Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability (original) (raw)
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Health Technology Assessment, 2020
Background Current options for temperature measurement in children presenting to primary care include either electronic axillary or infrared tympanic thermometers. Non-contact infrared thermometers could reduce both the distress of the child and the risk of cross-infection. Objectives The objective of this study was to compare the use of non-contact thermometers with the use of electronic axillary and infrared tympanic thermometers in children presenting to primary care. Design Method comparison study with a nested qualitative study. Setting Primary care in Oxfordshire. Participants Children aged ≤ 5 years attending with an acute illness. Interventions Two types of non-contact infrared thermometers [i.e. Thermofocus (Tecnimed, Varese, Italy) and Firhealth (Firhealth, Shenzhen, China)] were compared with an electronic axillary thermometer and an infrared tympanic thermometer. Main outcome measures The primary outcome was agreement between the Thermofocus non-contact infrared thermome...
Journal of Clinical Nursing, 2011
Aims. To assess the performance of the non-contact infrared thermometer compared with mercury-in-glass thermometer in children; to assess the diagnostic accuracy of non-contact infrared thermometer for detecting children with fever; to compare the discomfort caused by the two procedures in children aged > one month. Background. Non-contact infrared thermometer is a quick and non-invasive method to measure body temperature, not requiring sterilisation or disposables. It is a candidate for temperature recording in children. Design. Prospective multicenter study. Methods. Body temperature readings were taken from every child consecutively admitted to the Pediatric Emergency Departments or Pediatric Clinics participating in the study. Two bilateral axillary temperature measurements using the mercuryin-glass thermometers and three mid-forehead temperature measurements using the non-contact infrared thermometer were performed. Results. Two hundred and fifty-one children were enrolled in the study. Mean body temperature obtained by mercury-in-glass thermometer and non-contact infrared thermometer was 37AE18 (SD 0AE96)°C and 37AE30 (SD 0AE92)°C, respectively (p = 0AE153). Non-contact infrared thermometer clinical repeatability was 0AE108 (SD 0AE095)°C, similar to that of the mercury-in-glass thermometer (0AE11 SD 01°C; p = 0AE517). Bias was 0AE0150 (SD 0AE09)°C. The proportion of outliers >1°C was 4/251 children (1AE59%). A significant correlation between temperature values obtained with the two procedures was observed (r 2 = 0AE84; p < 0AE0001). The limits of agreement, by the Bland and Altman method, were À0AE62 (95% CI: À0AE47 to À0AE67) and 0AE76 (95% CI: 0AE61-0AE91). No significant correlation was evidenced between the difference of the body temperature values recorded by the two methods and age (p = 0AE226), or room temperature (p = 0AE756). Calculating the receiver operating characteristic curve to determine the best threshold for axillary temperature >38AE0°C, for a non-contact infrared thermometer temperature = 37AE98°C the sensitivity was 88AE7% and the specificity 89AE9%. Mean distress score (on a 5-point scale) was significantly lower using the non-contact infrared thermometer than using the mercury-in-glass thermometer (1AE92 SD 0AE56 and 2AE40 SD0AE93, respectively; p < 0AE0001). Conclusion. Non-contact infrared thermometer showed a good performance in our study population, has the advantage of measuring body temperature in two seconds and is comfortable for children. Relevance to clinical practice. Non-contact infrared thermometer may be taken into consideration when assessing body temperature in children aged > one month in hospital or ambulatory.
International Journal of Pediatric Otorhinolaryngology, 2002
Objective: The objective in this study was to compare the accuracy of the tympanic membrane infrared thermometer with the other conventional temperature measurement options. Methods: One hundred and ten randomly selected pediatric patients who admitted to our emergency room were included in the study. Each child underwent simultaneous temperature measurement via rectum, axilla, and external auditory canal. The rectal and axillary measurements were performed using conventional mercury in glass thermometers. The aural measurement was performed using the non-contact infrared thermometer (Braun ThermoScan IRT 1020, Germany). Results: On aural measurement, the results of both ears as well as the first, second and third measurements were similar (P<0.01). The mean results of the axillary, rectal and tympanic temperature measurements were 37.46±1, 38.18±1, and 38.01±1.1, respectively. The mean axillary temperature was 0.72 °C lower than the mean rectal temperature, and 0.55 °C lower than the tympanic temperature. The difference between the mean tympanic and rectal temperatures was 0.17 °C. The results of measurements via rectum, axilla and ear were similar (P<0.01). Conclusion: In conclusion, it is apparent that each of the temperature measurement options has some advantages and disadvantages. An optimal thermometer should have the following features; accurate temperature measurement; ease of application in a short while; safety and absence of potential risks; and tolerability by the patient. Since the aural infrared thermometer meets these criteria, its use in the routine clinical practice appears to be advantageous rather than or complementary to the conventional methods.
