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Mass screening for fever in children: a comparison of 3 infrared thermal detection systems
Monica U Selent1, Noelleangelique M Molinari, Amy Baxter
1Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA. monica.selent@us.af.mil
Insights
Infrared thermal detection systems (ITDSs) can accurately screen children for fever, with FLIR and OptoTherm showing good sensitivity and specificity. These noninvasive tools show promise for pediatric fever detection.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Disease Screening
- Medical Device Technology
Background:
- Infrared thermal detection systems (ITDSs) are used for fever screening during infectious disease outbreaks.
- Existing data on ITDS utility in children is limited, despite their accuracy in adults.
Purpose of the Study:
- To evaluate the accuracy of three ITDSs (OptoTherm, FLIR, Thermofocus) for detecting fever in children.
- To compare ITDS performance against traditional thermometry and parental fever reports.
Main Methods:
- A study in a pediatric emergency department compared temperatures from three ITDSs to standard thermometry in children under 18.
- Data analysis included descriptive, multivariate, and receiver operating characteristic analyses, comparing ITDS readings with confirmed fever and parental reports.
Main Results:
- OptoTherm and FLIR demonstrated high sensitivity (83.0%, 83.7%) and specificity (86.3%, 85.7%), comparable to or exceeding parental reports.
- Correlation coefficients between traditional thermometry and ITDSs were 0.78 for OptoTherm, 0.75 for FLIR, and 0.66 for Thermofocus.
- Of 855 patients, 306 had confirmed fever, and 400 reported fever.
Conclusions:
- FLIR and OptoTherm ITDSs are reasonably accurate for detecting fever in children, outperforming parental reports.
- These findings support the use of ITDSs as a valuable noninvasive tool for fever screening in pediatric populations.
Objectives:
Infrared thermal detection systems (ITDSs) have been used with limited success outside the United States to screen for fever during recent outbreaks of novel infectious diseases. Although ITDSs are fairly accurate in detecting fever in adults, there is little information about their utility in children.
Methods:
In a pediatric emergency department, we compared temperatures of children (<18 years old) measured using 3 ITDSs (OptoTherm Thermoscreen, FLIR ThermoVision 360, and Thermofocus 0800H3) to standard, age-appropriate temperature measurements (confirmed fever defined as ≥38.0°C [oral or rectal], ≥37.0°C [axillary]). Measured temperatures were compared with parental reports of fever using descriptive, multivariate, and receiver operating characteristic analyses.
Results:
Of 855 patients, 400 (46.8%) had parent-reported fever, and 306 (35.8%) had confirmed fever. At optimal fever thresholds, OptoTherm and FLIR had sensitivity (83.0% and 83.7%, respectively) approximately equal to parental report (83.9%) and greater than Thermofocus (76.8%), and specificity (86.3% and 85.7%) greater than parental report (70.8%) and Thermofocus (79.4%). Correlation coefficients between traditional thermometry and ITDSs were 0.78 (OptoTherm), 0.75 (FLIR), and 0.66 (Thermofocus).
Conclusions:
Compared with traditional thermometry, FLIR and OptoTherm were reasonably accurate in detecting fever in children and better predictors of fever than parental report. These findings suggest that ITDSs could be a useful noninvasive screening tool for fever in the pediatric age group.
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