Unmet needs: ideas for application of new tests or technologies that have not already been mentioned in table 2
| Test/technology/pathway | Quote | Participant |
| Acute serious illness | ||
| Predicting severity of bronchiolitis | it’s really difficult to tell which, which babies are going to have a mild broncholitic course and just settle down quite quickly and those that are going to progress and need additional respiratory support, so… whether there’s a breath-activated test… that tells you… [that] would be incredible | Clinician#2 |
| Remote observations using smartphone cameras and apps | we… are wary of sepsis for example…. in children who are poorly with acute illnesses we… spend quite a lot of time gaining information about those particular sepsis markers so I will be checking their oxygen levels, I’ll be measuring their respiratory rate. I’ll be checking their pulse. I’ll be checking their blood pressure if that’s appropriate. We’ll be checking their temperature, their capillary refill time… if a patient could do that [at home] so there is an App which can(quickly and non-invasively) assess these (sepsis) markers… that would be hugely helpful… in making a decision safely…and may mean that less patients need to be assessed face to face or in hospital… it would save us a lot of time and would provide a lot of assistance | Clinician#15 |
| Poisons and seizures | you can send the blood test off and get paracetamol salicylate levels; that’s fairly standard… It would be helpful to get those results earlier [with] other drugs… for your older teenager who comes in unconscious and you’re wondering what they might have taken…. children with epilepsy… are they taking the right dose of sodium valproate?… if you could find that out quickly then would, that would change our management… when they’re coming in having a seizure | Clinician#6 |
| Appendicitis | if you had a child who was suspected to have appendicitis clinically, but you wanted to be more certain, then you would have access to… a bedside ultrasound… and prove definitively whether they did or did not… 1) it could provide better selection of children who needed to have treatment for their appendicitis; and 2)… it could give reassurance to those who didn’t have appendicitis so they could be sent home | Clinician#1 |
| Ovarian torsion | ultrasound is used for ovarian torsion… [that] could be done at the bedside | Clinician#1 |
| Fracture | avoiding X-rays, doing near patient ultrasound to diagnose your fracture or whatever it is.… some of this stuff can really help with minors, reducing radiation exposure of children and, and speeding up the process | Clinician#6 |
| Distinguishing bacterial and viral infection | ||
| Diagnosing bacterial meningitis | you could distinguish viral meningitis and bacterial meningitis to high sensitivity and specificity with this 2 RNA transcript signature | Stakeholder#1 |
| I have read about the rapid DNA test for Neisseria meningitis… and that will be very useful in the context of a child presenting with non-blanching rash and fever… I tend to over treat these kind of children or to admit for observations waiting for… blood tests to come back | Clinician#7 | |
| Diagnosing and monitoring chronic disease | ||
| Assessing pain or stress in children unable to communicate | kids with ASD… you could monitor where [and] when their heart rate goes up and when there’s more signs of stress, even if they don’t realise that they’re getting stressed at these times… some objective monitoring could be helpful for those kids because they’re not very aware of their own emotions… you can [then] plan an intervention accordingly | Clinician#14 |
| Diagnosing genetic diseases | we’re talking of whole genetic sequencing coming along very, very quickly now…getting the results by the bedside | Clinician#13 |
ASD, autistic spectrum disorder; RNA, ribonucleic acid.