Acceptability of novel point-of-care tests for paediatric febrile illness in the emergency department: a qualitative analysis of views from children and young people in England

Acceptability of novel point-of-care tests for paediatric febrile illness in the emergency department: a qualitative analysis of views from children and young people in England | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Acceptability of novel point-of-care tests for paediatric febrile illness in the emergency department: a qualitative analysis of views from children and young people in England Emma Lim, Fabian Johannes Stanislaus van der Velden, Joanne Ball, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9093890/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 13 You are reading this latest preprint version Abstract Background Rapid point-of-care tests (POCTs) are increasingly used to support clinical decision making. and appropriate antibiotic prescribing. Whilst a few studies have explored healthcare workers’ views on using POCTs in paediatric febrile illness, little is known about the perspectives of children and young people (CYP) who may undergo these tests. This study aimed to explore the acceptability and perceptions of British CYP to POCTs. Methods Three focus groups were conducted with CYP aged 12-18 years, from Young Persons’ Advisory Groups, at university hospitals in Newcastle and London, UK. Data were collected using questionnaires and semi-structured group discussions. Qualitative thematic analysis was undertaken to identify key themes relating to POCT acceptability, availability and perceived impact. Results A total of 54 CYP participated (10 in 2017 focus group, 25 in 2018, and 19 in 2025). The majority supported the implementation of POCT tests, provided they are accessible through community or hospital healthcare services. Key themes identified included altruism, test reliability, and the need for healthcare advice or review in-person following the test. CYP prefer non-invasive tests such as saliva-based sampling, over blood tests, and reported aversion to urine samples. POCTs were viewed as a means of improving assessment of unwell children and potentially reduce the burden on health care services if the test results were reassuring. Conclusion CYP are in favour for POCTs to facilitate and improve the care they receive. They recognised the potential benefits they might have in their care, but are aware of important limitations particularly regarding availability, interpretation and potential impact on the wider healthcare system. children and young people febrile illness point-of-care testing Figures Figure 1 Figure 2 Background Febrile illness is one of the commonest causes of hospital attendance and admission for children, and management can often be a challenge 1 . Most febrile children will have self-limiting viral infections and can be safely cared for at home with symptomatic treatment and without antibiotics 2 – 4 . Even in the emergency department, only 10% of febrile children will have serious bacterial infections, and 1% sepsis 1 . Despite these low risks, there is a recognised anxiety amongst caregivers around fever in children. 5 Accurately identifying children with severe bacterial infections and sepsis early can be difficult, as clinical signs and symptoms are often non-specific, and, current investigative tests take time to yield results 3 . This can lead to children being subjected to more invasive tests, long waits for results and potentially being prescribed antibiotics, they do not need. The wait for inconclusive tests may result in delayed patient flow, unnecessary admissions or delayed discharge and overprescription risks worsening antimicrobial resistance. Unnecessary attendance and admission have financial implications for hospital trusts and affects families and patients directly in terms of distress, out-of-pocket costs and inconvenience 6 , 7 Point-of-care tests (POCTs) are diagnostic tests which can be performed close to the patient, and give results rapidly enough to influence immediate clinical decisions without a central laboratory, usually within one hour. 8 They have the potential to improve efficiency of patient flow, and limit the use of other invasive tests. POCTs are advocated for by the World Health Organization as a strategy to reduce inappropriate antibiotic use 9 . In low-and-middle-income countries, POCTs have been shown to be feasible and effective in improving appropriate antibiotic prescriptions rates. 10 The use of POCTs in clinical practice is dependent on uptake by healthcare workers, and acceptability to end users, patients and families. A variety of POCTs are currently available and used in the management of childhood fever including urine dipsticks, rapid respiratory tests for identifying pathogens such as Group A Streptococcus , Respiratory Syncytial Virus, SARS-CoV-2 and influenza, and blood tests for C-reactive protein (CRP), blood lactate and blood gases 11 . Other more novel POCTs are being trialled and implemented in clinical practice 12 , 13 such as MeMedBV test 12 . Research has been done to assess the perceptions of healthcare workers around the acceptability of POCTs in children with acute infections 14 , 15 . However, to our knowledge, there are no studies published on the acceptability and perceptions of children and young people (CYP) who undergo these POCTs in practice. This study aimed to explore CYP’s perceptions, preferences and acceptability of (novel) POCT tests in the context of acute febrile illness and infection in childhood. Methods Study Design This was a longitudinal qualitative study of three focus groups involving young people using a thematic questionnaire to guide group discussions. Anonymity of participants was maintained throughout the entire study. Participants CYP aged 12 to 18 years inclusive involved with the Young Persons’ Advisory Group North England (YPAGne) and YPAG Great Ormond Street Hospital (YPAG GOSH), two university tertiary hospitals in Newcastle and London, UK. Data Collection and Setting The first two focus groups were held on 9 November 2017 with YPAGne and 17 November 2018 with GOSH YPAG. Both groups do not allow recordings of young person’s so each focus group was led by a facilitator, and notes were kept by designated scribes. The third focus group was held on 10 July 2025 with YPAGne. For this group, the questionnaire (Supplemental File 1 https://docs.google.com/forms/ ) was distributed via QR code and using online messaging apps as preferred by participating CYP, small group discussion was recorded by facilitators and by young persons via the online questionnaire. Measures Data were collected on baseline demographics. Participants where firstly given a ranking and prioritisation task. CYP selected the factors they valued when attending a paediatric emergency department from a curated list of options and then ranked the six factors they valued most in order of priority. The second section of the questionnaire explored availability and characteristics of a novel POCTs for