Mass Screening for Fever in Children

Selent, Monica U.; Molinari, Noelle-Angelique; Baxter, A.P.; Nguyen, An V.; Siegelson, Henry; Brown, Clive; Plummer, Andrew; Higgins, Andrew; Podolsky, S.R.; Spandorfer, Philip R.; Cohen, Nicole J.; Fishbein, Daniel B.

doi:10.1097/pec.0b013e3182854465

Cited by 36 publications

(16 citation statements)

References 36 publications

(15 reference statements)

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“…In a study by Allagaert et al (12) who compared the infrared skin temperature measurement with rectal measurement in order to reflect core temperature, it was reported that temperature measurements by NCITs had been underperformed when compared with rectal measurement. Likewise, underperformance of our infrared skin scan results to detect fever also confirms previous studies (13,14) . There are very few studies about the effectiveness and reliability of NCITs.…”

Section: Discussionsupporting

confidence: 75%

The comparison of temporal temperature measurement method by non-contact infrared thermometer with other body temperature measurement methods

Hakan¹,

Okumuş²,

Aydın³

et al. 2017

BUCH

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Objective: To evaluate the effectiveness of non-contact infrared thermometer (NCIT) by comparing with other thermometers and/or body temperature measurement methods. Methods: The patients were divided into 3 groups: 0-1 year-old babies, >16 year-old female patients, and 1-16 year-old children. The body temperature of all patients was measured by NCIT at the temporal region, and the digital thermometer through the axillary region. Moreover, body temperature of the children was measured with tympanic thermometer and of adults with digital thermometer through oral route. Results: When compared to other temperature measurement methods, in all patients, the temporal temperature was not statistically different to that of rectal temperature (p>0.05); but it was 0.6°C higher than axillary (p<0.001), 0.3°C higher than oral (p<0.001), and 0.1°C higher than tympanic temperatures (p<0.001). If the rectal temperature of ≥38°C has been taken as a reference value for fever; the sensitivity, specificity, positive and negative predictive values for average temporal temperature were 48.5, 99.5, 88.9, and 96.3%, respectively. Based on visual inspection of the Bland-Altman plots, NCIT underestimated the higher body temperatures which resulted in a low sensitivity. Conclusion: Our findings indicate that NCITs can be used as a rapid, hygienic and noninvasive method for excluding fever in children. However, this method has low sensitivity for detecting fever compared to that of rectal measurement and other noninvasive techniques. Although temporal temperature seems to be close to rectal temperature, this method is not ideal for detecting febrile patients yet.Keywords: Fever, body temperature measurement, non-contact infrared thermometer, children ÖZ Amaç: Temassız kızıl ötesi termometrenin (TKÖT) diğer termometreler ve/veya vücut sıcaklığı ölçüm yöntemleri ile karşılaştırılması suretiyle etkinliğinin değerlendirilmesi amaçlandı. Yöntem: Hastalar 0-1 yaş arasındaki bebekler, >16 yaş kadınlar ve 1-16 yaş arasındaki çocuklar olmak üzere 3 gruba ayrıldı. Tüm hastaların vücut sıcaklığı, TKÖT aracılığıyla sağ ve sol temporal bölgelerden ve dijital termometre ile aksiller bölgeden ölçülmüştür. Ayrıca vücut sıcaklıkları tüm çocuklarda timpanik termometreyle ve yetişkinlerde ise oral yoldan dijital termometre ile ölçülmüştür. Bulgular: Diğer sıcaklık ölçüm yöntemlerine kıyasla, tüm hastalarda temporal sıcaklık rektal sıcaklıktan farklı değildi (p>0,05); aksiller sıcaklıktan 0,6°C daha yüksek (p<0,001), oral sıcaklıktan 0.3°C daha yüksek (p<0,001) ve timpanik sıcaklıktan ise 0,1°C daha yüksekti (p<0,001). Eğer ateş için ≥38°C rektal sıcaklık bir referans değer olarak alınırsa, ortalama temporal sıcaklık için duyarlılık, özgüllük, pozitif ve negatif prediktif değerler sırasıyla %48,5, %99,5, %88,9 ve %96,3 idi. Bland-Altman alanlarının görsel incelemesine göre, TKÖT yüksek vücut sıcaklığında sıcaklığı olduğundan daha düşük tahmin etmekte ve bu nedenle düşük duyarlılık göstermektedir. Sonuç: Bulgularımız TKÖT'lerin çocuklarda ateşi dışlam...

