Pediatric anesthesia & critical care
Impact of Tele-Emergency Consultations on Pediatric Interfacility Transfers: A Cluster-Randomized Crossover Trial
Primary result · Risk of transferResult — go to the resultRelative risk 0.93 95% CI 0.88–0.99Authors' conclusion
In this randomized trial, the use of telemedicine to conduct consultations for acutely ill children in rural and community EDs resulted in less frequent overall interfacility transfers than consultations done by telephone.
Study context
- Population
- Acutely ill children aged 14 years and younger presenting to 15 rural and community emergency departments (EDs) in northern California251 received telemedicine
- Participants
- 696 children
- Comparison
- Pediatric critical care telemedicine vs telephone consultations
- Telemedicinen = 537
- Primary endpoint
- Risk of transfer (mixed effects Poisson regression, random intercepts for presenting EDs)
Methodological detailscluster-randomized, unbalanced (3 telemedicine:1 telephone) assignment sequences, 15 rural and community EDs
- Cluster-randomized
- Unbalanced (3 telemedicine:1 telephone) assignment sequences
- 15 rural and community EDs
Primary result
Risk of transfer
Relative risk
0.93
95% CI 0.88–0.99
Telemedicine vs Telephone
RR 0.93 (95% CI 0.88–0.99)
As reported in the abstract
Further findings
| Outcome | RR (95% CI) | |
|---|---|---|
| Risk of transfer (treatment-received analysis)Adjusted · treatment-received | 0.81 (0.71–0.94) | |
| Risk of transfer (per-protocol analysis)Adjusted · per-protocol | 0.79 (0.68–0.92) | |
| 0.512Relative risk (log scale) |
Original publication
Impact of Tele-Emergency Consultations on Pediatric Interfacility Transfers: A Cluster-Randomized Crossover Trial. JAMA Netw Open. Published 1 February 2023. doi:10.
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