Performance of infrared ear and forehead thermometers: a comparative study in 205 febrile and afebrile children. STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT Clinical accuracy of a non-contact infrared skin thermometer in paediatric practice. Monitoring Temperature in Children Undergoing Anaesthesia: A Comparison of Methods Infrared tympanic thermometry in comparison with other temperature measurement techniques in febrile children Tympanic, Infrared Skin, and Temporal Artery Scan Thermometers Compared with Rectal Measurement in Children: A Real-Life Assessment Comparison of temporal artery, rectal and esophageal core temperatures in children: Results of a pilot study. Temporal Scanner Thermometry: A New Method of Core Temperature Estimation in ICU Patients Insufficiency in a New Temporal-Artery Thermometer for Adult and Pediatric Patients Comparison of temporal artery thermometer to standard temperature measurements in pediatric intensive care unit patients Unplanned perioperative hypothermia and agreement between oral, temporal artery, and bladder temperatures in adult major surgery patients. Comparison of temporal artery, nasopharyngeal, and axillary temperature measurement during anesthesia in children. Accuracy of a noninvasive temporal artery thermometer for use in infants.
AIMS AND OBJECTIVES This study compared readings from two professional- grade , commercially available infrared ( IR ) thermometers , the ThermoScan ® PRO 4000 prewarmed tip ear thermometer and the Temporal Scanner ( ™ ) TAT-5000 temporal artery thermometer . BACKGROUND The repeatability and precision of readings from IR thermometers for professional use were question ed in the past , but in recent years , these types of thermometers have been technologically improved , so their ability to replicate st and ard temperature readings reliably should be re-examined . DESIGN Febrile and afebrile children were recruited from the emergency department , overflow treatment areas and the paediatric intensive care unit of a large hospital in Argentina . Each child had a r and omised sequence of seven temperature readings , including three from the ear , three from the forehead or behind the ear and one reference oral or rectal reading . METHODS Temperature readings were taken with the ThermoScan PRO 4000 , the Temporal Scanner TAT-5000 and the monitor mode of SureTemp ® Plus , a widely used professional- grade contact thermometer , for reference . RESULTS Of 205 children , 46 % were febrile , per reference thermometer readings . While mean ThermoScan PRO 4000 febrile measurements did not differ significantly from reference , mean Temporal Scanner TAT-5000 febrile measurements were significantly lower ( by a mean of 0·42 ° C ) than the reference . Overall bias of the ThermoScan PRO 4000 was significantly lower than that of the Temporal Scanner TAT-5000 ; repeatability was 1·5 times higher , and overall false-negative rate was about a third that of Temporal Scanner TAT-5000 , when compared to the reference . CONCLUSIONS This study indicates that the ThermoScan PRO 4000 provides measurements closer to those of a professional- grade contact thermometer when compared to the Temporal Scanner TAT-5000 . RELEVANCE TO CLINICAL PRACTICE The odds of misclassifying a febrile child as non-febrile were about threefold higher with the Temporal Scanner TAT-5000 temporal artery thermometer than with the ThermoScan ® PRO 4000 ear thermometer In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old . Such investigations are often analysed inappropriately , notably by using correlation coefficients . The use of correlation is misleading . An alternative approach , based on graphical techniques and simple calculations , is described , together with the relation between this analysis and the assessment of repeatability BACKGROUND Rectal thermometry is considered the most reliable method for measuring the temperature in the paediatric population . Recently , a new non-contact skin infrared thermometer for children was introduced in the market with excellent acceptance by parents . METHODS A prospect i ve , analytical , cross-sectional study was design ed in order to assess the effectiveness of the infrared non-contact thermometer ( Thermofocus ) in comparison with two other known methods used to measure body temperature . Children aged 1 to 48 months were included from the emergency room and inpatient unit . All patients selected were assessed with three different thermometers : ( 1 ) non-contact infrared thermometer ( Thermofocus ) ; ( 2 ) temporal artery thermometer ( Exergen ) ; and ( 3 ) rectal glass mercury thermometer . RESULTS Four hundred and thirty-four patients were eligible to complete the study . One hundred and sixty-seven