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Is the temporal artery thermometer a reliable instrument for detecting fever in children?
Corine Penning1, Jan H van der Linden, Dick Tibboel
1Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands. c.penning@erasmusmc.nl
Insights
Temporal artery thermometers show low accuracy for detecting fever in children aged 0-18 years. Rectal temperature remains the recommended standard for accurate fever diagnosis in pediatric patients.
Area of Science:
- Pediatric Medicine
- Diagnostic Accuracy Studies
- Thermometry
Background:
- Conflicting evidence exists regarding the diagnostic accuracy of temporal artery thermometers in children.
- Previous studies have not evaluated a large, diverse pediatric age group (0-18 years).
Purpose of the Study:
- To assess the diagnostic accuracy of temporal artery thermometers compared to rectal temperature measurements.
- To evaluate the thermometer's performance across a wide age range of children (0-18 years).
Main Methods:
- A diagnostic accuracy/validation study was conducted.
- Children aged 0-18 years with and without fever were recruited.
- Temporal artery and rectal temperatures were recorded, and agreement, sensitivity, and specificity were calculated.
Main Results:
- The study included 198 children (mean age 5.1 years), with 81 having fever.
- Mean temperature difference was -0.11°C (SD 0.63°C) with an agreement of 0.812.
- Sensitivity for fever detection was 67.9%, and specificity was 98.3%.
Conclusions:
- The diagnostic accuracy of temporal artery thermometers for fever detection in children is low.
- Temporal artery thermometers are not recommended as a replacement for standard clinical thermometers.
Aims And Objective:
We aimed to study the diagnostic accuracy of the temporal artery thermometer vs. rectal temperature in a large group of children with and without fever, aged 0-18 years.
Background:
Many have studied the diagnostic accuracy of the temporal artery thermometer in children compared with a reference method, with contradictory outcomes. No studies have been carried out in a large group of children of all ages.
Design:
Diagnostic accuracy/validation study.
Method:
Children (0-18 years) with fever (T>38·0°C) were recruited through the emergency department and children with normal temperatures through the day-care department of the Children's Hospital. All children routinely had rectal temperature recordings. Temporal artery temperature was recorded shortly after the rectal recording. The mean absolute difference in temperature, the level of agreement (intraclass correlation coefficient) and the sensitivity and specificity of detecting fever were calculated.
Results:
A total number of 198 children (121 boys) participated, with a mean age of 5·1 (SD 4·7) years. Of those children, 81 had fever according to the rectal recording. Mean difference between temporal artery temperature and rectal temperature was -0·11 (SD 0·63)°C, with an agreement of 0·812. The sensitivity and specificity of the temporal artery thermometer for detecting fever were 67·9 and 98·3%, respectively.
Conclusions:
The diagnostic accuracy of the temporal artery thermometer in detecting fever in children of all ages is low.
Relevance To Clinical Practice:
We do not recommend replacement of standard clinical thermometers with temporal artery thermometers.
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