Evidence map›Paper›PMID 39929261›Full record

ArticleContemporary clinical trials2025

Treating seizures faster: The Quality Improvement in Time to Treat Status Epilepticus (QuITT-SE) multicenter randomized stepped wedge clinical trial protocol.

Adam P Ostendorf, Tobias Loddenkemper, Lindsey A Morgan, Brian Appavu, Raquel Farias-Moeller, Dana Harrar, Craig Press, Nicholas S Abend, William D Gaillard, Shasha Bai and 5 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Contemporary clinical trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06194747 (Quality Improvement in Time to Treatment of Status Epilepticus), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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.

NCT06194747 narecruitingnot on this map

Quality Improvement in Time to Treatment of Status Epilepticus

TypeinterventionalSponsorNationwide Children's HospitalRan2024 to 2027Enrolled450ConditionsStatus EpilepticusArmsQuality improvement bundle, Quality improvement bundle and local PDSA cycles with central support, Quality improvement bundle and local PDSA cycles without central support
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Review
  6. 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

15 authors.

Adam P OstendorfNationwide Children's Hospital and The Ohio State University, 700 Children's Drive, Columbus, OH 43230, USA. Electronic address: adam.ostendorf@nationwidechildrens.org.
Tobias LoddenkemperBoston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
Lindsey A MorganSeattle Children's Hospital and University of Washington, 4800 Sand Point Way NE, Seattle, WA 98105, USA.
Brian AppavuDivision of Neurology Department of Neuroscience, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85213, USA.
Raquel Farias-MoellerDepartment of Neurology, Division of Pediatric Neurology, Children's Wisconsin and the Medical College of Wisconsin, 8915 W Connell Avenue, Milwaukee, WI 53226, USA.
Dana HarrarCenter for Neuroscience and Behavioral Health, Children's National Hospital, George Washington University, 111 Michigan Avenue NW, Washington, DC 20010, USA.
Craig PressDepartments of Neurology and Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Nicholas S AbendDepartments of Neurology and Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
William D GaillardCenter for Neuroscience and Behavioral Health, Children's National Hospital, George Washington University, 111 Michigan Avenue NW, Washington, DC 20010, USA.
Shasha BaiEmory University School of Medicine, 2015 Uppergate Dr, Atlanta, GA 30307, USA.
Mariah EisnerBiostatics Resource at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43230, USA.
Lauren McHenryNationwide Children's Hospital and The Ohio State University, 700 Children's Drive, Columbus, OH 43230, USA.
Emily KroshusDepartment of Pediatrics, University of Washington, 4800 Sand Point Way NE, Seattle, WA 98105, USA.
Kathryn VannattaNationwide Children's Hospital and The Ohio State University, 700 Children's Drive, Columbus, OH 43230, USA.
Howard P GoodkinDepartment of Neurology, University of Virginia School of Medicine, 1215 Lee Street, Charlottesville, VA 22903, USA.

Funding

Quality Improvement in time to Treatment of Status Epilepticus (QuITT-SE)R01NS133037 · NINDS · RESEARCH INST NATIONWIDE CHILDREN'S HOSP · PI ADAM P. OSTENDORF · 2023 to 2026
$2.7M
NINDS NIH HHS R01 NS133037
6 · The paper itself

Abstract

backgroundAcute seizures may evolve into status epilepticus (SE), prolonged and self-sustaining seizures that may result in brain injury or death. Rapid treatment with a benzodiazepine (BZD) is most effective. However, SE treatment remains delayed in many cases. We previously performed a single-center quality improvement study which resulted in more rapid treatment, decreased intensive care utilization, and decreased cost. Now, we are conducting a multicenter trial to test the hypothesis that pragmatic changes in treating acute inpatient seizures reduce time and are implementable across diverse hospital settings. METHODS/

designWe designed a multicenter stepped wedge cluster randomized trial with three unidirectional 12-month steps following one baseline step. After dissemination visits, sites will attempt to implement a standardized bundle consisting of: (1) standardize default BZD to non-IV; (2) target treatment time within 10 min; (3) relocate and bundle items for BZD administration to a single location; (4) prioritize basic seizure first aid as initial assessment; (5) implement SE-specific documentation templates; (6) implement multidisciplinary site QI teams. Our primary outcome is median time from seizure diagnosis to BZD administration. Secondary outcomes are median changes in Pediatric Cerebral Performance Category score, ICU transfer rate, and cost of hospitalization. We will study implementation outcomes using mixed methods based on the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. DISCUSSION: QuITT-SE is designed to test the effect and implementation of a pragmatic set of interventions on treatment times in SE. If successful, results will provide a generalizable roadmap for broad implementation through healthcare systems that should improve outcomes in SE.

trial registrationClinicaltrials.gov (NCT06194747). Funded by the National Institutes of Health (R01NS133037).

Indexed as

AnticonvulsantsBenzodiazepinesQuality ImprovementSeizuresStatus EpilepticusTime-to-TreatmentHumansMulticenter Studies as TopicRandomized Controlled Trials as TopicTime FactorsAnticonvulsantsBenzodiazepinesBenzodiazepineImplementation scienceQuality improvementSeizureStatus epilepticusStepped wedge design

Identifiers

PMID39929261
PMCPMC12087793

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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.