febrile illness. CYP were asked if the test should be available; directly to patients, from a medical care centre, or hospital, and, who should interpret the results. Next, they were asked what kind of test they would prefer, e.g. blood, saliva or urine, and if a blood test whether they would prefer a finger prick or venous sample. The last section of the questionnaire explored the possible impact of test results. Participants were asked if the test was negative (e.g. no serious bacterial infection), would they still want to see a healthcare practitioner and why. Participants were asked how they thought test results would change healthcare practitioner’s explanations of their illness. A final open-ended text box was available for any further comments the participants might have. Analysis Quantitative data from closed questions were analysed in SPSS version 29. Data were not normally distributed. Qualitative data from open-ended questions was analysed using a qualitative thematic approach 16 . Qualitative data were compared between the 2017/2018 focus groups and the 2025 focus group. This allowed for identification in changes of CYP views. Participants from the 2017/18 focus groups were in the same age group as the 2025 iteration. Results 10 CYP participated in the 2017 focus group, 25 in 2018, and 19 in 2025. There was an equal male to female ratio, and all participants were between 12 and 18 years of age. The ranking exercise showed that participants primarily valued feeling safe, clear plans and effective communication (Fig. 1 ). They also valued efficiency, hygiene and seeing an experienced practitioner. They found it less important to have scans performed, or waiting to be seen. POCT test type preference For CYP, from all focus groups, first choice for a novel POCT was saliva samples (74% in 2025) followed by blood samples. “The saliva test is most acceptable, because it is easier to obtain, and carries less stigma of being sick (2017 participant)” . Blood samples were acceptable to half the group (53% in 2025 ) , but were associated with pain, discomfort and fear of needles. If a blood test had to be done, CYP preferred finger prick testing over venous blood sampling. Urine was least preferred, with 70% of CYP preferring a finger prick test over a urine test. CYP nearly universally expressed displeasure with urine samples as they perceived them as abhorrent. “Urine is gross (2017 participant).” POCT test availability CYP felt novel POCTs should be available directly to patients (84% in 2025), with the caveat that half felt it should only be available from a medical centre (53% in 2025). CYP expressed concerns with acquiring POCTs from the internet or a non-medical environment (e.g. supermarkets). They felt it was important that the test “Needs to be good, reliable and have few failures, otherwise it is better to see your general practitioner (2017 participant)”. “The internet is untrustworthy. buying the test over the internet might not be the real thing and might not be correctly made.(2025 participant)” CYP report that healthcare providers other than the hospitals are acceptable, for example pharmacies. They did not view it necessary to obtain tests from medical professionals. “It is nicer to have the test in the pharmacy; they can give clear instructions on how to use it and are reliable (2018 participant) .” One participant noted this would also be a solution for people living in rural or remote areas “I live in a small town where the general practice has recently closed, if I had the test, I might not need an appointment in another practice or hospital far away unnecessarily”.(2025 participant) Interpreting POCT results Just over half of the participants did not want to see a medical practitioner if the test showed it was not a bacterial infection and they were not seriously ill. The main theme was altruism. “It’s important for other people to receive expert care and not me in this situation (2018 participant)” . CYP also acknowledge the burden they might represent on the healthcare system: “Because ..(the system) will be flooded with patients who have serious issues and need urgent care, adding to that…. despite not needing medical attention, would increase the stress on doctors and prevent people who actually need to be seen from receiving care (2025 participant).” On the other hand, participants identified a common theme of seeking reassurance: “You don’t know if the test is entirely trustworthy and want some reassurance from a human. A person [who] tells you what to do next, especially if [you] get worse once [you] have gone home in a few days’ time.(2025 participant)” Additionally, CYP recognised a need for management plans for their health: “I’m still a bit sick, [I] would like to get advice on how to manage my health (2017 participant).” Participants did not feel this practitioner had to be a doctor: “[It] doesn’t matter if it’s a doctor or a nurse, as long as you know what they are doing. Just trust that if they are in the emergency department, they know what they are doing (2018 participant)” These views and themes were consistent across the focus groups. POCT test views on test outcomes Participants felt that a new POCT for febrile illness would change healthcare practitioners explanation of why they are sick particularly around reassurance and appropriate prescribing. “Some people do not trust or fully believe the doctor. If a test is quick and available, it will support the doctor, and the test will help eliminating quickly what the cause of the condition is. Hard evidence can reduce unnecessary treatment (2017 participant).” They acknowledge the potentially beneficial impact of a novel tests on patient flow and patient pathways. One participant stated: “This would alleviate so much pressure off the NHS [National Health Service red.] ... Waiting lists are crowded with people who do not need urgent care, yet people are confused as to what is and isn’t an emergency. This test will provide people assurance and allow more serious cases to be seen quickly (2025 participant)” . Discussion The 2022 UN Convention on the Rights of the Child Article 12 17 states that every child has the right to express their views, feelings and wishes in all matters affecting them, and to have their views considered and taken seriously. This underlines the importance of exploring CYP views on new health technologies, that may well become commonplace in paediatric care pathways. In fact, there is a risk if we do not involve CYP in the development of novel POCT implementation they will not meet expectations and be rejected by end users. Early patient involvement and engagement ‘ Through participation in health technology development, CYP and their families can provide context, insight, personal experience and tacit knowledge to ensure that the end-product is usable, acceptable, and can be integrated into its intended environment .’ 