Novel Technologies for Identifying Treatment Assignment in a Prehospital Pediatric Emergency Care Clinical Trial

Clinical trials are essential for generating evidence-based knowledge to support clinical practice. In the prehospital setting, particular challenges exist in clinical trial design that have a large impact on the quality of the results, including the appropriate and systematic allocation of assigned treatment arm. The Pediatric Prehospital Airway Resuscitation Trial is a multicenter clinical trial evaluating different paramedic airway management strategies on critically ill and injured children in the prehospital setting. The trial assigns airway management strategy using odd-even day pseudo-randomization, which pragmatically balances the rigor of a statistical design that minimizes bias with the complexities of operationalizing a clinical trial in the prehospital setting. We describe the development of 2 technologies to aid in treatment assignment adherence during the trial: (1) a quick response code-linked web application, and (2) a self-contained portable reminder device. These technologies offer novel approaches to support treatment allocation in acute care clinical trials.