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Accuracy of tympanic and forehead thermometers in private paediatric practice
J Teller1, M Ragazzi, G D Simonetti
1Private Paediatric Practice, Langnau i.E, Switzerland.
Insights
Infrared tympanic and forehead thermometers measure lower temperatures than rectal thermometers in children. Forehead thermometers showed wide agreement limits and are not recommended for pediatric use.
Area of Science:
- Pediatrics
- Medical Devices
- Thermometry
Background:
- Accurate temperature measurement is crucial for diagnosing fever in children.
- Traditional rectal thermometry is considered the gold standard but can be invasive.
- Non-contact and less invasive alternatives like infrared tympanic and forehead thermometers are increasingly used.
Purpose of the Study:
- To compare the accuracy of infrared tympanic and forehead thermometers against rectal digital thermometers.
- To evaluate the agreement and reliability of these devices in pediatric patients.
Main Methods:
- Prospective study involving 254 children (1-24 months) with fever.
- Body temperature measured using rectal, tympanic, and forehead infrared thermometers.
- Bland-Altman analysis used to assess agreement between devices.
Main Results:
- Both tympanic and forehead thermometers recorded lower temperatures than rectal thermometers.
- Forehead thermometer limits of agreement were wide (-1.18 to +1.64°C).
- Tympanic thermometer limits of agreement were considerable (-0.73 to +1.04°C); specificity was good, but sensitivity was low for fever detection.
Conclusions:
- Infrared forehead thermometers demonstrated significant variability and are not recommended for pediatric practice.
- Infrared tympanic thermometers can be used with caution due to ease of use and lower discomfort, despite limitations in agreement.
- Rectal thermometry remains a reliable reference standard in pediatric fever assessment.
Aim:
To compare infrared tympanic and infrared contact forehead thermometer measurements with traditional rectal digital thermometers.
Methods:
A total of 254 children (137 girls) aged one to 24 months (median 7 months) consulting a private paediatric practice because of fever were prospectively recruited. Body temperature was measured using the three different devices.
Results:
The median and interquartile range for rectal, tympanic and forehead thermometers were 37.6 (37.1-38.4)°C, 37.5 (37.0-38.1)°C and 37.5 (37.1-37.9)°C, respectively (p < 0.01). The limits of agreement in the Bland-Altman plots were -0.73 to +1.04°C for the tympanic thermometer and -1.18 to +1.64°C for the forehead thermometer. The specificity of both the tympanic and forehead thermometers for detecting fever above 38°C was good, but sensitivity was low. Forehead measurements were susceptible to the use of a radiant warmer.
Conclusion:
Both the tympanic and forehead devices recorded lower temperatures than the rectal thermometers. The limits of agreement were particularly wide for the forehead thermometer and considerable for the tympanic thermometer. In the absence of valid alternatives, because of the ease to use and little degree of discomfort, tympanic thermometers can still be used with some reservations. Forehead thermometers should not be used in paediatric practice.
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