Accuracy of infrared ear thermometry in children: a meta-analysis and systematic review
Chen Zhen1, Zhang Xia2, Li Long3
1Capital Institute of Pediatrics, Beijing, People's Republic of China Peking University, Beijing, People's Republic of China.
Insights
Infrared ear thermometers show poor accuracy in children, with wide agreement limits compared to rectal temperatures. These devices cannot replace rectal thermometry for clinical practice in pediatric febrile illnesses.
Area of Science:
- Pediatric Medicine
- Medical Device Technology
- Clinical Thermometry
Background:
- Accurate temperature determination is crucial for diagnosing and treating febrile illnesses in children.
- Infrared ear thermometry is a popular alternative to traditional methods, but its accuracy is a significant concern.
- Inaccurate temperature readings can lead to missed fevers or unnecessary medical interventions.
Purpose of the Study:
- To systematically review and meta-analyze the accuracy of infrared ear thermometry compared to rectal thermometry in children.
- To assess the clinical utility of infrared ear thermometers in pediatric practice.
Main Methods:
- A systematic review and meta-analysis were conducted.
- Data sources included Medline, Ovid, Elsevier, Google Scholar, and the Cochrane Library.
- Studies with a cross-sectional, prospective design were selected; data extraction was performed independently by two investigators.
Main Results:
- The overall pooled mean difference between tympanic and rectal temperature was 0.22°C (95% limits of agreement: -0.44°C to 1.30°C).
- In febrile children, the pooled mean temperature difference was 0.15°C (95% limits of agreement: -0.32°C to 1.10°C).
- Mean tympanic temperatures were consistently lower than rectal temperatures.
Conclusions:
- The accuracy of infrared ear thermometry in children is poor, characterized by a large mean difference and wide limits of agreement.
- Infrared ear thermometers are not a reliable replacement for rectal thermometry in pediatric clinical practice.
- Further research may be needed to improve the accuracy and reliability of non-invasive pediatric temperature measurement devices.
Background:
Accurate determination of temperature is important, especially in the diagnosis and treatment of febrile illnesses in the pediatric population. False negative measurement can lead to miss febrile and false positive measurement can cause excessive medical care. Temperatures can be measured at various sites, but we have not found the ideal thermometer yet. As a relatively new and popular alternative over traditional methods, infrared ear thermometry has many advantages, but its accuracy remains a major concern.
Design:
Systematic review and meta-analysis.
Data Sources:
Medline, Ovid, Elsevier, Google Scholar, Cochrane Library.
Study Selection:
Cross-sectional, prospective design.
Data Extraction:
Two investigators independently assessed selected studies and extracted data. Disagreements were resolved by discussion with other reviewers.
Results:
Mean tympanic temperature was always lower than rectal temperature. The overall pooled (random effects) mean difference between tympanic and rectal temperature was 0.22°C (95% limits of agreement -0.44°C to 1.30°C), which is similar to the within rectal device groups (mercury, 0.21°C, -0.44°C to 1.27°C; electronic, 0.24°C, -0.46°C to 1.34°C). In febrile children group, the pooled mean temperature difference between tympanic and rectal temperature was 0.15°C (95% limits of agreement -0.32°C to 1.10°C).
Conclusion:
The mean difference was large and the 95% limits of agreement was wide. The accuracy of infrared ear thermometry in children is poor, and it cannot replace rectal thermometry in clinical practice of children.
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