Department of Clinical Research

ComBaScale aims to empower community health workers (CHWs) in under-resourced settings to deliver a high-quality, evidence-based, holistic package of integrated care for cardiovascular risk factors (CVRF). Its scalability will be tested in two districts of Lesotho, a low-income country disproportionately affected by a rising burden of non-communicable diseases (NCDs).

Guided by a validated implementation framework, trial evidence on the safety and effectiveness of CHW-led titration of antihypertensive and antidiabetic therapy will be translated into practice, while embedded in the national system. A pilot study will refine the intervention and align it with CHWs’ routine responsibilities, including HIV and tuberculosis screening, before roll-out through a stepped-wedge cluster randomised trial with a hybrid effectiveness-implementation design.

The CHWs will be supported by a patient-facing clinical decision-support application, interoperable with the national information system and featuring an innovative authoring tool to ensure safety and guideline fidelity. The trial will include an equity-informative extended cost-effectiveness analysis, while mixed-methods will examine acceptability, stigma, and gender-related barriers.

People living with CVRF will play a central role in co-developing and monitoring the intervention via community advisory boards, alongside village authorities, implementing partners, and researchers. All trial results, implementation frameworks, training material, and digital tools will be compiled in a comprehensive toolkit and piloted in a separate district for further scale-up. By applying the principles of implementation science throughout, ComBaScale will generate a validated, co-created, integrated CVRF care package, ready for adaptation across Lesotho and other under-resourced populations to reduce the NCD burden globally.

In the PRISM project, professional clinical research infrastructures and service-oriented organisations will offer the paediatric clinical research community high-quality, leading-edge and coordinated TransNational Access (TNA) services for the design, planning and conduct of paediatric interventional or observational clinical studies. Services include end-to-end support for the design, planning and execution of multinational studies conducted in 3 to 6 countries in Europe and Canada (TNA1, WP1, 50% of total budget); consulting services for the planning and design of paediatric studies (TNA2, WP2) and virtual services (TNA3, WP4) on leading-edge methodologies, new trial designs (including platform trials, trials within cohorts, decentralised trials), and access to AI and digital tools, following final development and adaptation to paediatric needs (WP5). Supported paediatric studies will be selected based on scientific excellence and public health relevance by an independent expert panel (WP3), with a two-stage procedure for the TNA1 allowing for support to the planning and design of short-listed projects between the first and second steps, thus optimising the final study protocol before execution. Training will be provided (WP7) for infrastructure staff involved in the development and provision of new services, and for the infrastructure users, i.e. paediatric research and investigation / rare diseases networks, and private or public sponsor teams. Beyond the end of PRISM (WP6), its ambition is offering the paediatric research community coordinated services, avoiding duplication and promoting synergies, according to a mechanism agreed with all the relevant stakeholders in paediatric clinical research (infrastructures, technology providers, sponsors, investigation networks, patients) through contractual arrangements leading to a joint access mechanism.

Background: Accurate measurement of patient height is critical in intensive care units (ICUs) for calculating ideal body weight, which directly guides weight-based interventions such as lung-protective ventilation settings and tidal volume adjustments. Currently, height estimation by ICU physicians and nursing staff is often unreliable, potentially leading to medical errors and suboptimal patient care. To overcome the challenges of measuring highly instrumented or immobile patients, contactless smartphone-based distance-measurement applications could offer a reliable, safe, and practical alternative in clinical practice.

Study Aim: first, to investigate whether the visual height estimations by nursing staff and physicians at the intensive care unit of the University Hospital Basel are indeed unreliable when compared to standard tape-measure readings with patient contact; second, to evaluate whether contactless height measurement using smartphone distance-measuring apps can provide a reliable and accurate assessment of patient height from a distance; and third, to determine whether this app-supported height measurement remains stable and reliable when performed by different healthcare professionals from various imaging heights and distances.

Methods This prospective observational study will be conducted in the intensive care unit of the University Hospital Basel. In the first phase, ICU physicians and nurses will visually estimate the height of a sample of ICU patients, and these subjective estimates will be compared against actual patient height measured using a standard manual tape measure. In the second phase, staff will use designated smartphone distance-measurement apps to evaluate patient height from a distance without direct patient contact. In the third phase, to test the robustness and inter-rater reliability of the digital tool, height measurements will be repeated by different healthcare professionals and systematically varied by altering the camera angle, height, and distance from the patient bed.