A prehospital randomised controlled trial in South Africa : Challenges and lessons learnt

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dc.contributor.author Stassen, Willem
dc.contributor.author Wallis, Lee
dc.contributor.author Castren, Maaret
dc.contributor.author Vincent-Lambert, Craig
dc.contributor.author Kurland, Lisa
dc.date.accessioned 2019-10-02T06:48:03Z
dc.date.available 2019-10-02T06:48:03Z
dc.date.issued 2019-09
dc.identifier.citation Stassen , W , Wallis , L , Castren , M , Vincent-Lambert , C & Kurland , L 2019 , ' A prehospital randomised controlled trial in South Africa : Challenges and lessons learnt ' , African journal of emergency medicine , vol. 9 , no. 3 , pp. 145-149 . https://doi.org/10.1016/j.afjem.2019.02.002
dc.identifier.other PURE: 127184492
dc.identifier.other PURE UUID: 66d1b38a-7e08-4f03-b26e-b2e5e9a45fba
dc.identifier.other WOS: 000484785500008
dc.identifier.uri http://hdl.handle.net/10138/305772
dc.description.abstract The incidence of cardiovascular disease and STEMI is on the rise in sub-Saharan Africa. Timely treatment is essential to reduce mortality. Internationally, prehospital 12 lead ECG telemetry has been proposed to reduce time to reperfusion. Its value in South Africa has not been established. The aim of this study was to determine the effect of prehospital 12 lead ECG telemetry on the PCI-times of STEMI patients in South Africa. A multicentre randomised controlled trial was attempted among adult patients with prehospital 12 lead ECG evidence of STEMI. Due to poor enrolment and small sample sizes, meaningful analyses could not be made. The challenges and lessons learnt from this attempt at Africa's first prehospital RCT are discussed. Challenges associated with conducting this RCT related to the healthcare landscape, resources, training of paramedics, rollout and rando-misation, technology, consent and research culture. High quality evidence to guide prehospital emergency care practice is lacking both in Africa and the rest of the world. This is likely due to the difficulties with performing prehospital clinical trials. Every trial will be unique to the test intervention and setting of each study, but by considering some of the challenges and lessons learnt in the attempt at this trial, future studies might experience less difficulty. This may lead to a stronger evidence-base for prehospital emergency en
dc.format.extent 5
dc.language.iso eng
dc.relation.ispartof African journal of emergency medicine
dc.rights cc_by_nc_nd
dc.rights cc_by_nc_nd
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject ST-elevation myocardial infarction
dc.subject South Africa
dc.subject Telemedicine
dc.subject Randomised controlled trials
dc.subject Research methods
dc.subject ACUTE MYOCARDIAL-INFARCTION
dc.subject ST-SEGMENT ELEVATION
dc.subject LIFE-SUPPORT PARAMEDICS
dc.subject INFORMED-CONSENT
dc.subject 12-LEAD ELECTROCARDIOGRAM
dc.subject PRIMARY ANGIOPLASTY
dc.subject EMERGENCY CARE
dc.subject TO-BALLOON
dc.subject TIME
dc.subject REPERFUSION
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title A prehospital randomised controlled trial in South Africa : Challenges and lessons learnt en
dc.type Article
dc.contributor.organization HUS Emergency Medicine and Services
dc.contributor.organization Department of Diagnostics and Therapeutics
dc.contributor.organization Anestesiologian yksikkö
dc.contributor.organization Clinicum
dc.contributor.organization Helsinki University Hospital Area
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/j.afjem.2019.02.002
dc.relation.issn 2211-419X
dc.rights.accesslevel openAccess
dc.type.version publishedVersion
dc.type.version draft

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