were identified with fever . The mean age of the patients studied was 14.6 ± 10.7 months . Both devices were strongly correlated with the rectal temperature : r = 0.950 for Exergen and r = 0.952 for Thermofocus . The mean difference in temperature between the rectal temperature and the non-contact thermometer was 0.029 ± 0.01 ° C ( P < 0.001 ) , while the mean difference between the temporal artery thermometer and the rectal temperature was -0.20 ± 0.27 ° C ( P < 0.001 ) . The sensitivity and specificity for the non-contact thermometer is 97 % . The negative predictive value is 99 % , which is especially important to rule out fever and avoid unnecessary laboratory work-up . CONCLUSIONS The non-contact infrared thermometer is a reliable , comfortable and accurate option for measurement of temperature and is very useful for the screening of fever in the paediatric population . More studies are recommended to support the evidence found in this study and compare its accuracy with more complex devices Children undergoing anaesthesia are prone to hypothermia . Perioperative monitoring of patient temperature is , therefore , st and ard practice . Postoperative temperature is regarded as a key anaesthetic performance indicator in Australian hospitals . Many different methods and sites of temperature measurement are used perioperatively . It is unclear to what degree these methods might be interchangeable . The aim of this study was to determine the relationships between temperatures measured at different sites in anaesthetised children . Two hundred children , 0 to 17 years , undergoing general anaesthesia for elective non-cardiac surgery , were prospect ively recruited .  Temperature measurements  were taken in the operating theatre concurrently at the nasopharynx , tympanic membranes , temporal artery , axilla and skin ( chest ) . Patient age and weight were documented .  Temperatures varied according to site of measurement . The mean difference from nasopharyngeal temperature to temperatures at left and right tympanic , temporal , axillary and cutaneous sites were + 0.24 ° C , + 0.24 ° C , + 0.35 ° C , −0.38 ° C and −1.70 ° C , respectively . Levels of agreement to nasopharyngeal temperature were similar at tympanic , temporal and axillary sites . Tympanic and temporal temperatures were superior to axillary temperatures for detection of mild hypothermia ( < 36 ° C ) . Skin temperature showed a large variation from nasopharyngeal measurements . Our findings indicate that measured temperatures vary between sites . Underst and ing these variations is important for interpreting temperature readings Objective : To determine whether infrared tympanic thermometry ( ITT ) measurements more accurately reflect core body temperatures than axillary , forehead , or rectal measurements during fever cycles in children . Design : Prospect i ve cohort study . Setting : Pediatric and cardiac intensive care units at a tertiary care children ’s hospital . Patients : Critically ill children < 7 yrs of age with indwelling bladder catheters . Interventions : Simultaneous temperatures were recorded during both febrile and nonfebrile periods using ITT , indwelling bladder ( core ) , axillary , forehead , and indwelling rectal measurements in 36 children . Measurements and Main Results : Overall ITT measurements were 0.03 ± 1.43 ° F less than core temperature measurements . In comparison , rectal , forehead , and axillary measurements averaged 0.62 ± 1.44 , 0.56 ± 1.81 , and 1.25 ± 1.73 ° F less than core temperature measurements . ITT measurements had better agreement with core measurements during increasing and decreasing temperature cycles . Receiver operating characteristic analysis performed on increasing and decreasing temperature cycle data revealed that ITT measurements performed well , with an area under the curve of 0.855 ( 95 % confidence interval , 0.797–0.913 ) in comparison with rectal measurement area under the curve of 0.777 ( 95 % confidence interval , 0.701–0.853 ) , forehead measurement area under the curve of 0.710 ( 95 % confidence interval , 0.715–0.888 ) , and axillary measurement area under the curve of 0.664 ( 95 % confidence interval , 0.579–0.750 ) . Conclusions : ITT measurements more accurately reflect core temperatures than any other measurement site during febrile and nonfebrile periods in children . ITT measurements are a reproducible and relatively noninvasive substitute for bladder or rectal measurements in febrile children Introduction Body temperature measurement in children is of clinical relevance . Although rectal measurement is the gold st and ard , less invasive tools have become available . We aim ed to describe the accuracy of tympanic , infrared skin , or temporal artery