

  1. Article
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  4. Characteristics of Hearing Aid Use in Adolescents Who Are Deaf and Hard of Hearing.Language, speech, and hearing services in schools · 2025
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  8. Review
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  13. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 2 countries.

Susan D EmmettDepartment of Head and Neck Surgery and Communication Science, Duke University School of Medicine, Duke University, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA; Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA. Electronic address: sdemmett@uams.edu.
Alyssa PlattDuke Global Health Institute, Duke University, Durham, NC, USA; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
Elizabeth L TurnerDuke Global Health Institute, Duke University, Durham, NC, USA; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
Joseph J GalloMixed Methods Research Training Program, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Alain B LabriqueDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
S Meade InglisDuke Global Health Institute, Duke University, Durham, NC, USA; Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA.
Cole D JensonDepartment of Audiology, Norton Sound Health Corporation, Nome, AK, USA.
Heather E ParnellDuke Global Health Institute, Duke University, Durham, NC, USA; Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA.
Nae-Yuh WangDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kelli L HicksDepartment of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Joseph R EggerDuke Global Health Institute, Duke University, Durham, NC, USA.
Peter F HalpinSchool of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Michael YongDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; BC Rotary Hearing and Balance Centre, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
Jeromie BallreichDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Samantha Kleindienst RoblerDepartment of Audiology, Norton Sound Health Corporation, Nome, AK, USA; Department of Population Health, Norton Sound Health Corporation, Nome, AK, USA.
Duke Institute for Health Innovation · USDuke University · USJohns Hopkins University · USNorton Sound Health Corporation · USUniversity of North Carolina at Chapel Hill · USJohns Hopkins Medicine · USUniversity of British Columbia · CA

Funding

Patient-Centered Outcomes Research Institute AD-1602-34571
6 · The paper itself

Abstract

backgroundSchool-based programmes, including hearing screening, provide essential preventive services for rural children. However, minimal evidence on screening methodologies, loss to follow-up, and scarcity of specialists for subsequent care compound rural health disparities. We hypothesised telemedicine specialty referral would improve time to follow-up for school hearing screening compared with standard primary care referral.

methodsIn this cluster-randomised controlled trial conducted in 15 rural Alaskan communities, USA, we randomised communities to telemedicine specialty referral (intervention) or standard primary care referral (control) for school hearing screening. All children (K-12; aged 4-21 years) enrolled in Bering Straight School District were eligible. Community randomisation occurred within four strata using location and school size. Participants were masked to group allocation until screening day, and assessors were masked throughout data collection. Screening occurred annually, and children who screened positive for possible hearing loss or ear disease were monitored for 9 months from the screening date for follow-up. Primary outcome was the time to follow-up after a positive hearing screen; analysis was by intention to treat. The trial was registered with ClinicalTrials.gov, NCT03309553.

findingsWe recruited participants between Oct 10, 2017, and March 28, 2019. 15 communities were randomised: eight (750 children) to telemedicine referral and seven (731 children) to primary care referral. 790 (53·3%) of 1481 children screened positive in at least one study year: 391 (52∤1%) in the telemedicine referral communities and 399 (50∤4%) in the primary care referral communities. Of children referred, 268 (68·5%) in the telemedicine referral communities and 128 (32·1%) in primary care referral communities received follow-up within 9 months. Among children who received follow-up, mean time to follow-up was 41·5 days (SD 55·7) in the telemedicine referral communities and 92·0 days (75·8) in the primary care referral communities (adjusted event-time ratio 17·6 [95% CI 6·8-45·3] for all referred children). There were no adverse events.

interpretationTelemedicine specialty referral significantly improved the time to follow-up after hearing screening in Alaska. Telemedicine might apply to other preventive school-based services to improve access to specialty care for rural children.

fundingPatient-Centered Outcomes Research Institute.

Indexed as

TelemedicineAlaskaChildHumansReferral and ConsultationRural PopulationSchools

Identifiers

PMID35714630
PMCPMC10642973
OpenAlexW4282914325

What OpenQuestion holds

Textmetadata
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.