Bedside breath tests in Children with abdominal pain: a Prospective Pilot Feasibility Study

David Wong, Samuel Relton, Victoria Lane, Mohamed Ismail, Victoria Goss, Jane Bytheway, Robert West, Jim Deuchars, Jonathan Sutcliffe

Research output: Contribution to journalArticlepeer-review


Background There is no definitive method of accurately diagnosing appendicitis before surgery. We evaluated the feasibility of collecting breath samples in children with abdominal pain and gathered preliminary data on the accuracy of breath tests.

Methods We conducted a prospective pilot study at a large tertiary referral paediatric hospital in the UK. We recruited 50 participants with suspected appendicitis, aged between 5 and 15 years. Five had primary diagnosis of appendicitis. The primary outcome was the number of breath samples collected. We also measured the number of samples processed within 2 hours and had CO2 ≥ 3.5%. Usability was assessed by: patient-reported pain pre- and post-sampling; user-reported sampling difficulty. Logistic regression analysis was used to predict appendicitis and evaluated using Area Under the Receiver-Operator Curve (AUROC).

Results Samples were collected from all participants. 36/45 samples were processed within 2 hours. 19/49 samples had %CO2 ≥ 3.5%. No difference in patient-reported pain was observed (p=0.24). Sampling difficulty was associated with patient age (p=0.004). The logistic regression model had AUROC=0.86.

Conclusions Breath tests are feasible and acceptable to patients presenting with abdominal pain in clinical settings. We demonstrated adequate data collection with no evidence of harm to patients. The AUROC was better than a random classifier; more specific sensors are likely to improve diagnostic performance.

Key Words: Appendicitis; Child; Exhalation; Volatile Organic Compounds; Breathomics; Biomarkers

Trial Registration: (ID: NCT03248102). Registered: 14 Aug 2017
Original languageEnglish
Article number121
JournalPilot and Feasibility Studies
Publication statusPublished - 5 Nov 2019


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