Evidence map›Paper›PMID 41523929›Full record

ArticleHRB open research2025

Navigating Complexities In Randomized Trials: Insights From The EMERGE Trial Amidst Pandemic And Cybersecurity Threat.

Christine Newman, Fidelma Dunne, Alberto Alvarez-Iglesias, Marie Browne, Michelle Courcy Byrnes, Declan Devane, Paddy Gillespie, Chloe Ryan, Roberta Scairati, Sinead Wallace and 2 more

Abstract read
In one paragraph

Article in HRB open research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Christine NewmanCollege of nursing, medicine and health science, University of Galway, Galway, County Galway, Ireland.ORCID https://orcid.org/0000-0003-2387-4109
Fidelma DunneCollege of nursing, medicine and health science, University of Galway, Galway, County Galway, Ireland.
Alberto Alvarez-IglesiasHRB Clinical Research Facility, Galway, County Galway, Ireland.
Marie BrowneHRB Clinical Research Facility, Galway, County Galway, Ireland.
Michelle Courcy ByrnesHRB Clinical Research Facility, Galway, County Galway, Ireland.
Declan DevaneCollege of nursing, medicine and health science, University of Galway, Galway, County Galway, Ireland.
Paddy GillespieSchool of Business and Economics, University of Galway, Galway, County Galway, Ireland.
Chloe RyanHRB Clinical Research Facility, Galway, County Galway, Ireland.
Roberta ScairatiHRB Clinical Research Facility, Galway, County Galway, Ireland.ORCID https://orcid.org/0009-0002-7353-8437
Sinead WallaceHRB Clinical Research Facility, Galway, County Galway, Ireland.
Martin O'DonnellCollege of nursing, medicine and health science, University of Galway, Galway, County Galway, Ireland.
Andrew SmythCollege of nursing, medicine and health science, University of Galway, Galway, County Galway, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The COVID-19 pandemic caused by the SARS-CoV-2 virus changed the global landscape of clinical trials; changes in staffing, clinical priorities and recruitment challenges led to the delay or termination of many clinical trials. The Early Metformin in Gestational Diabetes (EMERGE) trial was completed despite COVID-19 and institutional computer network attacks (CNAs). Methods: Here we outline the challenges encountered and the solutions employed to continue the active recruitment of a potentially high risk patient cohort during the Covid-19 pandemic and detail the techniques adapted to enable recruitment, adverse event reporting and lab reporting during two critical computer network attacks. We present our solutions from both the site and sponsor perspective. Results: COVID-19 and the computer network attacks presented many challenges for the clinical trial site and Sponsor including staff shortages, remote working, deferred recruitment, changes in the diagnostic pathway for gestational diabetes mellitus and pivoting to remote working and telemedicine. The first CNA impeded clinical and laboratory systems, impacting recruitment and follow up. The second CNA delayed access to the Clinical Data Management System. Solutions employed included telemedicine, videoconferencing, shortened in-person reviews, contact tracing, COVID-19 risk mitigations, paper-based back-up systems and vigorous data integrity checks. Conclusion: Overcoming the multiple challenges posed by COVID-19 and computer network attacks required rapid re-organisation, teamwork and flexibility from staff and Sponsor. The use of both digital solutions and paper-based records highlighted the importance of rapid innovation and comprehensive protocol planning.

Indexed as

COVID-19; Diabetesgestational; Clinical Trials; Computer security

Identifiers

PMID41523929
PMCPMC12784043

What OpenQuestion holds

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Registered trials

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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.