18 Despite the growing literature on healthcare and parental perspectives, this is one of the first studies exploring the views and perspectives of CYP around the use of POCT for febrile illness. In general, over the 8-year period CYP views did not change. What they valued during a paediatric emergency attendance was feeling safe, good plans and clear communication, and they ranked length of stay as less important. CYP are open to the use of POCT to enhance the clinical assessment of their illness, provided the test is reliable and has a low failure rate. This is in line with studies among CYP using assisted technology tools to manage chronic illnesses, where CYP also voiced the necessity of an ‘official source’ or endorsement by clinicians before they would be comfortable to use a new tool or test. 19 Participants always preferred non-invasive sampling such as saliva tests, as this is more convenient, not painful and carries less stigma, unsurprisingly this preference did not change over time. CYP disliked urine testing, as it was perceived as repulsive and embarrassing. Urine samples are also slow and technically difficult to collect in younger children for parents and staff alike. Blood tests were deemed suitable if needed but are less preferred due to pain and fear of needles and finger prick tests were the majority choice. In contrast primary care physicians perceived finger prick testing in children as a barrier and would consider skipping a POCT and prescribe antibiotics regardless for young children in view of their vulnerability. 20 Participants valued trust and reliability of POCT, so acquiring tests from unknown sources such as the internet was considered risky. CYP wanted to access to tests from trusted healthcare providers, such as primary or secondary healthcare centres and pharmacies. This concurs with national initiatives such as ‘Pharmacy First’ where community pharmacies in the UK provide treatment for certain minor illnesses. CYP also recognised the benefit of access to tests in rural settings or where availability of a primary care physicians may be limited. Availability of novel tests locally would support the 2019 NHS long term plan to shift care from hospitals to community and primary care and reduce avoidable admissions and emergency department attendances. The relationship between delivery of a new test and assessment by a healthcare provider is complex and multifactorial, in participants’ view. Half felt if the test had excluded a bacterial infection and the need for antibiotics, they would be happy to leave without review. Although this identifies the need for consistent safety netting information and self-care advice such as the NHS website or UK Healthier Together Programme which provides information and resources for families and professionals. The other half of participants wanted interpretation of results, reassurance and advice on managing symptoms from a person and felt that results could not be trumped by expert opinion of a healthcare provider. Participants recognised the potential benefit POCTs may offer to the paediatric healthcare system as a whole. Perceived advantages included improvements in patient flow and communication, consistent with the views reported by healthcare providers and parents in similar clinical settings 7 , 14 . However, CYP were less aware of the potential negative impact of POCTs, particularly in relation to diagnostic uncertainty, and the role of POCTs as part of the broader clinical assessment rather than a standalone test. In addition, compared with healthcare workers, CYP showed limited awareness of cost implications associated with introducing or using novel POCTs and whether these tests would be economically beneficial to the wider healthcare system. 15 , 20 Findings across the three focus group iterations were broadly consistent, with little change in views over time around the role and administration of new POCTs. We had anticipated that the COVID-19 pandemic might influence CYP perspectives particularly increasing acceptance of saliva-based tests or reducing expectations of in-person healthcare reviews, given the widespread use of SARS-CoV-2 POCT mouth and nasal swabs. However, no such shift was observed. We recognise our study is limited due to the small sample size, and recruitment from only two regions within the UK. Participants were recruited from Young Persons Advisory Groups and may have had more interest or experience of the healthcare system than the general population, potentially limiting the transferability of findings. Further studies involving larger and more diverse cohorts from different countries and cultural contexts are needed to assess whether our findings are generalisable. However, this study provides valuable insights into the views and perspectives of young people over an eight-year period. Conclusion This study shows that children and young people value novel POCTs as important and acceptable tools to improve the diagnosis of febrile illness and potentially reduce avoidable hospital admissions and attendances. They have a preference for non-invasive sampling (e.g. saliva) and if necessary, finger prick blood tests. They view tests as a decision- making aid but still value expert healthcare opinion and the value of face-to-face assessment and to ensure trust and reliability is maintained. Abbreviations CRP: C-reactive protein CYP: Children and Young People NHS: National Health Service POCT: point-of-care test UK: United Kingdom YPAG: Young Persons’ Advisory Group for research YPAGne: Young People’s Advisory Group Northeast Declarations Ethics approval and consent to participate This research study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from London and Dulwich Research Ethics Committee, NHS Health Research Authority. This study is part of the wider Diagnosis and Management of Febrile Illness using RNA Personalised Molecular Signature Diagnosis (DIAMONDS) study, ethics approval was obtained for the UK under IRAS 209035, REC 16/LO/1684. Participants were members of a Young Persons’ Advisory Group (YPAG), for which parental or legal guardian consent for attendance had been obtained as part of standard governance procedures. This included all participants over and under the age of 16 years. For this research activity, all participants were provided with age-appropriate participant information sheets and given the opportunity to ask questions prior to participation. Informed assent was obtained directly from all young people before participation in focus groups and anonymous surveys. Participants were considered competent to provide assent in line with Gillick competence. Participation was entirely voluntary, and young people were informed that they could decline or withdraw at any time without affecting their involvement in the advisory group. No identifiable personal data were collected. Given the low-risk, non-sensitive and fully anonymous nature of the data, and in line with guidance from the Health Research Authority, additional parental consent for the specific research activity was not required, and a proportionate approach to consent was adopted. Consent for Publication Not applicable. