Step-forward randomization in multicenter emergency treatment clinical trials

Wenle Zhao*, Jody Ciolino, Yuko Palesch

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


The authors present a new centralized randomization method for multicenter emergency treatment clinical trials. With this step-forward method, treatment randomization for the next subject is performed immediately after the enrollment of the current subject. This design ensures the readiness of the treatment assignment for each subject at the point of study enrollment, and it simultaneously provides effective control on treatment assignments balance and distributions of covariates. The authors also discuss procedures of the step-forward randomization method along with its implementation for two National Institute of Neurological Disorders and Stroke-funded multicenter acute stroke trials, one double-blinded and one open-labeled. Advantages and limitations are presented based on experience gained in these two trials.

Original languageEnglish (US)
Pages (from-to)659-665
Number of pages7
JournalAcademic Emergency Medicine
Issue number6
StatePublished - Jun 2010


  • Emergency treatment
  • Multicenter clinical trials
  • Randomization
  • Step-forward

ASJC Scopus subject areas

  • Emergency Medicine


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