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Accuracy of tympanic and infrared skin thermometers in children
B F Paes1, K Vermeulen, R M Brohet
1Department of Pediatrics, Spaarne Hospital, Hoofddorp, The Netherlands.
Insights
Rectal thermometers remain the gold standard for measuring children's temperature. Tympanic and infrared thermometers are not accurate enough to replace rectal measurements for detecting fever in pediatric patients.
Area of Science:
- Pediatric medicine
- Medical devices
- Clinical thermometry
Background:
- Rectal temperature measurement is the gold standard for pediatric fever detection.
- Existing alternative thermometers have limitations.
- Tympanic and infrared thermometers are potential alternatives.
Purpose of the Study:
- To evaluate the accuracy of tympanic and infrared thermometers against rectal temperature in children.
- To assess the influence of variables on temperature measurements.
- To determine if alternative thermometers can reliably detect fever.
Main Methods:
- Prospective cohort study of 100 children (0-18 years).
- Comparison of rectal, tympanic, and two infrared (Beurer, Thermofocus) thermometers.
- Analysis of temperature differences and diagnostic values.
Main Results:
- Tympanic, Beurer, and Thermofocus thermometers showed significant differences from rectal temperatures (p<0.001).
- Diagnostic accuracy (sensitivity, specificity) was unacceptable for all tested devices, especially Beurer.
- Temperature discrepancies persisted across different demographics and conditions.
Conclusions:
- Tympanic, Beurer, and Thermofocus thermometers cannot reliably predict rectal temperature in children.
- These devices are not recommended to replace rectal measurement as the gold standard for fever detection.
- Infrared skin thermometers performed less accurately than tympanic measurements when rectal measurement was not used.
Background:
Rectal measurement is considered a gold standard in many healthcare systems for body temperature measurement in children. Although this method has several disadvantages, an ideal alternative thermometer has not yet been introduced. However tympanic and infrared skin thermometers are potential alternatives.
Methods:
A prospective cohort study was performed including 100 children between 0 and 18 years of age admitted to the general paediatric ward of Spaarne Hospital in The Netherlands between January and March 2009. The objectives of this study are to evaluate the accuracy of tympanic and two types of infrared skin thermometers (Beurer and Thermofocus) compared to rectal measurement and furthermore to evaluate the influence of different variables on temperature measurements.
Results:
Compared to rectal measurement (37.56°C), the mean temperatures of the tympanic (37.29°C), Beurer (36.79°C) and Thermofocus (37.30°C) thermometers differed significantly (p<0.001). Mean and SD of differences between rectal temperature and temperature measured with these alternative devices varied significantly (p<0.001). Sensitivity, specificity, positive and negative predictive values for detecting rectal fever measured with the tympanic, Beurer and Thermofocus thermometers are unacceptable, especially for the Beurer thermometer. This difference in temperature between rectal and the alternative thermometers remained after stratification on gender, age, skin colour and otoscopic abnormalities.
Conclusions:
In this study the authors demonstrated that the tympanic, Beurer and Thermofocus thermometers cannot reliably predict rectal temperature. Therefore the authors do not advise replacement of rectal measurement as the gold standard for detecting fever in children by one of these devices. When rectal measurement is not used, the infrared skin thermometers appear to perform less well than tympanic measurements.
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