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About Sickkids
About SickKids

May 7, 2014

SickKids technology opens door to mobile use of CALIPER database

By John Berwick

The Division of Clinical Biochemistry, Department of Paediatric Laboratory Medicine and the Research Information Technology team at SickKids have developed an app that health-care providers all over the world can use.

The app allows them to compare their patients’ test results with those recorded in The Canadian Laboratory Initiative for Paediatric Reference Intervals (CALIPER), an innovative project based at SickKids. It is particularly intended for paediatricians, family physicians, fellows and residents who can readily interpret medical test results in children and adolescents.

CALIPER database

Dr. Khosrow Adeli, Head of the Division of Clinical Biochemistry, is the inventor of the app.  Shayanthan Parameswaran, Senior Developer in Research IT, assisted in the design and development.

This is the first mobile app developed in house at SickKids by the Research Institute’s IT team. The CALIPER database, which lists normal reference values for a wide range of biochemical markers in children, was originally accessed through a website. Since there were thousands of website visits from all over the world, the team concluded that a mobile app offering the ability to access CALIPER data without a network connection would be beneficial.

The app compares a child’s test results against normal reference values based on demographic information thus helping care providers administer better diagnostics to children and families in various locations, said Parameswaran. After downloading, it can be used anywhere in the world, without a network connection.

The database includes the reference values for over 60 medical tests, established on the results of blood tests performed on thousands of ethnically diverse and healthy children ages 2 days to 18 years. It records normal levels of a wide range of biomarkers, such as cholesterol, Vitamin D, and thyroid hormones.

“This is a large study that has been going on for about five years supported largely by the Canadian Institutes of Health Research,” Adeli says. “We have also had a number of industry partners, diagnostic companies involved in patient testing and they are keen to see this kind of work completed. 

“What we’re doing is basically establishing a database of reference values for children based on a Canadian population of healthy community children. It’s like a health survey but in this case we collect a blood sample and we measure a number of biochemical tests.”  

Few studies have included health data for the entire paediatric age group from birth to 18 years. Data from other published studies are old, and some are based on samples taken from hospital patients rather than a healthy population. Also, adult information is often used as a baseline because an accurate paediatric baseline has not been available. This can lead doctors to misdiagnose or miss a disease.

“Using an adult baseline can lead to inappropriate interpretation of results, meaning they think there may be something wrong with the test, so they may then ask for additional tests which in many cases may not be necessary or may recommend an MRI or an X-ray. This is not only problematic for the family by causing unnecessary worry, but it is also very costly to the healthcare system,” Adeli says.

The mobile app is now available on iTunes, and a new website, which provides the latest graphical and tabular reference values, was launched May 5, 2014. Android versions of the app will also be released on Google Play shortly. Future plans include translating the app to Chinese and Spanish languages. More work is also underway to continue to update the app with more data on additional medical tests.

For more information see www.caliperproject.ca and http://www.sickkids.ca/Caliperproject/intervals.

Download the app here.