Trial of a computer decision support system and structured medical assessment for children with a febrile illness presenting to the Emergency Department of The Children's Hospital at Westmead

Phase 3

Completed

• Conditions: Febrile illness; Infection - Other infectious diseases

• Registration Number: ACTRN12609000042246
• Lead Sponsor: The Childrens Hospital at Westmead

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2009-01-19
• Last Update Posted: 13 January 2020

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 17000

Inclusion Criteria

Children less than 5.0 years at presentation to The Childrens Hospital at Westmead Emergency Department, presenting for assessment of a febrile illness. A febrile illness is defined as; A preseting problem recorded by a triage nurse as relating to fever (ICD10AM codes R50.0, R50.1, R50.9, R56.0), or A positive response to the triage questions; Has your child felt hot in the past 24 hours? or Has your child’s temperature been taken in the past 24 hours?, (yes) and the response options 38.0 – 38.9oC or 39.0 – 39.9oC or > 40.0oC are chosen OR Nurse measured temperature of =38.0 o C recorded in Observation screen/notes

Exclusion Criteria

Children greater than 5.0 years of age at presentation
Children transferred in from another hospital (assessed elsewhere and transferred here from another facility)
Children with a reference test result performed less than 24 hours prior to ED presentation for the current illness (ie urine, blood, CSF, joint/fluid cultures, chest x ray, bone scan as detailed in the ED Summary)
Children presenting as a child protection unit case (ie suspected child abuse as detailed in ED Summary)
Children currently or previously treated for cancer (as detailed in ED Summary)
Children on immunosuppression therapy or with a primary immunodeficiency (as detailed in ED summary)
Children who present with a new burn injury (ie the reason for the visit) and who trigger the study only because they 'Felt Hot' and have no other indications that the visit is related to a febrile illness

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Appropriate antibiotic use. Results of urine culture, blood culture and chest x rays done at The Childrens Hospital at Westmead (CHW) and other health carers will determine disease positive or negative. Antibiotic use is collected from ED medical notes and asking parents at follow-up. Diagnoses of non-serious bacterial illness is collected from ED medical notes.[At the time of the febrile illness. Measured once for each febrile illness, children may present more than once during the study period with a febrile illness. The study period is 2 years, 20th February 2007 to 19th February 2009]