Evidence map›Paper›PMID 42349912›Full record

Trial reportBMJ global health2026

Feasibility of prehospital telemedicine for paediatric emergencies: a cluster-randomised pilot trial in Karachi, Pakistan.

Junaid Abdul Razzak, Sheza Hassan, Huba Atiq, Walid Farooqi, Kamran Idris, Irfan Habib, Saira Noushad, Shane Pathania, Brady Rippon, Zeeshan Noor Shaikh and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07027813 (Feasibility and Efficacy of Ambulance-Based m-Health for Pediatric Emergencies in Low Resource Settings), which is not on this 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.

NCT07027813 narecruitingnot on this map

Feasibility and Efficacy of Ambulance-Based m-Health for Pediatric Emergencies in Low Resource Settings (FEAMER) Trial

TypeinterventionalSponsorWeill Medical College of Cornell UniversityRan2025 to 2026Enrolled900ConditionsEmergencies, mHealth, Child Health, Critical IllnessArmsTelemedicine, Control
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

13 authors.

Junaid Abdul RazzakDepartment of Emergency Medicine, Weill Cornell Medicine, New York, New York, USA Jur9123@med.cornell.edu.ORCID 0000-0003-0735-9094
Sheza HassanDepartment of Emergency Medicine, Weill Cornell Medicine, New York, New York, USA.ORCID 0000-0002-9432-8212
Huba AtiqCenter of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Sindh, Pakistan.
Walid FarooqiDepartment of Emergency Medicine, Weill Cornell Medicine, New York, New York, USA.ORCID 0000-0002-2974-2636
Kamran IdrisSindh Integrated Emergency and Health Services, Karachi, Sindh, Pakistan.ORCID 0009-0004-0254-1617
Irfan HabibChildLife Foundation, Karachi, Sindh, Pakistan.
Saira NoushadChildLife Foundation, Karachi, Sindh, Pakistan.
Shane PathaniaWeill Cornell Medical College, New York, New York, USA.
Brady RipponDepartment of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA.
Zeeshan Noor ShaikhSindh Integrated Emergency and Health Services, Karachi, Sindh, Pakistan.
Ali KashanSindh Integrated Emergency and Health Services, Karachi, Sindh, Pakistan.
Amyna HusainJohns Hopkins Medicine, Baltimore, Maryland, USA.
Adil HaiderCenter of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Sindh, Pakistan.

Funding

NICHD Eunice Kennedy Shriver National Institute of Child Health and Human Development R21-HD103049
6 · The paper itself

Abstract

backgroundNearly half of all 4.8 million annual paediatric deaths worldwide are caused by acute illnesses, which are preventable with timely triage, emergency care and prehospital transport. We assessed the feasibility of using telemedicine to connect emergency medical technicians (EMTs) in ambulances with paediatric telemedicine physicians (TMPs) to improve patient care in a low-resource setting.

methodsWe conducted a pilot cluster-randomised trial in Karachi, Pakistan, with city's primary emergency medical transport provider and a paediatric telemedicine facility. Ten ambulances were randomised equally to intervention (real-time audiovisual telemedicine support) and control arms. The intervention was piloted using 25 simulated cases, followed by low-acuity and high-acuity patients as classified by the Medical Priority Dispatch System. Primary outcomes included rates of refusal, call completion, safety (rated by EMTs and TMPs) and completion of the Paediatric Early Warning Score (PEWS) in ambulances and hospitals.

findingsOf 166 parents approached, 151 (91%) consented; 73 patients were assigned to the intervention and 78 to the control. The mean patient age was 2.5 years (SD 43 months; range 1 day-12 years). Ambulance dispatchers categorised 35.7% as low acuity and 64.3% as high acuity. Most cases (68%) were interhospital transfers. Calls were completed in 96% of cases; 87% of calls received favourable audio/video quality scores. All interactions were rated as very safe, safe or neutral; none was deemed unsafe. 91% of EMTs and TMPs rated the system as usable (System Usability Scale). PEWS was completed for 100% of patients in ambulances and 86% in the emergency department.

interpretationProviding real-time telemedicine support to EMTs in ambulances is feasible and safe in low-resource settings. These findings support further research into the clinical impact and scalability of prehospital telemedicine for paediatric emergencies. TRIAL REGISTRATION NUMBER: This project is a pilot trial for the Cluster Randomised Trial NCT07027813 titled 'Feasibility and Efficacy of Ambulance-Based m-Health for Paediatric Emergencies (FEAMER) Trial (FEAMER)' registered on 19 June 2025. The link to the clinicaltrials.gov is attached here: https://clinicaltrials.gov/study/NCT07027813.

Indexed as

EmergenciesEmergency Medical ServicesTelemedicineAmbulancesChildChild, PreschoolFeasibility StudiesFemaleHumansInfantInfant, NewbornMalePakistanPilot ProjectsResource-Limited SettingsChild healthCluster randomized trialHealth services researchPublic HealthTelemedicine

Identifiers

PMID42349912
PMCPMC13295838

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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.