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Technique developed to improve appendicitis care for pediatric patients

March 13, 2018

MINNEAPOLIS - Mar. 13, 2018 - Researchers from Children's Minnesota (Children's) and HealthPartners Institute have developed a new pediatric appendicitis risk calculator (pARC) to aid in the diagnosis of appendicitis. The calculator was developed as part of a $3.1 million, five-year grant from the National Institutes of Health (NIH).

In the April issue of Pediatrics, the researchers describe a novel method to calculate a patient's specific risk for appendicitis. With this new method, clinicians will be able to provide tailored medical and surgical guidance to a patient. In the study, researchers used data collected from ten pediatric emergency departments to develop the risk calculator and then independently validated the score using data from a single children's hospital. Potential benefits of using the new risk calculator include a reduction in the use of computed tomography (CT), more judicious utilization of ultrasound and a reduction in healthcare expenditures.

"This method is of great benefit to our patients and the health care system overall," said Dr. Anupam Kharbanda, co-Principal Investigator and chief of critical care services at Children's Minnesota. "In addition to being able to target our care specifically to each patient, we're also reducing the use of unnecessary medical tests and expenses. We're thrilled to have developed a new way to standardize care for children and adolescents with abdominal pain."

Abdominal pain is one of the most common reasons children visit the emergency department and appendicitis is the most frequent surgical emergency in pediatrics. CT is one of the most common ways clinicians diagnose appendicitis and CT scans are not only costly, but can also put pediatric patients at risk for radiation-induced injuries, especially because their bodies are smaller and organs more sensitive than adults. As a result, researchers at Children's and HealthPartners have sought methods to develop a safer, more cost-efficient way to determine the risk for appendicitis when a patient has presented at an emergency department with abdominal pain.

Children's and HealthPartners continue to collaborate on methods to improve the care of children in our community. The same researchers, along with colleagues from Kaiser Permanente Northern California, are conducting a 17-center trial to improve the care of pediatric patients who seek care in general emergency departments, including the six HealthPartners-affiliated emergency departments. This study will utilize the appendicitis risk calculator to guide care in the community setting.
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Anupam Kharbanda, MD, chief of critical care services, Children's Minnesota and Elyse Kharbanda, MD, MPH from HealthPartners Institute, are the co-Principal Investigators on this project to implement clinical decision support tools for children with possible appendicitis across multiple general emergency departments.

Additional information can be found in the April issue of Pediatrics.

About Children's Minnesota

Children's Minnesota is the seventh largest pediatric health system in the United States and the only health system in Minnesota to provide care exclusively to children, from before birth through young adulthood. An independent and not-for-profit system since 1924, Children's serves kids throughout the Upper Midwest at two free-standing hospitals, 12 primary and specialty care clinics and six rehabilitation sites. Additionally, Children's is Minnesota's only Level I pediatric trauma center inside a hospital dedicated solely to children. Children's maintains its longstanding commitment to the community to improve children's health by providing high-quality, family-centered pediatric services and advancing those efforts through research and education. This work is made possible in large part by generous philanthropic and volunteer support from individuals and organizations throughout the state and region. An award-winning health system, Children's is regularly ranked by U.S. News & World Report as a top children's hospital. Please visit childrensMN.org.

About HealthPartners Institute

HealthPartners Institute is part of HealthPartners, the largest consumer-governed, non-profit health care organization in the nation with a mission to improve health and well-being in partnership with members, patients and the community. HealthPartners Institute supports this mission through research, education and practice. The Institute annually conducts 400+ research studies, provides continuing medical education to 24,000 health professionals and trains 575 medical residents and fellows and 1,200 medical and advanced practice students. The Institute also supports clinical quality improvement and patient education programs. Its integration with HealthPartners' hospitals, clinics and health plan strengthens the Institute's ability to discover and develop evidence-based solutions and translate them into practice. Based in the Midwest, the Institute's work has an impact on care, health and well-being locally, nationally and internationally. For more information, visit healthpartnersinstitute.org.

Children's Hospitals and Clinics of Minnesota

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