Study of Paediatric Appendicitis Scores and Management Strategies

Abdominal pain is a common reason for children to attend emergency departments (ED), with acute appendicitis the most common cause of abdominal pain requiring surgery.

Various clinical prediction scores have been developed internationally to help diagnose appendicitis; however, these scores are not routinely used or validated in Australia and New Zealand (ANZ) EDs. Many children undergo investigations such as blood tests, ultrasound and computerised tomography scans which expose them to pain, discomfort, and even ionising radiation. Moreover, there are many children every day who are transferred from regional and rural EDs to tertiary paediatric centres for surgical consultation but do not require operations, increasing the costs and stress to patients and their carers.

We will therefore undertake the SPASMS project to review the accuracy of clinical prediction scores compared to clinician impression in children with suspected appendicitis.

The aim of the study is to determine which (if any) score is the most accurate in diagnosing appendicitis with a plan to implement the best performing scores into management strategies in ANZ EDs. We will review the management and outcomes of children with suspected appendicitis.

This is an international study led by Perth Children’s Hospital that will involve 8 other Australian and New Zealand EDs within the PREDICT network. The study has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622001293752).

Study design

International observational non-interventional study.

Chief Investigators

Meredith Borland (Perth Children’s Hospital)
Wei Hao Lee (Perth Children’s Hospital)
Sharon O’Brien (Perth Children’s Hospital)





Site locations

  • Perth Children’s Hospital, Perth – lead hospital (CPI Meredith Borland)
  • Royal Children’s Hospital, Melbourne (PI Franz Babl)
  • Monash Children’s Hospital, Melbourne (PI Simon Craig)
  • Starship Children’s Hospital, Auckland (PI Stuart Dalziel)
  • Royal Hobart Hospital, Hobart (PI Viet Tran)
  • Sunshine Hospital, Melbourne (PI Doris Tham)
  • The Children’s Hospital at Westmead, Sydney (PI Shefali Jani)
  • Gold Coast University Hospital, Gold Coast (PI Shane George)
  • Queensland Children’s Hospital, Brisbane (PI Natalie Phillips)


Total sites 1500, children aged >=5 years – < 18 years.

Trial Registration

Australian New Zealand Clinical Trials Registry: ACTRN12622001293752