Evidence mapPaperPMID 41535774Full record

Trial reportBMC medical research methodology2026

Rapid, effective, and affordable randomisation for emergency neonatal research in a low-resource setting: a feasibility randomised controlled trial.

Kathy Burgoine, Francis Okello, Grace Abongo, Eunice Akot, Linda Isabirye, Daniel Caleb, Alice Nakiyemba, Agnes Napyo, Cornelia Hagmann, Judith Namuyonga and 7 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC medical research methodology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

17 authors.

Kathy BurgoineMbale Clinical Research Institute (MCRI), Mbale, Uganda. Kathy.burgoine@gmail.com.
Francis OkelloFaculty of Health Science, Busitema University, Mbale, Uganda.
Grace AbongoMbale Clinical Research Institute (MCRI), Mbale, Uganda.
Eunice AkotMbale Clinical Research Institute (MCRI), Mbale, Uganda.
Linda IsabiryeMbale Clinical Research Institute (MCRI), Mbale, Uganda.
Daniel CalebMbale Clinical Research Institute (MCRI), Mbale, Uganda.
Alice NakiyembaBusitema University, Tororo, Uganda.
Agnes NapyoFaculty of Health Science, Busitema University, Mbale, Uganda.
Cornelia HagmannDepartment of Neonatology, University Hospital Zürich, Zürich, Switzerland.
Judith NamuyongaMakerere University College of Health Sciences, Kampala, Uganda.
Adam Hewitt-SmithMbale Regional Referral Hospital, Mbale, Uganda.
Martha MuduwaMbale Clinical Research Institute (MCRI), Mbale, Uganda.
Kate LoeDelft University of Technology, Delft, Netherlands.
Denis AmorutMbale Clinical Research Institute (MCRI), Mbale, Uganda.
Julius WandabwaFaculty of Health Science, Busitema University, Mbale, Uganda.
Peter Olupot-OlupotMbale Clinical Research Institute (MCRI), Mbale, Uganda.
John M SsenkusuSchool of Public Health, Makerere University, Kampala, Uganda.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundRandomisation is an essential component of any clinical trial to eliminate selection bias and ensure similar distribution of confounders between the treatment groups. For randomisation to be successfully implemented, there must be adequate allocation concealment. Many low-cost randomisation and allocation concealment methods have the potential to introduce bias by ineffectively concealing the allocation sequence from the researcher and are now rarely used in high-resource settings. In such settings, centralised randomisation services have been developed to prepare the randomisation sequence, conceal the sequence, and provide a secure mechanism to acquire the allocation. Such services are often prohibitively expensive for researchers in low-resource settings or for small/pilot trials. We describe our experience of adopting a low-cost third-party randomisation and allocation concealment process for emergency neonatal research in a low-resource setting.

methodsThis was a single-site feasibility trial in Eastern Uganda, which randomly assigned neonates in a 1:1 ratio at birth to receive either early continuous positive airways pressure (intervention) or standard of care (control). Centralised third-party randomisation and allocation were used, with two researchers not involved in the trial serving as randomisation coordinators. The lead coordinator prepared a randomisation schedule using http://www.randomization.com/ . This was stored securely on a server with exclusive access granted to the randomisation coordinators. Randomly permuted block randomisation was used to ensure balance between the two arms and enhance concealment in group allocation. Block sizes were varied and kept confidential from the investigators and research assistants to prevent prediction of upcoming assignments, and the randomisation sequence was managed by an independent third party. After identifying and obtaining consent, the research assistant requested an allocation from the randomisation coordinators by SMS. Upon receiving the SMS request, the randomisation coordinators sent the allocation to a study tablet device by email. The time from sending the SMS request to the time the allocation email was received was used to evaluate the suitability of this method.

resultsOne hundred participants were successfully randomised. Group allocation was received for 91/100 (91.0%; 95%CI 84–96%) of participants within 15 min of the research assistant sending the SMS request, and for 98/100 (98.0%; 95%CI 93–100%) within 30 min.

conclusionThis study demonstrates that a low-cost, third-party randomisation method is a feasible and effective approach for emergency neonatal research in low-resource settings. It enabled timely and concealed allocation without the high costs associated with centralised systems. This method presents a scalable solution for small to medium-sized trials where rapid and unbiased allocation is critical.

trial registrationStudy is registered on Pan African Clinical Trials Registry (PACTR) PACTR202208462613789. Registered 08 August 2022. https//pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=23,888 .

Indexed as

Continuous Positive Airway PressureFeasibility StudiesFemaleHealth ResourcesHumansInfant, NewbornResource-Limited SettingsUgandaEmergency researchLow-resource settingRandomisation

Identifiers

PMID41535774
PMCPMC12888521

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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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 Socratic graph.