A Monte Carlo Simulation Algorithm to Assess Rollout Feasibility in Stepped-Wedge Trials: A Case Study of National CPR Training Kiosk Deployment
Bibliographic record
Abstract
Background: Stepped-wedge cluster randomized trials (SW-CRTs) are increasingly used to evaluate population-level interventions, but trial validity depends on timely cluster transitions. Rollout feasibility is often assumed rather than modelled. In the context of a planned national trial of CPR training kiosks, we developed a Monte Carlo simulation algorithm to quantify logistical feasibility under uncertainty. Methods: A stochastic Monte Carlo algorithm was implemented to simulate deploying 100 CPR kiosks across eight Canadian cities under four team structures. Inputs included productivity (0.8–1.2 kiosks/day), disruption probabilities (weather, venue access, technical failure, staff illness, transport delays), and cost parameters (salaries, per diems, travel). Each scenario was simulated across 3000 iterations. Outputs included per-city feasibility (p ≤ 60 days), total project duration, and risk–cost trade-offs. Results: Single-team strategies required 9–10 months for full rollout, with winter-exposed cities such as Halifax and Charlottetown having up to 30% probability of exceeding 60 days. Two-team strategies halved rollout time (4–5 months) and achieved >95% on-time rollout across cities. Adding a third onsite staff member reduced risk by 5–15% with modest additional cost (~CAD 1500–2000 per city). Risk–cost analysis identified two teams with three staff as the most reliable strategy. Conclusions: Monte Carlo simulation provides a practical framework for assessing rollout feasibility in SW-CRTs. Applied to CPR kiosk deployment, it highlights the importance of staffing, seasonality, and city-level context. The approach is generalizable to other national interventions requiring phased rollout under uncertainty.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.038 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".