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Trial registered on ANZCTR
Registration number
ACTRN12622000972729
Ethics application status
Approved
Date submitted
6/04/2022
Date registered
11/07/2022
Date last updated
11/07/2022
Date data sharing statement initially provided
11/07/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Procalcitonin in the Febrile Paediatric Population
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Scientific title
The Validity of Procalcitonin as a Screening Measure in the Febrile Paediatric Population of South Australia
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Secondary ID [1]
306747
0
None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Paediatric Infections
325754
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Condition category
Condition code
Emergency medicine
323091
323091
0
0
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Other emergency care
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Infection
323252
323252
0
0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The information collected will be the patients medical history and the investigations performed on presentation to the hospital. These investigations are at the discretion of the clinicians but in order to be eligible for the study the clinicians will have needed to collect blood and a urine sample at a minimum. Other investigations (but not criteria for inclusion in the study) include cerebral spinal fluid, microbiological swabs and imaging such as chest X-rays.
There is no active involvement for the participants. Clinicians will be asked to fill out a form to highlight relevant patients to the study and from there the data collection will be done by the study clinicians.
The duration of the study is 2 years. The duration of observation of individual participants is the duration of time from when they present to the paediatric emergency until discharge.
To evaluate the validity of procalcitonin as a screening marker for predicting serious or invasive bacterial infections in febrile children between the ages of 0 and 18 years of age presenting to the paediatric emergency department.
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Intervention code [1]
323196
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Diagnosis / Prognosis
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
330860
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The primary outcome is to assess the accuracy of blood protein marker Procalcitonin in detecting bacterial infections in the febrile paediatric population using data collected from investigations done on patient arrival to the paediatric emergency department.
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Assessment method [1]
330860
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Timepoint [1]
330860
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The blood tests and investigations done will be on arrival to the paediatric emergency department with data collected after patient discharge.
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Secondary outcome [1]
407855
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To specifically assess the accuracy of procalcitonin in the paediatric age group less than 3 months of age in detecting bacterial infections from data collected from the investigations done when the patient arrived to the paediatric emergency department.
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Assessment method [1]
407855
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Timepoint [1]
407855
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The blood tests and investigations done will be on arrival to the paediatric emergency department with data collected after patient discharge.
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Secondary outcome [2]
407856
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To assess the accuracy of procalcitonin for detecting bacterial infections between different paediatric age groups using the information retrieved from the investigations done on the patients presentation to the paediatric emergency department.
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Assessment method [2]
407856
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Timepoint [2]
407856
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The blood tests and investigations done will be on arrival to the paediatric emergency department with data collected after patient discharge.
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Eligibility
Key inclusion criteria
Patients from 0-18 years of age (including those <90 day corrected gestational age)
Febrile with an axillary or rectal temperature > 38 in emergency department or at home.
Clinician suspicion of a bacterial infection.
Blood cultures, procalcitonin, C-reactive protein and white cell count taken.
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Minimum age
No limit
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Maximum age
18
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Antibiotics within the past 48 hours (including prior to intrahospital transfer)
Absence of fever by reliable method of measurement
Absence of relevant tests (1+ of blood culture, procalcitonin, white cell count, C-reactive protein)
Age > 18 years of age
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Based on a review of data of patients who presented to the emergency department and had relevant tests collected (CRP, PCT and WCC) from the previous 4 years we are expecting between 1500-2000 presentations of fever to Women’s and Children’s Hospital Emergency Department per year. Of these we expect at least a quarter to a half to meet the inclusion/exclusion criteria to fulfil enrolment. Over 2 years we are expecting 1000 patients to be enrolled.
Data analysis for both primary and secondary outcomes will be performed once all the data has been collected.
Calculation of means, standard deviations (SDs), rates, and ratios for all appropriate variables or if not evenly distributed use of medians and interquartile ranges.
Evaluation of differences in patient characteristics stratified by type of infection status. Of note a two tailed level of significance of p value less than 0.05 will be considered significant to all the tests.
Student’s t-test for parametric data
Mann-Whitney U-test for nonparametric data.
Fischer exact test for comparison of proportions.
McNemer Chi-square testing of all results.
Receiver operating characteristic (ROC) curve with 95% confidence interval (CI) for both CRP and PCT at different cut off points. We will calculate the area under the curve (AUC) of both ROC curves for predicting bacterial infection.
Calculation of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and negative and positive likelihood ratios (LR) for both tests. Logistic regression will be used to analyze CRP and PCT in predicting bacterial infection.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
8/08/2022
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
1000
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
22010
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Womens and Childrens Hospital - North Adelaide
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Recruitment postcode(s) [1]
37128
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5006 - North Adelaide
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Funding & Sponsors
Funding source category [1]
311083
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Hospital
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Name [1]
311083
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Hospital - Womens and Childrens Hospital
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Address [1]
311083
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Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006
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Country [1]
311083
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Australia
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Primary sponsor type
Individual
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Name
Ruth Jusaitis
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Address
Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006
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Country
Australia
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Secondary sponsor category [1]
312452
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None
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Name [1]
312452
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Address [1]
312452
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Country [1]
312452
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310621
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Women's and Children's Health Network Research Ethics Committee.
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Ethics committee address [1]
310621
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72 King William Rd, North Adelaide SA 5006
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Ethics committee country [1]
310621
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Australia
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Date submitted for ethics approval [1]
310621
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08/02/2022
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Approval date [1]
310621
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09/03/2022
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Ethics approval number [1]
310621
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2022/GEM00039
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Summary
Brief summary
The majority of paediatric infections are benign and viral in origin, more serious infections - particularly of bacterial causes - are important to diagnosis and treat promptly. So the purpose of this study is to look at a investigation called procalcitonin and see if it can be accurately used as a prediction of bacterial infection. Then to look at the level of procalcitonin, in patients with bacterial infections, and compare it to other inflammatory markers, assess it against a timeline from fever onset, and look at it in comparison of different age groups. In order to do this we will have clinicians in the paediatric emergency department fill in a form of relevant patients to highlight those suitable for the study. Then after diagnosis and discharge we will look at data (that is investigations performed) pertaining to procalcitonin and infections and use this information to come to conclusions. The hypothesis is that procalcitonin is a sensitive and specific marker of bacterial infections, superior in both its sensitivity and specificity, as well as its rise in relation to fever onset, to other inflammatory markers and will be a useful marker in diagnosing bacterial infections.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
118290
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Dr Ruth Jusaitis
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Address
118290
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Women's and Children's Hospital
72 King William Road
North Adelaide
SA
5006
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Country
118290
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Australia
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Phone
118290
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+61 0422575978
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Fax
118290
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Email
118290
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[email protected]
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Contact person for public queries
Name
118291
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Ruth Jusaitis
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Address
118291
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Women's and Children's Hospital
72 King William Road
North Adelaide
SA
5006
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Country
118291
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Australia
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Phone
118291
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+61 8 81617000
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Fax
118291
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Email
118291
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[email protected]
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Contact person for scientific queries
Name
118292
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Ruth Jusaitis
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Address
118292
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Women's and Children's Hospital
72 King William Road
North Adelaide
SA
5006
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Country
118292
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Australia
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Phone
118292
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+61 8 81617000
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Fax
118292
0
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Email
118292
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
We will not be sharing data with others
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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