Project Snapshot – PAPA


  • To describe the prevalence of clinically significant abdominal pathology, patterns of imaging and pathology tests, management and outcomes of children presenting to ED with abdominal pain.
  • To assess the diagnostic accuracy based on clinical gestalt of ED clinicians according to clinician seniority in diagnosing paediatric acute appendicitis.


Four PREDICT EDs (listed below) prospectively enrolled children aged 0-16 presenting with abdominal pain over a one-month period at each site. Descriptive data was collected for each patient, and clinicians completed a questionnaire stating their seniority and estimated likelihood of their patient having acute appendicitis which was compared with the patient’s final diagnosis.


PAPA has completed enrolment and has 555 patients enrolled as of 27/7/17.

Recruitment stats

  • 555 enrolled
  •     0 excluded
  •   12 refused (verbal consent for CRF phone follow up – refused)
  • 166 missed (verbal consent for CRF phone follow up – missed)


  • Casey Hospital – 72 enrolled
  • Dandenong Hospital – 35 enrolled
  • Monash Medical Centre, Clayton – 138 enrolled
  • Princess Margaret Hospital, Perth – 310 enrolled

No significant issues with processes or follow up system.
Missed 174 (31.4%) for clinician gestalt due to no CRF filled for clinician gestalt.
Reviewed ‘missed’ cases of appendicitis to see if there were documentation of planned review.

NEWS: Data collection and cleaning is complete for the project with two abstracts (‘Diagnostic accuracy of clinical gestalt in paediatric appendicitis in Australian emergency departments’ and ‘Paediatric abdominal pain: prevalence, patterns and clinical outcomes in Australian emergency departments’) submitted for ACEM ASM in Sydney for poster/oral presentation in Nov 2017