scan thermometers compared with rectal measurement to reflect core temperature . Methods Rectal ( Filac 3000 ; Covidien , Mechelen , Belgium ) , tympanic ( AccuSystem Genius2 Typmanic Infrared Ear Thermometer , Covidien , Mechelen , Belgium ) , temporal artery scan ( Exergen , Exergen Corp , Watertown , Massachusetts ) , and infrared ( ThermoFlash Contactless Medical Electronic Thermometer , Visiomedlab , Paris , France ) body temperature measurements were r and omly performed and readings were collected once . Temperature readings were described as median and range , and observations were compared with rectal temperature readings ( using Wilcoxon , Bl and -Altman , sensitivity , and specificity tests ) . The child ’s comfort was assessed by the child , parent , and nurse ( using Likert scales ) and ease of use was assessed by nurses ( using visual analog scale ) . Results Based on observations in 294 ( median age = 3.2 years , range = 0.02–17 years ) children , the mean difference was 0.49 ° C ( tympanic scan ; P < 0.0001 ) , 0.34 ° C ( infrared skin scan ; P < 0.0001 ) , and 0 ° C ( temporal artery scan ; P = 0.9288 ) , respectively , when compared with rectal temperature readings . Based on visual inspection of Bl and -Altman plots , all tools overestimated the temperature at lower body temperature and underestimated the temperature at higher body temperature , result ing in a sensitivity of 22 % to 41 % and a specificity of 98 % to 100 % for rectal temperatures above 38 ° C . The Likert scale scores and the visual analog scale scores for rectal measurement were only slightly higher when compared with the other methods . Conclusions All noninvasive techniques underperformed compared with rectal measurement . The temporal artery scan deviations were smallest , but all noninvasive techniques overestimate lower temperatures and underestimate higher temperatures compared with rectal measurement . In our h and s , temporal artery scan measurement seems to be second best , but not yet ideal BACKGROUND Rectal thermometry correlates with core temperature and represents the criterion st and ard of measuring temperatures in young children . However , it has numerous disadvantages , and thus , an alternative method of measuring temperature with similar agreement with the core temperature as rectal thermometry is desired . A new , noninvasive temporal artery ( TA ) thermometer synthesizes the skin surface and ambient temperatures to produce an arterial temperature . OBJECTIVE To examine the agreement between the TA and esophageal core thermometers , and to compare it with that between rectal and esophageal temperatures . METHODS In the present prospect i ve , cross-sectional agreement study , intubated surgical out patients younger than 18 years of age had temperatures measured with esophageal and rectal probes , and rectal electronic and TA thermometers . The agreement between esophageal versus rectal and TA thermometers was analyzed by intraclass correlation coefficients and by differences between esophageal versus TA and rectal temperatures with 95 % CIs . The esophageal-rectal and esophageal-TA slopes were compared by Student 's t test . RESULTS In 80 enrolled children , the intraclass correlation coefficients for the esophageal probe versus rectal probe , rectal electronic thermometer and TA thermometer were 0.91 , 0.95 and 0.88 , respectively . The mean esophageal-rectal difference was 0.00+/-0.18 degrees C and esophageal-TA difference was 0.14+/-0.20 degrees C. Linear regression analysis of the relation between esophageal probe versus rectal probe , rectal thermometer and TA thermometer yielded slopes of 0.93 , 0.94 and 0.89 , respectively . The slopes were neither different from each other ( P=0.70 ) nor from the value of 1 . CONCLUSION The TA and esophageal thermometers agree well , and the esophageal-TA and esophageal-rectal temperature agreements are not significantly different Background and Aims : Temperature measurement is a routine task of patient care , with considerable clinical impact , especially in the ICU . This study was conducted to evaluate the accuracy and variability of the  Temporal Artery Thermometer ( TAT ) in ICU- patients . Therefore , a convenience sample of 57 adult patients , with indwelling pulmonary artery catheters ( PAC ) in a 40-bed intensive care unit in a university teaching hospital was used . Methods : The study design was a prospect i ve , descriptive comparative analysis . Body temperature was thereby measured simultaneously with the TAT and the Axillary Thermometer ( AT ) , and was compared with the temperature recording of the PAC . The use of vasoactive medication was recorded . Results and conclusions : Mean temperature of all measurements was : PAC : 37.1 ° C ( SD : 0.87 ) , TAT : 37.0 ° C ( SD : 0.68 ) and axillary thermometer : 36.6 ° C ( SD : 0.94 ) . The measurements of the TAT and the PAC were not significantly different ( mean difference : 0.14 ° C ; SD : 0.51 ; p= 0.33 ) ; whereas the measurements of the PAC and the AT differed significantly ( mean difference : 0.46 ° C ; SD : 0.39 ; p < 0.001 ) . Mean difference in PAC versus TAT analyses , between patients with vasopressor therapy ( 0.12 ° C ; SD : 0.55 ) , and without vasopressor therapy ( 0.19 ° C ; SD : 0.48 ) was not statistically significant ( p= 0.47 ) . Conclusion : We can conclude that the temporal scanner has a relatively good reliability with an acceptable accuracy and variability in patients with normothermia . The results are comparable to those of the AT , but they do not seem to be sufficient to prove any substantial benefit compared to rectal , oral or bladder thermometry SensorTouch ™ is a new noninvasive temperature monitor and consists of an infrared scanner that detects the highest temperature on the skin of the forehead , presumably over the temporal artery . The device estimates core temperature ( Tcore ) . We tested the hypothesis that the SensorTouch ™ is sufficiently precise and accurate for routine clinical use . We studied adults ( n = 15 ) and children ( n = 16 ) who developed mild fever , a core temperature of at least 37.8 ° C , after cardiopulmonary bypass .  Temperature was recorded at 15-min intervals throughout recovery with the SensorTouch ™ thermometer and from the pulmonary artery ( adults ) or bladder ( children ) . Pulmonary artery ( Tcore ) and SensorTouch ™ ( Tst ) temperatures correlated poorly in adults : Tcore = 0.7 · Tst + 13 , r2 = 0.3 . Infrared and pulmonary artery temperatures differed by 1.3 ± 0.6 ° C ; 89 % of the adult temperatures thus differed by more than 0.5 ° C . Bladder and infrared temperatures correlated somewhat better in pediatric patients : Tcore = 0.9 · Tst + 12 , r2 = 0.6 . Infrared and bladder temperatures in children differed by only 0.3 ° C , but the sd of the difference was 0.5 ° C . Thus , 31 % of the values in the infants and children differed by more than 0.5 ° C Objectives : To determine the accuracy of noninvasive infrared temporal artery thermometry compared with rectal , axillary , and pulmonary artery catheter measurements in pediatric intensive care patients , and to determine whether temporal artery temperatures are affected by circulatory shock or by vasopressor use . We hypothesized that temporal artery temperatures do not differ from axillary and rectal temperatures in critically ill children , but temporal artery accuracy is decreased by shock or vasopressor use . Design : Observational study , unblinded . Setting : Pediatric intensive care unit of a quarternary referral children ’s hospital . Patients : Seventy-five temperature comparison pairs were obtained in 44 pediatric intensive care unit patients . Interventions : Temperature measurements were made using a temporal artery thermometer with simultaneously obtained rectal , axillary , and , when available , pulmonary artery catheter measurements . Measurements and Main Results : Mean bias was calculated between comparison pairs using each temperature method . Bl and -Altman analysis demonstrated wide variability between methods . No significant differences in mean bias were seen between method pairs for all temperatures , but bias was significantly less in pulmonary artery catheter-rectal pairs compared with other method pairs . In febrile ( > 38 ° C ) patients , bias in rectal-temporal artery and rectal-axillary was significantly greater than in temporal artery-axillary pairs ( p < .001 ) . Mean bias in pulmonary artery catheter-rectal pairs was also significantly smaller than in other pairs for all patients ( p = .008 ) and febrile patients ( p = .049 ) . Presence of shock or vasopressor use did not significantly increase bias in any comparison pair . Sensitivity and specificity of both temporal artery and axillary for diagnosing fever were similar and improved with fever definition at temperatures > 38.5 ° C . Conclusions : Temporal artery and axillary temperature measurements showed variability to rectal temperatures but had marked variability in febrile children . Neither was sufficiently accurate to recommend replacing rectal or other invasive methods . As temporal artery and axillary provide similar accuracy , temporal artery thermometers may serve as a suitable alternative for patients in whom invasive thermometry is contraindicated Accurate body core temperature measurement is essential in perioperative areas to quickly recognize and address abnormal temperatures . The purpose s of this prospect i ve , descriptive study were to