Open Journal of Pediatrics
Background: Accurate temperature measurement is a critical step in evaluating health or disease especially in children and immmunocompromised subjects; inaccurate measurement may lead to improper diagnosis, wrong treatment or inappropriate intervention. Several methods of temperature measurements exist and comparing these gives room for choosing a near ideal method in terms of speed, safety and accuracy. The study aimed to compare the forehead non touch infra-red thermometer with the axilllary mercury-in-glass method of temperature measurement in the Paediatric age-group. Methods: Study was given ethical approval as part of a larger study. Four hundred and thirty seven children aged 1 to 24 months were studied at the well-baby/immunizationclinic of the University of Ilorin Teaching Hospital over a 6-months period. Both non-touch infrared and theregular mercury-in-glass thermometers were used to take the body temperatures. Data were analysed with SPSS version 21. Pearson correlation was used to determine the relationship between the two methods of temperature measurements, while Bland-Altman method was used to test for level of agreement between them. Results: The mean age and SD was 5.81 ± 4.04 months. Pearson correlation showed a positive correlation between the axillary mercury-in-glass and forehead non-touch infra-red thermometry readings (r = 0.281, p < 0.001). Also, Bland-Altman method revealed a good agreement between both methods of thermometry as 96% of the readings were within the limits of agreement. Mean difference was 0.09˚C (95% confidence interval 0.05-0.13
Comparison of Infrared Tympanic Thermometer with Non-Contact Infrared Thermometer
Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection, 2014
Objective: Non-contact infrared thermometer (NCIT) is a quick, non-invasive, and easy-to-use method to measure body temperature, not requiring sterilization. We aimed to evaluate the reliability of NCIT in the first assessment of patients in a hospital. Material and Methods: The study was carried out in Hacettepe University İhsan Doğramacı Children's Hospital between August and September 2013 with patients older than 4 months who were admitted to the infectious disease outpatient clinic or hospitalized. Body temperature of patients was measured with a tympanic infrared thermometer that is routinely used and with NCIT at the same time. Temperature values, age, and disease of patients were recorded. Results: During the study, 220 measurements were obtained from 76 patients. Fifteen (6.8%) of 220 tympanic measurements were >38.0°C, and 7 of them were also >38.0°C with NCIT measurements. The difference between tympanic and NCIT measurements for each reading was calculated. Positive and negative values were obtained when tympanic readings were higher and lower than NCIT readings, respectively. Mean difference was-0.5°C (±0.3) for negative values and 0.6°C (±0.4)°C for positive ones. Conclusion: NCIT can be preferred for screening of fever, but before routine use in hospitals, more expanded studies with NCIT should be performed.
Italian Journal of Pediatrics, 2011
Background: Monitoring of body temperature is an important clinical procedure in the care of sick children, especially the under-5 children, as many disease conditions present with fever. The oral mercury-in-glass thermometer which has relatively good accuracy cannot be used in children less than 5 years because it requires their cooperation. Objective: This study was aimed at using the infrared tympanic thermometer (IRTT) in oral mode to measure temperature in febrile and afebrile children less than 5 years.
Parents’ concerns and beliefs about temperature measurement in children: a qualitative study
BMC Family Practice, 2021
Background Nearly 40% of parents with children aged 6 to 17 months consult a healthcare professional when their child has a high temperature. Clinical guidelines recommend temperature measurement in these children, but little is known about parents’ experiences of and beliefs about temperature measurement. This study aimed to explore parents’ concerns and beliefs about temperature measurement in children. Methods Semi-structured qualitative interviews were conducted from May 2017 to June 2018 with 21 parents of children aged 4 months to 5.5 years, who were purposively sampled from the METRIC study (a method comparison study comparing non-contact infrared thermometers to axillary and tympanic thermometers in acutely ill children). Data analysis followed a thematic approach. Results Parents described the importance of being able to detect fever, in particular high fevers, and how this then influenced their actions. The concept of “accuracy” was valued by parents but the aspects of per...
2020
A gradual replacement of the mercury thermometers with alternative devices is ongoing around the world as effect of the global strategies to reduce mercury pollution. However, to reduce the risks of misdiagnosis, unnecessary treatments, and omission of care in the pediatric population, more evidence on the reliability and validity of alternative thermometers are needed. The aim of this comparative observational study was to detect any differences in temperature measurements between the gold-standard axillary mercury thermometer (AXLMER) and the alternative devices. Temperature values in Celsius (°C) were simultaneously measured in a group of Albanian children aged up to 14 years using both (AXLMER) and digital axillary thermometers (AXLDGT), as well as forehead and tympanic infra-red thermometers. The AXLDGT device, compared with the AXLMER, showed no clinically significant difference in the mean values (-0.04 ± 0.29 °C) and the narrowest 95% Level of Agreement (+0.53 °C to -0.62 °C...
Use of noncontact infrared thermography to measure temperature in children in a triage room
Medicine
We compared the accuracy and utility of 3 infrared (IFR) thermographs fitted with axillary digital thermometers used to measure temperature in febrile and afebrile children admitted to an emergency triage room. A total of 184 febrile and 135 afebrile children presenting to a triage room were consecutively evaluated. Axillary temperature was recorded using a digital electronic thermometer. Simultaneously, IFR skin scans were performed on the forehead, the neck (over the carotid artery), and the nape by the same nurse. Fever was defined as an axillary temperature ≥37.5°C. The temperature readings at the 4 sites were compared. For all subjects, the median axillary temperature was 37.7 ± 1.5°C, the IFR forehead temperature was 37 ± 1.1°C, the IFR neck temperature was 37.6 ± 1.5°C, and the IFR nape temperature was 37 ± 1.2°C. A Bland-Altman plot of the differences suggested that all agreements between IFR and axillary measures were poor (the latter measure was considered the standard). The forehead measurements had a sensitivity of 88.6% and a specificity of 60% in patients with temperatures ≥36.75°C. The sensitivities of the neck measurement at cutoffs of ≥37.35°C and ≥36.95 were 95.5% and 78.8% for those aged 2 to 6 years. Thus, 11.4% of febrile subjects were missed when forehead measurements were performed. An IFR scan over the lateral side of neck is a reliable, comfortable, rapid, and noninvasive method for fever screening, particularly in children aged 2 to 6 years, in busy settings such as pediatric triage rooms. Abbreviations: AD = axillary digital, IFR = infrared, ROC = receiver-operating characteristics.