Related Experiment Videos
A probability nomogram to predict rectal temperature in children
R D Brown1, G Kearns, V F Eichler
1Department of Pharmacology, Lousiana State University Medical Center, Shreveport 71130.
Insights
Predicting child fever is more reliable using statistical nomograms than fixed temperature differences. This method accurately estimates rectal temperature fever from peripheral site measurements, aiding in assessing illness severity when rectal readings are unavailable.
Area of Science:
- Pediatrics
- Medical Thermometry
- Biostatistics
Background:
- Accurate temperature measurement is crucial for diagnosing fever in children.
- Current practices often rely on simplified intersite temperature adjustments, which may lack precision.
- Predicting core body temperature from peripheral sites is challenging but clinically significant.
Purpose of the Study:
- To evaluate the reliability of using a fixed temperature difference for intersite adjustments.
- To develop and validate a statistical method for predicting rectal temperature from peripheral measurements in children.
- To aid in fever assessment when direct rectal temperature measurement is not feasible.
Main Methods:
- Measured rectal, oral, axillary, abdominal skin, and forehead skin temperatures in 257 children using an electronic thermometer.
- Assessed the consistency of temperature differences between peripheral sites and the rectal site.
- Developed cumulative probability nomograms based on statistical criteria for intersite temperature differences.
Main Results:
- A simple, invariant temperature difference was found unreliable for predicting rectal temperature.
- Intersite temperature differences met statistical criteria allowing for normal distribution theory application.
- Constructed nomograms provide clinically reliable predictions of rectal-site fever from peripheral measurements (oral, axillary).
Conclusions:
- Fixed intersite temperature adjustments are not reliable for accurate fever prediction in children.
- A nomogram-based statistical method offers a reliable approach to estimate rectal fever from peripheral temperatures.
- This method enhances the assessment of febrile illness severity when rectal temperature data is unavailable.
Abstract:
The relationship between rectal and peripheral-site temperature was investigated to achieve two objectives: 1) to evaluate a prevailing practice of intersite adjustment by use of an invariant temperature difference; and 2) to develop a statistical method for intersite temperature predictions in the individual child, especially for fever as defined by rectal measurement. Rectal, oral, axillary, left abdomen skin, and forehead skin temperatures (degrees F) were measured with an electronic thermometer in 257 children. Objective 1 was not achieved because a simple temperature difference between a peripheral site and the rectal site could not be used to predict rectal temperature reliably. For objective 2, intersite differences met three statistical criteria so that normal distribution theory could be used to derive the probabilities for occurrence of each difference. Accordingly, cumulative probability nomograms were constructed to estimate rectal-site fever from measurements at peripheral sites. This nomogram method produces a clinically reliable prediction of rectal-site fever from temperature measurement at peripheral sites, especially the oral and axillary sites. These predictions offer useful assessments of febrile illness severity when rectal temperature is not available.