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Section: Discussionsupporting

confidence: 75%

The comparison of temporal temperature measurement method by non-contact infrared thermometer with other body temperature measurement methods

Hakan¹,

Okumuş²,

Aydın³

et al. 2017

BUCH

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“…Sensitivity, specificity, positive predictive value, and negative predictive value for rectal fever (38°C) were 80%, 97%, 91%, and 94% for tympanic and 64%, 96%, 84%, and 89% for an infrared method 6 . Finally, Selent et al 13 compared 3 different infrared thermal skin detection systems (OptoTherm Thermoscreen, Sewickley, PA; FLIR ThermoVision 360, Boston, MA; and Thermofocus), and documented that sensitivity (compared with 38°C rectal) was between 77% and 84%; specificity was between 79% and 86%.…”

Section: Discussionmentioning

confidence: 90%

Tympanic, Infrared Skin, and Temporal Artery Scan Thermometers Compared with Rectal Measurement in Children: A Real-Life Assessment

Allegaert

Casteels

Gorp

et al. 2014

Current Therapeutic Research

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IntroductionBody temperature measurement in children is of clinical relevance. Although rectal measurement is the gold standard, less invasive tools have become available. We aimed to describe the accuracy of tympanic, infrared skin, or temporal artery scan thermometers compared with rectal measurement to reflect core temperature.MethodsRectal (Filac 3000; Covidien, Mechelen, Belgium), tympanic (AccuSystem Genius2 Typmanic Infrared Ear Thermometer, Covidien, Mechelen, Belgium), temporal artery scan (Exergen, Exergen Corp, Watertown, Massachusetts), and infrared (ThermoFlash Contactless Medical Electronic Thermometer, Visiomedlab, Paris, France) body temperature measurements were randomly performed and readings were collected once. Temperature readings were described as median and range, and observations were compared with rectal temperature readings (using Wilcoxon, Bland-Altman, sensitivity, and specificity tests). The child’s comfort was assessed by the child, parent, and nurse (using Likert scales) and ease of use was assessed by nurses (using visual analog scale).ResultsBased on observations in 294 (median age = 3.2 years, range = 0.02–17 years) children, the mean difference was 0.49°C (tympanic scan; P < 0.0001), 0.34°C (infrared skin scan; P < 0.0001), and 0°C (temporal artery scan; P = 0.9288), respectively, when compared with rectal temperature readings. Based on visual inspection of Bland-Altman plots, all tools overestimated the temperature at lower body temperature and underestimated the temperature at higher body temperature, resulting in a sensitivity of 22% to 41% and a specificity of 98% to 100% for rectal temperatures above 38°C. The Likert scale scores and the visual analog scale scores for rectal measurement were only slightly higher when compared with the other methods.ConclusionsAll noninvasive techniques underperformed compared with rectal measurement. The temporal artery scan deviations were smallest, but all noninvasive techniques overestimate lower temperatures and underestimate higher temperatures compared with rectal measurement. In our hands, temporal artery scan measurement seems to be second best, but not yet ideal.

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“…Only a few studies have compared IFR thermometers with axillary devices in children, and the results have been inconsistent. [ 9 – 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…By contrast, a moderate correlation between axillary and IFR temperature ( r =0.66, P = .001) was observed in another study. [ 9 ] Chiappini et al [ 10 ] found a strong correlation between IFR measurements and axillary temperatures in 251 children ( r = 0.84). However; a mercury-in-glass thermometer was used for axillary measurements.…”

Section: Discussionmentioning

confidence: 99%

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Use of noncontact infrared thermography to measure temperature in children in a triage room

et al. 2018

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We compared the accuracy and utility of 3 infrared (IFR) thermographs fitted with axillary digital thermometers used to measure temperature in febrile and afebrile children admitted to an emergency triage room.A total of 184 febrile and 135 afebrile children presenting to a triage room were consecutively evaluated. Axillary temperature was recorded using a digital electronic thermometer. Simultaneously, IFR skin scans were performed on the forehead, the neck (over the carotid artery), and the nape by the same nurse. Fever was defined as an axillary temperature ≥37.5°C. The temperature readings at the 4 sites were compared.For all subjects, the median axillary temperature was 37.7 ± 1.5°C, the IFR forehead temperature was 37 ± 1.1°C, the IFR neck temperature was 37.6 ± 1.5°C, and the IFR nape temperature was 37 ± 1.2°C. A Bland–Altman plot of the differences suggested that all agreements between IFR and axillary measures were poor (the latter measure was considered the standard). The forehead measurements had a sensitivity of 88.6% and a specificity of 60% in patients with temperatures ≥36.75°C. The sensitivities of the neck measurement at cut-offs of ≥37.35°C and ≥36.95 were 95.5% and 78.8% for those aged 2 to 6 years. Thus, 11.4% of febrile subjects were missed when forehead measurements were performed.An IFR scan over the lateral side of neck is a reliable, comfortable, rapid, and noninvasive method for fever screening, particularly in children aged 2 to 6 years, in busy settings such as pediatric triage rooms.

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Mass Screening for Fever in Children

Abstract: 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.

Cited by 36 publications

References 36 publications

The comparison of temporal temperature measurement method by non-contact infrared thermometer with other body temperature measurement methods

The comparison of temporal temperature measurement method by non-contact infrared thermometer with other body temperature measurement methods

Tympanic, Infrared Skin, and Temporal Artery Scan Thermometers Compared with Rectal Measurement in Children: A Real-Life Assessment

Use of noncontact infrared thermography to measure temperature in children in a triage room

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