accurately identify unplanned perioperative hypothermia ( UPH ) in 64 elective major surgery patients ; to describe factors that increased the risk of UPH ; to describe active/passive warming measures ; to describe thermal comfort in patients with and without UPH ; and to compare oral , temporal artery , and bladder temperatures . Based on bladder temperatures , 52 % of the patients had UPH in the operating room ( OR ) and 42 % on postanesthesia care unit ( PACU ) admission . The temporal artery thermometer did not detect any hypothermia . Descriptive data and Bl and -Altman plots showed lack of agreement between the temporal artery thermometer readings and those of the oral and bladder thermometers . The patient 's thermal comfort report did not accurately reflect hypothermia . Factors found to increase the risk of UPH included older age , BMI lower than 30 , and OR ambient temperature lower than 68 ° F . All but one patient had active warming in the OR ; active warming was infrequently used in the PACU . Based on our findings and findings in previous studies , we do not recommend using the temporal artery thermometer in perioperative areas . To prevent UPH , we recommend aggressive use of convective and conductive warming measures in perioperative areas and increasing OR ambient temperatures STUDY OBJECTIVE To evaluate the accuracy and precision of a new , noninvasive infrared thermometer applied to the temporal artery . DESIGN Prospect i ve r and omized study . SETTING Trakya University Hospital . PATIENTS 60 ASA physical status 1 and 2 children undergoing surgery . INTERVENTIONS During anesthesia ,  temperature measurements were recorded with three different techniques : temporal artery , nasopharynx , and axillary temperature . MEASUREMENTS Temperatures  measured from the nasopharynx , temporal artery , and the axilla were recorded at 15-minute intervals for the first hour , then at 30-minute intervals until the completion of surgery . During each measurement , heart rate and midarterial pressure were recorded . MAIN RESULTS There were no statistically significant differences between temperatures recorded at the temporal artery and nasopharynx at 15 , 30 , 45 , 60 , 90 , and 120 minutes , and the completion of surgery . Axillary temperatures were statistically lower than those recorded at the nasopharynx and the temporal artery ( P < 0.001 ) . Bl and -Altman plots showed a correlation of temperature measurements between the temporal artery and nasopharyngeal methods . The axillary method had a lower correlation with the temporal artery and the nasopharyngeal methods . CONCLUSIONS The temporal artery thermometer is a substitute for the nasopharyngeal thermometer for core temperature measurement during anesthesia in children OBJECTIVES To assess the accuracy of a new noninvasive temporal artery ( TA ) thermometer  in infants ; to compare the accuracy of the TA thermometer with that of a tympanic thermometer , using rectal thermometry as the criterion st and ard ; and to compare the tolerability of the TA thermometer with that of the tympanic and rectal thermometers . DESIGN Prospect i ve evaluation of the accuracy of TA and tympanic thermometry , using rectal thermometry as the criterion st and ard . SETTING Emergency department of an urban pediatric hospital . SUBJECTS Convenience sample of 304 infants younger than 1 year presenting for care . MAIN OUTCOME MEASURES Temperatures were measured using  TA , tympanic , and rectal thermometers  for all infants . Agreement between TA or tympanic and rectal temperatures was assessed . The sensitivity and specificity of TA or tympanic thermometers for detecting rectal fever were determined . Discomfort scores , using a st and ardized scale , were assessed by trained observers after each temperature measurement was made . RESULTS Linear regression analysis of the relation between TA and rectal temperatures yielded a model with a slope of 0.79 ( vs a slope of 0.68 for tympanic vs rectal temperature ; P = .02 ) and an r of 0.83 ( vs r = 0.75 for tympanic vs rectal temperature ; P<.001 ) . Among 109 patients with a rectal temperature of 38 degrees C or higher , the TA thermometer had a sensitivity of 0.66 compared with the tympanic thermometer 's sensitivity of 0.49 ( P<.001 ) . Discomfort scores with TA thermometry were significantly lower than with rectal thermometry ( P = .007 ) . CONCLUSIONS The TA thermometer has limited sensitivity for detecting cases of rectal fever in infants . However , the TA thermometer is more accurate than the tympanic thermometer in infants , and it is better tolerated by infants than rectal thermometry
Objectives Systematic review and meta- analysis on the diagnostic accuracy of temporal artery thermometers ( TAT ) .