In children with acute asthma of moderate severity who are treated with adequate doses of salbutamol and prednisolone, the addition of IB is not significantly associated with a reduction in admission rates. There is a significantly higher rate of adverse effects if IB is given. IB should be reserved for children with severe asthma exacerbations.

Objective: This pilot study assessed the efficacy of personalised, printed and mobile-accessible discharge instructions for pain relief for patients discharged from the ED. Methods: Patients presenting with pain caused by acute musculoskeletal or visceral complaints not requiring admission were eligible. Both groups received usual pain relief discharge advice, the intervention group received additional personalised printed and mobile-accessible discharge instructions. Numerical Rating Scale pain scores were measured at ED visit. Pain scores, Patient Global Impression of Change scale improvement scores, satisfaction with instructions, recall of pain relief advice, receipt of side effects advice and unscheduled visits were measured at 5 days. Results: A total of 80 patients, recruited over 14 days, were randomly allocated to the intervention or control group. Two patients were excluded and 81% (n = 65) were followed up at 5 days. There was no significant difference in change of pain scores or improvement scores between groups from visit to 5 day follow up. The intervention group showed significantly higher odds of being 'very satisfied' compared to the control group (odds ratio [OR] 7.14, 95% confidence interval [CI] 1.18-50.00), significantly higher odds of full recall of pain relief medication advice (OR 20.00, 95% CI 1.56-100.00) and significantly higher odds of receiving information on medication side effects (OR 6.25, 95% CI 1.67-20.00). Conclusions: Patients who received personalised printed and mobileaccessible ED discharge instructions for pain relief reported higher levels of satisfaction with their instructions, had better recall of their pain relief medications advice and received more information on medication side-effects.

Background Acute respiratory infection (ARI) in childhood is common, but more knowledge on the burden and natural history of ARI in the community is required. A better understanding of ARI risk factors, treatment, and outcomes will help support parents to manage their sick child at home. Digital health tools are becoming more widely adopted in clinical care and research and may assist in understanding and managing common pediatric diseases, including ARI, in hospitals and in the community. We integrated 2 digital tools—a web-based discharge communication system and the REDCap (Research Electronic Data Capture) platform—into the Pragmatic Adaptive Trial for Acute Respiratory Infection in Children to enhance parent and physician engagement around ARI discharge communication and our patient registry. Objective The objective of this study is to determine the efficacy and usability of digital tools integrated into a pediatric patient registry for ARI. Methods Semistructured interviews and software interface usability testing were conducted with 11 parents and 8 emergency department physicians working at a tertiary pediatric hospital and research center in Perth, Western Australia, in 2019. Questions focused on experiences of discharge communication and clinical trial engagement. Responses were analyzed using the qualitative Framework Method. Participants were directly observed using digital interfaces as they attempted predetermined tasks that were then classified as success, failure, software failure, or not observed. Participants rated the interfaces using the System Usability Scale (SUS). Results Most parents (9/11, 82%) indicated that they usually received verbal discharge advice, with some (5/11, 45%) recalling receiving preprinted resources from their physician. Most (8/11, 73%) would also like to receive discharge advice electronically. Most of the physicians (7/8, 88%) described their usual practice as verbal discharge instructions, with some (3/8, 38%) reporting time pressures associated with providing discharge instructions. The digital technology option was preferred for engaging in research by most parents (8/11, 73%). For the discharge communication digital tool, parents gave a mean SUS score of 94/100 (SD 4.3; A grade) for the mobile interface and physicians gave a mean usability score of 93/100 (SD 4.7; A grade) for the desktop interface. For the research data management tool (REDCap), parents gave a mean usability score of 78/100 (SD 11.0; C grade) for the mobile interface. Conclusions Semistructured interviews allowed us to better understand parent and physician experiences of discharge communication and clinical research engagement. Software interface usability testing methods and use of the SUS helped us gauge the efficacy of our digital tools with both parent and physician users. This study demonstrates the feasibility of combining qualitative research methods with software industry interface usability testing methods to help determine the efficacy of digital tools in a pediatric clinical research setting.

Our data confirm the impression that children with certain categories of first names have an increased likelihood of admission to hospital after presenting to the ED. We speculate that our findings, which are in concordance with those from educational and psychological literature, may reflect socio-economic status and/or a 'self-fulfilling prophecy'. Further research may make it possible to assign names an RR rating (e.g. for hospital admission in the first 16 years of life), thus providing parents with another factor to consider when choosing names for their children. More studies are of course needed.

BACKGROUND Acute respiratory infection (ARI) in childhood is common but more knowledge on the burden and natural history of ARI in the community is required. A better understanding of ARI risk factors, treatment and outcomes will help support parents/carers managing their sick child at home. Digital health tools are becoming more widely adopted in clinical care and research and may assist in understanding and managing common paediatric diseases including ARI in hospitals and the community. We integrated 2 digital tools - a web-based discharge communication system and the Research Electronic Data Capture management platform (REDCap) into the Pragmatic Adaptive Trial for Acute Respiratory Infection in Children (PATRIC) - to enhance parent/carer and doctor engagement around ARI discharge communication and our research initiative. OBJECTIVE To determine the efficacy and usability of digital tools integrated into a paediatric patient registry for acute respiratory infection. METHODS Semi-structured interviews followed by software interface usability testing was conducted with 11 parents and 8 emergency department (ED) doctors working at a tertiary paediatric hospital and research centre in Perth, Western Australia in 2019. Interview questions focussed on experiences of discharge communication and clinical trial engagement. Responses were analysed using the qualitative framework method. Usability testing was carried out by directly observing participants attempting pre-determined tasks which were classified as a “success”, “failure”, “failure due to software” or “not-observed”. Participants rated the interface with the System Usability Scale (SUS - a widely used Likert-type 10 question survey measuring a user’s satisfaction converted into an overall usability score out of 100). RESULTS Parents expressed concerns about recalling verbal discharge advice and suggested technology as a viable option for discharge communication and engagement in clinical research. Doctors described the time-pressures and challenges associated with providing discharge instructions. For the discharge communication digital tool, parents gave a mean System Usability Scale score of 94/100 (“A” rating) for the mobile interface and doctors gave a mean usability score of 93/100 (“A” rating”) for the desktop interface. For the research data management tool (REDCap), parents gave a mean usability score of 78/100 (“C” rating) for the mobile interface. CONCLUSIONS This study demonstrates the feasibility of combining qualitative research methods with software industry interface usability testing methods to help determine the efficacy of digital tools in a paediatric clinical research setting.