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding FvdV, ME and EL received funding from the European Union’s Horizon 2020 Research & Innovation programme under grant number 848196. Author contributions EL and ME conceptualised the study. EL, DL and LV designed the survey, conducted the focus groups in 2017/2018, and performed the thematic analysis. FvdV, EL, and JB conducted the survey in 2025. FvdV analysed the combined dataset and wrote the manuscript. All authors read the manuscript, provided feedback and approve of the final manuscript for submission. Acknowledgments We kindly thank the YPAGne and YPAG GOSH teams for facilitating the focus groups and the young people for their participation. References Sands R, Shanmugavadivel D, Stephenson T, Wood D. Medical problems presenting to paediatric emergency departments: 10 years on. Emerg Med J. 2012;29(5):379-82. Kolberg L, Khanijau A, van der Velden FJS, Herberg J, De T, Galassini R, et al. Raising AWaRe-ness of Antimicrobial Stewardship Challenges in Pediatric Emergency Care: Results from the PERFORM Study Assessing Consistency and Appropriateness of Antibiotic Prescribing Across Europe. Clin Infect Dis. 2024;78(3):526-34. 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BMJ Open. 2021;11(5):e044510. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57. UN Commission on Human Rights UCoH. Convention on the Rights of the Child. Geneva: UN Commission on Human Rights, 1990 7 March 1990. Report No.: E/CN.4/RES/1990/74. Wheeler G, Mills N, Ankeny U, Howsley P, Bartlett C, Elphick H, et al. Meaningful involvement of children and young people in health technology development. J Med Eng Technol. 2022;46(6):462-71. Blower S, Swallow V, Maturana C, Stones S, Phillips R, Dimitri P, et al. Children and young people's concerns and needs relating to their use of health technology to self-manage long-term conditions: a scoping review. Arch Dis Child. 2020;105(11):1093-104. Schot MJ, Broekhuizen BD, Cals JW, Brussee E, de Wit NJ, Verheij TJ, et al. C-reactive protein point-of-care testing in children with cough: qualitative study of GPs' perceptions. BJGP Open. 2018;1(4):bjgpopen17X101193. Additional Declarations No competing interests reported. Supplementary Files POCTQuestionnaire.pdf Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 15 Apr, 2026 Reviewers agreed at journal 13 Apr, 2026 Reviews received at journal 12 Apr, 2026 Reviewers agreed at journal 10 Apr, 2026 Reviewers agreed at journal 09 Apr, 2026 Reviewers agreed at journal 08 Apr, 2026 Reviews received at journal 06 Apr, 2026 Reviewers agreed at journal 06 Apr, 2026 Reviewers invited by journal 06 Apr, 2026 Editor invited by journal 27 Mar, 2026 Editor assigned by journal 24 Mar, 2026 Submission checks completed at journal 23 Mar, 2026 First submitted to journal 23 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9093890","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":620481690,"identity":"9604ca75-b53f-49d3-bb57-8be6a22aafe2","order_by":0,"name":"Emma 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England","fulltext":[{"header":"Background","content":"\u003cp\u003eFebrile illness is one of the commonest causes of hospital attendance and admission for children, and management can often be a challenge\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Most febrile children will have self-limiting viral infections and can be safely cared for at home with symptomatic treatment and without antibiotics \u003csup\u003e\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. Even in the emergency department, only 10% of febrile children will have serious bacterial infections, and 1% sepsis\u003csup\u003e1\u003c/sup\u003e. Despite these low risks, there is a recognised anxiety amongst caregivers around fever in children.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e Accurately identifying children with severe bacterial infections and sepsis early can be difficult, as clinical signs and symptoms are often non-specific, and, current investigative tests take time to yield results\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. This can lead to children being subjected to more invasive tests, long waits for results and potentially being prescribed antibiotics, they do not need. The wait for inconclusive tests may result in delayed patient flow, unnecessary admissions or delayed discharge and overprescription risks worsening antimicrobial resistance. Unnecessary attendance and admission have financial implications for hospital trusts and affects families and patients directly in terms of distress, out-of-pocket costs and inconvenience\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003ePoint-of-care tests (POCTs) are diagnostic tests which can be performed close to the patient, and give results rapidly enough to influence immediate clinical decisions without a central laboratory, usually within one hour.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e They have the potential to improve efficiency of patient flow, and limit the use of other invasive tests. POCTs are advocated for by the World Health Organization as a strategy to reduce inappropriate antibiotic use\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. In low-and-middle-income countries, POCTs have been shown to be feasible and effective in improving appropriate antibiotic prescriptions rates.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe use of POCTs in clinical practice is dependent on uptake by healthcare workers, and acceptability to end users, patients and families. A variety of POCTs are currently available and used in the management of childhood fever including urine dipsticks, rapid respiratory tests for identifying pathogens such as \u003cem\u003eGroup A Streptococcus\u003c/em\u003e, Respiratory Syncytial Virus, SARS-CoV-2 and influenza, and blood tests for C-reactive protein (CRP), blood lactate and blood gases\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Other more novel POCTs are being trialled and implemented in clinical practice\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e such as MeMedBV test\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eResearch has been done to assess the perceptions of healthcare workers around the acceptability of POCTs in children with acute infections\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. However, to our knowledge, there are no studies published on the acceptability and perceptions of children and young people (CYP) who undergo these POCTs in practice. This study aimed to explore CYP\u0026rsquo;s perceptions, preferences and acceptability of (novel) POCT tests in the context of acute febrile illness and infection in childhood.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis was a longitudinal qualitative study of three focus groups involving young people using a thematic questionnaire to guide group discussions. Anonymity of participants was maintained throughout the entire study.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eCYP aged 12 to 18 years inclusive involved with the Young Persons\u0026rsquo; Advisory Group North England (YPAGne) and YPAG Great Ormond Street Hospital (YPAG GOSH), two university tertiary hospitals in Newcastle and London, UK.