PRIMED Study

PRIMED

Precision Medicine for Improving the Diagnosis of Pediatric Appendicitis in the Emergency Department

Study Summary

It has been shown that next-generation precision medicine “Omics” technologies can improve the diagnosis of appendicitis. Our team is using systems-biology multi-omics approach to identify unique “bioprofiles”, like fingerprints, in the blood and urine of children with suspected appendicitis. These profiles can be integrated into point-of-care clinical tests to rapidly identify children at risk. Examples of the cutting-edge methodologies being used by our team include nuclear magnetic resonance, bead-based multiplexing, inductively coupled plasma mass spectrometry, time of flight cytometry and multiplexed ion beam imaging. The study enrollment is occurring in the Emergency Departments (EDs) of 11 hospitals across Canada. Participating study sites are: Calgary (lead site), Edmonton, Halifax, Hamilton, Kingston, London, Montreal, Ottawa, Saskatoon, Vancouver and Winnipeg. All study sites are members of Pediatric Emergency Research Canada (PERC) and the Canadian Association of Pediatric Surgeons (CAPS). Together these EDs care for over 600,000 acutely ill and injured children yearly. We are expecting to enroll over 3000 children to participate in the PRIMED study. The PRIMED study is funded by the Canadian Institutes of Health Research (CIHR). 

Objectives

  1. To determine the bioprofiles of children with true appendicitis versus those with non-appendicitis abdominal pain
  2. To determine the bioprofiles of children with perforated appendicitis versus simple appendicitis
  3. To compare the test performance characteristics of the bioprofiles we establish to those of traditionally used clinical prediction rules, laboratory investigations and imaging tests in our population. Existing measures will be integrated if they improve the predictive ability of our bioprofiles.

Principal Study Investigator: Dr. Graham Thompson

Project Lead: Dr. Beata Mickiewicz

Study Team: Dr. Darcy Beer, Dr. Maala Bhatt, Dr. William Craig, Eleanor Fitzpatrick, Dr. Jocelyn Gravel, Dr. Craig Jenne, Dr. April Kam, Dr. Karen Kopciuk, Dr. Ahmed Mater, Dr. Anne Moffatt, Dr. Naveen Poonai, Dr. Vikram Sabhaney, Dr. Hans J. Vogel, Dr. Richard Bachur, Dr. Samarjeet Bhandal, Dr. Mary Brindle, Dr. Robin Eccles, Dr. Ari Joffe