Clinical thermometry: possible causes and potential solutions to electronic, digital thermometer inaccuracies

Previous research has indicated that the improvements in safety, speed, and ease of use of the newer electronic, digital oral and tympanic clinical thermometers have been offset by a loss in accuracy and reliability when compared with the traditional glass/mercury oral clinical thermometers. The purpose of this study was to determine possible causes of the relative lack of accuracy and reliability in these thermometers and suggest logical potential solutions. Evidence has been reviewed, which suggests that problems with the tympanic thermometers are the result of the range of normal anatomical variability. The combination of an otoscope with the tympanic thermometers is suggested and discussed as a potential solution. Evidence has been reviewed, which suggests that problems with the newer oral thermometers are the results of the size of the temperature sensors and the speed with which they respond. The small sensor size results in variability in placement relative to the primary heat source. The speed of sensor response results in too great a sensitivity to local, acute vasomotor activity (clinical temperature noise). Potential solutions, including an increase in sensor size and a reduction in response speed are discussed.