\u003c/p\u003e\n\u003ch3\u003eData Collection and Setting\u003c/h3\u003e\n\u003cp\u003eThe first two focus groups were held on 9 November 2017 with YPAGne and 17 November 2018 with GOSH YPAG. Both groups do not allow recordings of young person\u0026rsquo;s so each focus group was led by a facilitator, and notes were kept by designated scribes. The third focus group was held on 10 July 2025 with YPAGne. For this group, the questionnaire (Supplemental File 1 \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://docs.google.com/forms/\u003c/span\u003e\u003cspan address=\"https://docs.google.com/forms/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) was distributed via QR code and using online messaging apps as preferred by participating CYP, small group discussion was recorded by facilitators and by young persons via the online questionnaire.\u003c/p\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cp\u003eData were collected on baseline demographics. Participants where firstly given a ranking and prioritisation task. CYP selected the factors they valued when attending a paediatric emergency department from a curated list of options and then ranked the six factors they valued most in order of priority.\u003c/p\u003e \u003cp\u003eThe second section of the questionnaire explored availability and characteristics of a novel POCTs for febrile illness. CYP were asked if the test should be available; directly to patients, from a medical care centre, or hospital, and, who should interpret the results. Next, they were asked what kind of test they would prefer, e.g. blood, saliva or urine, and if a blood test whether they would prefer a finger prick or venous sample.\u003c/p\u003e \u003cp\u003eThe last section of the questionnaire explored the possible impact of test results. Participants were asked if the test was negative (e.g. no serious bacterial infection), would they still want to see a healthcare practitioner and why. Participants were asked how they thought test results would change healthcare practitioner\u0026rsquo;s explanations of their illness. A final open-ended text box was available for any further comments the participants might have.\u003c/p\u003e\n\u003ch3\u003eAnalysis\u003c/h3\u003e\n\u003cp\u003eQuantitative data from closed questions were analysed in SPSS version 29. Data were not normally distributed. Qualitative data from open-ended questions was analysed using a qualitative thematic approach\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Qualitative data were compared between the 2017/2018 focus groups and the 2025 focus group. This allowed for identification in changes of CYP views. Participants from the 2017/18 focus groups were in the same age group as the 2025 iteration.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e10 CYP participated in the 2017 focus group, 25 in 2018, and 19 in 2025. There was an equal male to female ratio, and all participants were between 12 and 18 years of age. The ranking exercise showed that participants primarily valued feeling safe, clear plans and effective communication (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). They also valued efficiency, hygiene and seeing an experienced practitioner. They found it less important to have scans performed, or waiting to be seen.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003ePOCT test type preference\u003c/h3\u003e\n\u003cp\u003eFor CYP, from all focus groups, first choice for a novel POCT was saliva samples (74% in 2025) followed by blood samples. \u003cem\u003e\u0026ldquo;The saliva test is most acceptable, because it is easier to obtain, and carries less stigma of being sick (2017 participant)\u0026rdquo;\u003c/em\u003e. Blood samples were acceptable to half the group (53% in 2025\u003cem\u003e)\u003c/em\u003e, but were associated with pain, discomfort and fear of needles. If a blood test had to be done, CYP preferred finger prick testing over venous blood sampling. Urine was least preferred, with 70% of CYP preferring a finger prick test over a urine test. CYP nearly universally expressed displeasure with urine samples as they perceived them as abhorrent. \u003cem\u003e\u0026ldquo;Urine is gross (2017 participant).\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003ch3\u003ePOCT test availability\u003c/h3\u003e\n\u003cp\u003eCYP felt novel POCTs should be available directly to patients (84% in 2025), with the caveat that half felt it should only be available from a medical centre (53% in 2025). CYP expressed concerns with acquiring POCTs from the internet or a non-medical environment (e.g. supermarkets). They felt it was important that the test \u003cem\u003e\u0026ldquo;Needs to be good, reliable and have few failures, otherwise it is better to see your general practitioner (2017 participant)\u0026rdquo;. \u0026ldquo;The internet is untrustworthy. buying the test over the internet might not be the real thing and might not be correctly made.(2025 participant)\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003eCYP report that healthcare providers other than the hospitals are acceptable, for example pharmacies. They did not view it necessary to obtain tests from medical professionals. \u003cem\u003e\u0026ldquo;It is nicer to have the test in the pharmacy; they can give clear instructions on how to use it and are reliable (2018 participant)\u003c/em\u003e.\u0026rdquo; One participant noted this would also be a solution for people living in rural or remote areas \u003cem\u003e\u0026ldquo;I live in a small town where the general practice has recently closed, if I had the test, I might not need an appointment in another practice or hospital far away unnecessarily\u0026rdquo;.(2025 participant)\u003c/em\u003e\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eInterpreting POCT results\u003c/h2\u003e \u003cp\u003eJust over half of the participants did not want to see a medical practitioner if the test showed it was not a bacterial infection and they were not seriously ill. The main theme was altruism. \u003cem\u003e\u0026ldquo;It\u0026rsquo;s important for other people to receive expert care and not me in this situation (2018 participant)\u0026rdquo;\u003c/em\u003e. CYP also acknowledge the burden they might represent on the healthcare system: \u003cem\u003e\u0026ldquo;Because ..(the system) will be flooded with patients who have serious issues and need urgent care, adding to that\u0026hellip;. despite not needing medical attention, would increase the stress on doctors and prevent people who actually need to be seen from receiving care (2025 participant).\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003eOn the other hand, participants identified a common theme of seeking reassurance: \u003cem\u003e\u0026ldquo;You don\u0026rsquo;t know if the test is entirely trustworthy and want some reassurance from a human. A person [who] tells you what to do next, especially if [you] get worse once [you] have gone home in a few days\u0026rsquo; time.