Related Experiment Video
Updated: Jun 14, 2025
Mouse Body Temperature Measurement Using Infrared Thermometer During Passive Systemic Anaphylaxis and Food Allergy Evaluation
Published on: September 14, 2018
Accuracy, precision and diagnostic accuracy of oral thermometry in pediatric patients
Apostolos Deligakis1, Diamanto Aretha2, Eleni Almpani3
1Infection Department, General Hospital of Patras "Agios Andreas", Greece.
Insights
Oral thermometry shows low sensitivity for fever detection and suboptimal specificity for hypothermia in pediatric patients. Adjusting temperature thresholds can improve diagnostic accuracy for fever and hypothermia.
Area of Science:
- Pediatric Medicine
- Clinical Thermometry
- Diagnostic Accuracy Studies
Background:
- Accurate temperature measurement is crucial in pediatric care.
- Oral thermometry is a common method, but its reliability for detecting fever and hypothermia needs evaluation.
- Rectal thermometry serves as the gold standard for core body temperature assessment.
Purpose of the Study:
- To assess the accuracy and precision of oral thermometry in pediatric patients.
- To determine the sensitivity and specificity of oral thermometry for detecting fever and hypothermia.
- To compare oral temperature readings against rectal thermometry as the reference standard.
Main Methods:
- A method-comparison study involving 100 pediatric patients (6-17 years) over 21 months.
- Oral temperatures were measured using KD-2150, and rectal temperatures using IVAC Temp Plus II.
- Bland-Altman analysis evaluated accuracy and precision; sensitivity, specificity, and predictive values were calculated for fever (≥38.0 °C) and hypothermia (≤35.9 °C).
Main Results:
- The mean difference between oral and rectal temperatures was -0.34 °C (95% limits of agreement: -0.52 to -0.16).
- Oral thermometry demonstrated a sensitivity of 0.50 and specificity of 1.0 for fever.
- For hypothermia, sensitivity was 1.0 and specificity was 0.88. An oral threshold of 35.7 °C optimized hypothermia detection.
Conclusions:
- Oral thermometry exhibits low sensitivity for fever and suboptimal specificity for hypothermia in children.
- Current temperature cutoffs (<38.0 °C for fever, <36.0 °C for hypothermia) lack high certainty for excluding fever or confirming hypothermia.
- Utilizing adjusted oral temperature thresholds (<38.0 °C for fever, <35.9 °C for hypothermia) can enhance diagnostic accuracy.
Purpose:
To determine the accuracy and precision of oral thermometry in pediatric patients, along with its sensitivity and specificity for detecting fever and hypothermia, with rectal thermometry as reference standard.
Design And Methods:
This method-comparison study enrolled patients aged between 6 and 17 years, admitted to the surgical ward during a 21-month period. KD-2150 and IVAC Temp Plus II were used for oral and rectal temperature measurements respectively. Fever and hypothermia were defined as core temperature ≥38.0 °C and ≤ 35.9 °C respectively. Accuracy and precision of oral thermometry were determined by the Bland-Altman method. Sensitivity, specificity, positive and negative predictive value, and correct classification of oral temperature cutoffs for detecting fever and hypothermia were calculated.
Results:
Based on power analysis, 100 pediatric patients were enrolled. The mean difference between oral and rectal temperatures was -0.34 °C, with 95 % limits of agreement ranging between -0.52 and -0.16. Sensitivity and specificity of oral thermometry for detecting fever were 0.50 and 1.0 respectively; its sensitivity and specificity for detecting hypothermia were 1.0 and 0.88 respectively. The oral temperature value of 37.6 °C provided excellent sensitivity for detecting fever, while the value of 35.7 °C provided optimal sensitivity and specificity for detecting hypothermia.
Conclusions:
Oral thermometry had low sensitivity for detecting fever and suboptimal specificity for detecting hypothermia; thus, temperature values <38.0 °C and <36.0 °C cannot exclude fever and confirm hypothermia respectively with high certainty.
Practice Implications:
Diagnostic accuracy of oral thermometry can be improved by the use of oral temperature thresholds <38.0 °C for detecting fever and <35.9 °C for detecting hypothermia.
Related Concept Videos
01:14Assessing Body Temperature - Oral
Step 1:
Start by practicing proper hand hygiene to prevent the spread of microorganisms.
Step 2:
Take the thermometer out of the charging unit, switch it on, and wait for the ready sign.
Step 3:
Gently slide the probe cover until a click is heard. This simple action prevents cross-contamination and ensures the correct placement of the probe cover.
Step 4:
Instruct the patient to open their mouth and place...
01:14Temperature Measurement Sites
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...
01:13Equipments Used to Measure Body Temperature
Glass-bulb Thermometer:
Glass-bulb thermometers are hollow glass tubes with a bulb tip containing liquid such as ethanol or mercury. Historically, glass bulb mercury thermometers were the standard device to measure body temperature. Today, mercury thermometers are prohibited in many countries due to the hazardous effects of mercury and the risk of exposure if the glass bulb breaks. In general,...
01:27Assessing Body Temperature - Rectal
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
01:14Assessing Body Temperature - Tympanic membrane
Step 1: Begin by practicing good hand hygiene to prevent the transmission of microorganisms.
Step 2: Turn on the thermometer and wait until the ready sign appears on the screen to ensure accurate measurement.
Step 3: Slide the probe cover in place to prevent cross-contamination.
Step 4: Instruct the patient to tilt their head to the side for comfort and check for cerumen...
01:19Assessing Body Temperature - Temporal Artery
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's...