Personalised Risk assessment in febrile illness to optimise Real-life Management across the European Union (PERFORM)

Clinical & Veterinary Sciences; Economic, Social & Political Sciences

LSHTM PI and Workpackage 5 lead: Shunmay Yeung

Other LSHTM co-investigators:  Martin Hibberd, Alec Miners

Consortium Co-ordinator: Michael Levin (Imperial College)

Funding: European commission (Horizon 2020), 5 years

Summary: PERFORM aims at developing new “omics” diagnostic tests to distinguish between bacterial and viral infections in febrile children. Work package 5, led by LSHTM, is responsible for conducting a comparative health services analysis and economic evaluation to evaluate the potential costs and impacts of introducing the tests in different European health system.

Project details: The management of fever is one of the most common and important problems facing clinicians providing care for children. Distinction between bacterial infections and viral infection on clinical grounds is unreliable. As a result many children worldwide undergo hospitalization, invasive investigation and are treated with antibiotics for presumed bacterial infection when, in fact, they are suffering from self-limiting viral infection, with resulting costs and consequences including antibiotic resistance.

PERFORM aims at improving the diagnosis and management of febrile children, by identifying, and validating promising new discriminators of bacterial and viral infection including genomic, transcriptomic and proteinomic markers. The study is being undertaken with collaborating partners in 8 European countries (Austria, Germany, Greece, Netherlands, Latvia, Slovenia, Spain, United Kingdom) and the Gambia and Nepal. The most accurate biomarkers will be translated into new point-of-care tests in partnership with industry partners and new clinical alogrithms to improve the management of febrile children will be developed. 

LSHTM is leading Workpackage 5, an intergrating workpackage which aims to describe and compare the current management of febrile children and to evaluate the likely costs and consequences of introducing the new point-of-care tests in different health systems in Europe. This will include mixed methods studies of parents and health care providers, and a cost-effectiveness analysis of new diagnostic approaches.