(2025 participant)\u0026rdquo;\u003c/em\u003e Additionally, CYP recognised a need for management plans for their health: \u003cem\u003e\u0026ldquo;I\u0026rsquo;m still a bit sick, [I] would like to get advice on how to manage my health (2017 participant).\u0026rdquo;\u003c/em\u003e Participants did not feel this practitioner had to be a doctor: \u003cem\u003e\u0026ldquo;[It] doesn\u0026rsquo;t matter if it\u0026rsquo;s a doctor or a nurse, as long as you know what they are doing. Just trust that if they are in the emergency department, they know what they are doing (2018 participant)\u0026rdquo;\u003c/em\u003e These views and themes were consistent across the focus groups.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003ePOCT test views on test outcomes\u003c/h2\u003e \u003cp\u003eParticipants felt that a new POCT for febrile illness would change healthcare practitioners explanation of why they are sick particularly around reassurance and appropriate prescribing. \u003cem\u003e\u0026ldquo;Some people do not trust or fully believe the doctor. If a test is quick and available, it will support the doctor, and the test will help eliminating quickly what the cause of the condition is. Hard evidence can reduce unnecessary treatment (2017 participant).\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003eThey acknowledge the potentially beneficial impact of a novel tests on patient flow and patient pathways. One participant stated: \u003cem\u003e\u0026ldquo;This would alleviate so much pressure off the NHS [National Health Service red.] ... Waiting lists are crowded with people who do not need urgent care, yet people are confused as to what is and isn\u0026rsquo;t an emergency. This test will provide people assurance and allow more serious cases to be seen quickly (2025 participant)\u0026rdquo;\u003c/em\u003e.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe 2022 UN Convention on the Rights of the Child Article 12\u003csup\u003e17\u003c/sup\u003e states that every child has the right to express their views, feelings and wishes in all matters affecting them, and to have their views considered and taken seriously. This underlines the importance of exploring CYP views on new health technologies, that may well become commonplace in paediatric care pathways. In fact, there is a risk if we do not involve CYP in the development of novel POCT implementation they will not meet expectations and be rejected by end users. Early patient involvement and engagement \u0026lsquo;\u003cem\u003eThrough participation in health technology development, CYP and their families can provide context, insight, personal experience and tacit knowledge to ensure that the end-product is usable, acceptable, and can be integrated into its intended environment\u003c/em\u003e.\u0026rsquo;\u003csup\u003e18\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDespite the growing literature on healthcare and parental perspectives, this is one of the first studies exploring the views and perspectives of CYP around the use of POCT for febrile illness. In general, over the 8-year period CYP views did not change. What they valued during a paediatric emergency attendance was feeling safe, good plans and clear communication, and they ranked length of stay as less important. CYP are open to the use of POCT to enhance the clinical assessment of their illness, provided the test is reliable and has a low failure rate. This is in line with studies among CYP using assisted technology tools to manage chronic illnesses, where CYP also voiced the necessity of an \u0026lsquo;official source\u0026rsquo; or endorsement by clinicians before they would be comfortable to use a new tool or test.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e Participants always preferred non-invasive sampling such as saliva tests, as this is more convenient, not painful and carries less stigma, unsurprisingly this preference did not change over time. CYP disliked urine testing, as it was perceived as repulsive and embarrassing. Urine samples are also slow and technically difficult to collect in younger children for parents and staff alike. Blood tests were deemed suitable if needed but are less preferred due to pain and fear of needles and finger prick tests were the majority choice. In contrast primary care physicians perceived finger prick testing in children as a barrier and would consider skipping a POCT and prescribe antibiotics regardless for young children in view of their vulnerability.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e Participants valued trust and reliability of POCT, so acquiring tests from unknown sources such as the internet was considered risky. CYP wanted to access to tests from trusted healthcare providers, such as primary or secondary healthcare centres and pharmacies. This concurs with national initiatives such as \u0026lsquo;Pharmacy First\u0026rsquo; where community pharmacies in the UK provide treatment for certain minor illnesses. CYP also recognised the benefit of access to tests in rural settings or where availability of a primary care physicians may be limited. Availability of novel tests locally would support the 2019 NHS long term plan to shift care from hospitals to community and primary care and reduce avoidable admissions and emergency department attendances.\u003c/p\u003e \u003cp\u003eThe relationship between delivery of a new test and assessment by a healthcare provider is complex and multifactorial, in participants\u0026rsquo; view. Half felt if the test had excluded a bacterial infection and the need for antibiotics, they would be happy to leave without review. Although this identifies the need for consistent safety netting information and self-care advice such as the NHS website or UK Healthier Together Programme which provides information and resources for families and professionals. The other half of participants wanted interpretation of results, reassurance and advice on managing symptoms from a person and felt that results could not be trumped by expert opinion of a healthcare provider.\u003c/p\u003e \u003cp\u003eParticipants recognised the potential benefit POCTs may offer to the paediatric healthcare system as a whole. Perceived advantages included improvements in patient flow and communication, consistent with the views reported by healthcare providers and parents in similar clinical settings\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. However, CYP were less aware of the potential negative impact of POCTs, particularly in relation to diagnostic uncertainty, and the role of POCTs as part of the broader clinical assessment rather than a standalone test. In addition, compared with healthcare workers, CYP showed limited awareness of cost implications associated with introducing or using novel POCTs and whether these tests would be economically beneficial to the wider healthcare system.