CLASSIC

Development of a clinical tool to aid identification of serious infections in children in primary care.

Clinical tools

Clinical tools are standardised checklists or scoring systems used by healthcare professionals to help guide treatment decisions.

The aim of this study is to identify or develop an accurate clinical tool to help General Practitioners (GPs), and other primary care clinicians, to identify which ill children have a serious illness and need to be assessed in hospital, and which children can be safely managed at home.

Background

Identifying the few children who are seriously ill, among the many who visit GPs, is a challenge, as those with serious and less serious illnesses may present with similar symptoms. Clinical tools look at groups of symptoms and examination findings, which together can help identify which children can safely be managed at home, or who need to be assessed in hospital.

Existing tools have mostly been developed in hospitals. We have tested two well-known existing tools and found that they performed poorly in General Practice. Tools developed in General Practice are likely to perform better.

Papers

Clark A, Cannings-John R, Blyth M, Hay A, Butler CC, Hughes K. Accuracy of the NICE Traffic Light system for detecting serious illness in acutely unwell children presenting to general practice: a retrospective cohort study. British Journal of General Practice March 2022 DOI: https://doi.org/10.3399/BJGP.2021.0633

https://pubmed.ncbi.nlm.nih.gov/35577588/

Clark A, Cannings-John R, Carrol ED, Thomas-Jones E, Sefton G, Hay AD, Butler CC, Hughes K. Assessing children who are acutely ill in general practice using the National PEWS and LqSOFA clinical scores: a retrospective cohort study. Br J Gen Pract. 2025 Jan 30;75(751):e98-e104. doi: 10.3399/BJGP.2023.0638. PMID: 38858101; PMCID: PMC11497154.

https://pubmed.ncbi.nlm.nih.gov/38858101/

Project plan

From the scientific literature, we have identified only one clinical tool developed in General Practice (in Belgium). We want to test how this performs using data we already have from General Practice about young children in the UK. We will also use this data to develop a new tool because our dataset includes additional measurements which could make a more accurate tool.

Our dataset

The dataset we will use was formed as part of a previous study, focusing on urinary tract infection (LUCI study), and uses data from a previous large study (DUTY study) linked with hospital admission data. The dataset is fully anonymised and stored securely in the SAIL Databank.

Once we have identified an accurate tool, future work will determine the acceptability of the tool, integrate the tool into clinical computer systems, and test the tool in clinical practice.

Patient and public involvement

We have two parent representatives on the project and a clinical advisory group. We are also forming a parent advisory group. Both groups will advise on this project and on future work.