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eFindings across the three focus group iterations were broadly consistent, with little change in views over time around the role and administration of new POCTs. We had anticipated that the COVID-19 pandemic might influence CYP perspectives particularly increasing acceptance of saliva-based tests or reducing expectations of in-person healthcare reviews, given the widespread use of SARS-CoV-2 POCT mouth and nasal swabs. However, no such shift was observed.\u003c/p\u003e \u003cp\u003eWe recognise our study is limited due to the small sample size, and recruitment from only two regions within the UK. Participants were recruited from Young Persons Advisory Groups and may have had more interest or experience of the healthcare system than the general population, potentially limiting the transferability of findings. Further studies involving larger and more diverse cohorts from different countries and cultural contexts are needed to assess whether our findings are generalisable. However, this study provides valuable insights into the views and perspectives of young people over an eight-year period.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study shows that children and young people value novel POCTs as important and acceptable tools to improve the diagnosis of febrile illness and potentially reduce avoidable hospital admissions and attendances. They have a preference for non-invasive sampling (e.g. saliva) and if necessary, finger prick blood tests. They view tests as a decision- making aid but still value expert healthcare opinion and the value of face-to-face assessment and to ensure trust and reliability is maintained.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCRP: C-reactive protein\u003c/p\u003e\n\u003cp\u003eCYP: Children and Young People\u003c/p\u003e\n\u003cp\u003eNHS: National Health Service\u003c/p\u003e\n\u003cp\u003ePOCT: point-of-care test\u003c/p\u003e\n\u003cp\u003eUK: United Kingdom\u003c/p\u003e\n\u003cp\u003eYPAG: Young Persons\u0026rsquo; Advisory Group for research\u003c/p\u003e\n\u003cp\u003eYPAGne: Young People\u0026rsquo;s Advisory Group Northeast\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from London and Dulwich Research Ethics Committee, NHS Health Research Authority. This study is part of the wider Diagnosis and Management of Febrile Illness using RNA Personalised Molecular Signature Diagnosis (DIAMONDS) study, ethics approval was obtained for the UK under IRAS 209035, REC 16/LO/1684.\u003cbr\u003e\u0026nbsp;\u003cbr\u003e\u0026nbsp;Participants were members of a Young Persons’ Advisory Group (YPAG), for which parental or legal guardian consent for attendance had been obtained as part of standard governance procedures. This included all participants over and under the age of 16 years. For this research activity, all participants were provided with age-appropriate participant information sheets and given the opportunity to ask questions prior to participation.\u003c/p\u003e\n\u003cp\u003eInformed assent was obtained directly from all young people before participation in focus groups and anonymous surveys. Participants were considered competent to provide assent in line with Gillick competence. Participation was entirely voluntary, and young people were informed that they could decline or withdraw at any time without affecting their involvement in the advisory group.\u003c/p\u003e\n\u003cp\u003eNo identifiable personal data were collected. Given the low-risk, non-sensitive and fully anonymous nature of the data, and in line with guidance from the Health Research Authority, additional parental consent for the specific research activity was not required, and a proportionate approach to consent was adopted.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for Publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFvdV, ME and EL received funding from the European Union’s Horizon 2020 Research \u0026amp; Innovation programme under grant number 848196.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthor contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEL and ME conceptualised the study. EL, DL and LV designed the survey, conducted the focus groups in 2017/2018, and performed the thematic analysis. FvdV, EL, and JB conducted the survey in 2025. FvdV analysed the combined dataset and wrote the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll authors read the manuscript, provided feedback and approve of the final manuscript for submission.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgments\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe kindly thank the YPAGne and YPAG GOSH teams for facilitating the focus groups and the young people for their participation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSands R, Shanmugavadivel D, Stephenson T, Wood D. Medical problems presenting to paediatric emergency departments: 10 years on. Emerg Med J. 2012;29(5):379-82.\u003c/li\u003e\n\u003cli\u003eKolberg L, Khanijau A, van der Velden FJS, Herberg J, De T, Galassini R, et al. Raising AWaRe-ness of Antimicrobial Stewardship Challenges in Pediatric Emergency Care: Results from the PERFORM Study Assessing Consistency and Appropriateness of Antibiotic Prescribing Across Europe. Clin Infect Dis. 2024;78(3):526-34.\u003c/li\u003e\n\u003cli\u003eVan den Bruel A, Haj-Hassan T, Thompson M, Buntinx F, Mant D, European Research Network on Recognising Serious Infection i. Diagnostic value of clinical features at presentation to identify serious infection in children in developed countries: a systematic review. Lancet. 2010;375(9717):834-45.\u003c/li\u003e\n\u003cli\u003eDe S, Williams GJ, Hayen A, Macaskill P, McCaskill M, Isaacs D, et al. Accuracy of the \u0026quot;traffic light\u0026quot; clinical decision rule for serious bacterial infections in young children with fever: a retrospective cohort study. BMJ. 2013;346:f866.\u003c/li\u003e\n\u003cli\u003eMerlo F, Falvo I, Caiata-Zufferey M, Schulz PJ, Milani GP, Simonetti GD, et al. New insights into fever phobia: a pilot qualitative study with caregivers and their healthcare providers. Eur J Pediatr. 2023;182(2):651-9.\u003c/li\u003e\n\u003cli\u003evan der Velden FJS, Lim E, Smith H, Walsh R, Emonts M. Quantifying the costs of hospital admission for families of children with a febrile illness in the North East of England. BMJ Paediatr Open. 2024;8(1).\u003c/li\u003e\n\u003cli\u003eLeigh S, Grant A, Murray N, Faragher B, Desai H, Dolan S, et al. The cost of diagnostic uncertainty: a prospective economic analysis of febrile children attending an NHS emergency department. BMC Med. 2019;17(1):48.\u003c/li\u003e\n\u003cli\u003eLarkins MC, Thombare A. Point-of-Care Testing. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Aparna Thombare declares no relevant financial relationships with ineligible companies.2025.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Global Action Plan on Antimicrobial Resistance 2015 [cited 2025 16 October]. Available from: https://iris.who.int/server/api/core/bitstreams/1a487887-e162-46a0-8aef-802907c66070/content.\u003c/li\u003e\n\u003cli\u003eGres E, Brigadoi G, Zamperetti E, Dramowski A, Dahourou D, Mavoko HM, et al. Antibiotic stewardship and point-of-care testing for children in 25 low-income and lower-middle-income countries: a systematic review and meta-analysis. EClinicalMedicine. 2025;90:103667.\u003c/li\u003e\n\u003cli\u003eLarsson A, Greig-Pylypczuk R, Huisman A. The state of point-of-care testing: a European perspective. Ups J Med Sci. 2015;120(1):1-10.\u003c/li\u003e\n\u003cli\u003eDiamantopoulou P, Karagiannidou S, Loizou CE, Papaevangelou V, Syridou G. Real-World Utility of the Host-Response MeMed BV Test in a Pediatric Emergency Department: A Non-Randomized Study with Optimized Antimicrobial and Diagnostic Stewardship. Children (Basel). 2025;12(9).\u003c/li\u003e\n\u003cli\u003eChokkalla AK, Tam E, Liang R, Cruz AT, Devaraj S. Validation of a multi-analyte immunoassay for distinguishing bacterial vs. viral infections in a pediatric cohort. Clin Chim Acta. 2023;546:117387.\u003c/li\u003e\n\u003cli\u003eBustinduy AL, Jeyaratnam D, Douthwaite S, Tonkin-Crine S, Shaw R, Hyrapetian L, et al. Point-of-care tests for infectious diseases: barriers to implementation across three London teaching hospitals. Acta Paediatr. 2017;106(7):1192-5.\u003c/li\u003e\n\u003cli\u003eLi E, Dewez JE, Luu Q, Emonts M, Maconochie I, Nijman R, et al. Role of point-of-care tests in the management of febrile children: a qualitative study of hospital-based doctors and nurses in England. BMJ Open. 2021;11(5):e044510.\u003c/li\u003e\n\u003cli\u003eTong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57.\u003c/li\u003e\n\u003cli\u003eUN Commission on Human Rights UCoH. Convention on the Rights of the Child. Geneva: UN Commission on Human Rights, 1990 7 March 1990. Report No.: E/CN.4/RES/1990/74.\u003c/li\u003e\n\u003cli\u003eWheeler G, Mills N, Ankeny U, Howsley P, Bartlett C, Elphick H, et al. Meaningful involvement of children and young people in health technology development. J Med Eng Technol. 2022;46(6):462-71.\u003c/li\u003e\n\u003cli\u003eBlower S, Swallow V, Maturana C, Stones S, Phillips R, Dimitri P, et al. Children and young people\u0026apos;s concerns and needs relating to their use of health technology to self-manage long-term conditions: a scoping review. Arch Dis Child. 2020;105(11):1093-104.\u003c/li\u003e\n\u003cli\u003eSchot MJ, Broekhuizen BD, Cals JW, Brussee E, de Wit NJ, Verheij TJ, et al. C-reactive protein point-of-care testing in children with cough: qualitative study of GPs\u0026apos; perceptions. BJGP Open. 2018;1(4):bjgpopen17X101193.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-ethics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meth","sideBox":"Learn more about [BMC Medical Ethics](http://bmcmedethics.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meth/default.aspx","title":"BMC Medical Ethics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"children and young people, febrile illness, point-of-care testing","lastPublishedDoi":"10.21203/rs.3.rs-9093890/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9093890/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRapid point-of-care tests (POCTs) are increasingly used to support clinical decision making.\u003c/p\u003e\n\u003cp\u003eand appropriate antibiotic prescribing. Whilst a few studies have explored healthcare workers’ views on using POCTs in paediatric febrile illness, little is known about the perspectives of children and young people (CYP) who may undergo these tests. This study aimed to explore the acceptability and perceptions of British CYP to POCTs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThree focus groups were conducted with CYP aged 12-18 years, from Young Persons’ Advisory Groups, at university hospitals in Newcastle and London, UK. Data were collected using questionnaires and semi-structured group discussions. Qualitative thematic analysis was undertaken to identify key themes relating to POCT acceptability, availability and perceived impact.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 54 CYP participated (10 in 2017 focus group, 25 in 2018, and 19 in 2025).\u003c/p\u003e\n\u003cp\u003eThe majority supported the implementation of POCT tests, provided they are accessible through community or hospital healthcare services. Key themes identified included altruism, test reliability, and the need for healthcare advice or review in-person following the test. CYP prefer non-invasive tests such as saliva-based sampling, over blood tests, and reported aversion to urine samples. POCTs were viewed as a means of \u0026nbsp;improving assessment of unwell children and potentially reduce the burden on health care services if the test results were reassuring.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCYP are in favour for POCTs to facilitate and improve the care they receive. They recognised the potential benefits they might have in their care, but are aware of important limitations particularly regarding availability, interpretation and potential impact on the wider healthcare system.\u003c/p\u003e","manuscriptTitle":"Acceptability of novel point-of-care tests for paediatric febrile illness in the emergency department: a qualitative analysis of views from children and young people in England","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-12 07:41:03","doi":"10.21203/rs.3.rs-9093890/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-15T06:46:39+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"291923599327165492006903008690298707601","date":"2026-04-13T08:01:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-12T08:41:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"290416813846971228249020248082292049297","date":"2026-04-10T08:38:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"18695680086740020491650639863241291119","date":"2026-04-09T15:18:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17886574891548425307321254141073233148","date":"2026-04-08T13:10:07+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-06T14:16:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"303577719585107787731239723334105149920","date":"2026-04-06T13:04:35+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-06T12:47:40+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-27T12:33:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-24T05:03:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-23T13:13:24+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Ethics","date":"2026-03-23T09:45:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-ethics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meth","sideBox":"Learn more about [BMC Medical Ethics](http://bmcmedethics.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meth/default.aspx","title":"BMC Medical Ethics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"60cf5967-1c51-4d34-bbf0-f00a9084b127","owner":[],"postedDate":"April 12th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-06T04:10:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-12 07:41:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9093890","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9093890","identity":"rs-9093890","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}