Lack of Agreement of Tympanic Membrane Temperature Assessments With Conventional Methods in a Private Practice Setting

Abstract

An infrared tympanic membrane thermometer (FIRST temp) said to approximate core temperature accurately is being marketed as a noninvasive, quick, and easy-to-use clinical instrument. The determination of tympanic membrane temperatures by this device was compared with the determination of oral, rectal, or axillary temperatures by a conventional glass thermometer. Subjects were patients of a pediatric group practice in Houston, Texas. FIRST temp and conventional temperature determinations on individual patients were completed within 5 minutes of each other. The presence or absence of otitis media was noted by the examining physician. Agreement between the two methods of temperature determination was assessed by calculating limits of agreement within which 95% (±2 standard deviations) of individual differences would fall. The location of conventional thermometer (oral, rectal, axillary), time interval between the two separate measures, and the presence or absence of otitis media were entered into a multiple regression analysis to determine whether these factors influenced the observed differences between the two methods. A total of 144 patients were enrolled in the study; oral comparisons were obtained in 92 (57%) patients, rectal in 35 (24%), and axillary in 29 (19%). The upper and lower limits of agreement between temperature methods were 1.12°C and 0.89°C and the mean difference was –0.12°C. Regression analysis revealed that only the site of conventional thermometer location (oral, rectal, axillary) was a significant predictor of FIRST temp/conventional differences. Each site had a range of agreement greater than 1.65°C; axillary temperatures had the greatest range (–0.94°C to +1.30°C). Although ease and time reduction with use are attractive properties of the FIRST temp device, these data show that it is unreliable compared with conventional methods of temperature determination.

Infrared tympanic thermometer can accurately measure the body temperature in children in an emergency room setting

“…According to a study performed in a private practice setting, the infrared thermometer is unreliable compared with conventional methods of temperature determination [22]. Our study was performed in an emergency room setting, more patients were included, and a different model of infrared thermometer was used.…”

Fever in children: review of national and international studies and clinical guidelines

“…Показания температуры в наибольшей степени соответствуют внутренней температуре тела, хотя отражающие устройства инфракрасного излучения, которые обычно используются в домашних условиях, значительно менее точные, чем термометры, используемые в стационаре. Кроме того, в некоторых исследованиях были получены противоречивые данные при сравнении с ректальной термометрией [13][14][15]. Инфракрасные контактные и бесконтактные термометры для измеряют количество тепла, выделяемого височными артериями.…”

An assessment of infrared tympanic thermometers for body temperature measurement

“…Obviously, axillary/oral/rectal and tympanic temperature readings are not coincident. A 0967-3334/97/030215+11$19.50 c 1997 IOP Publishing Ltd number of clinical studies have been carried out in order to determine the equivalence, or the correlation factors, between the tympanic temperature reading and the axillary/oral/rectal temperature readings (Freed and Fraley 1992, Yetman et al 1993, Petersen-Smith et al 1994, Chamberlain et al 1991, Brown et al 1992. The use of the term equivalence, although useful to provide users with familiar scales for interpreting aural temperature readings (i.e., for prediction of fever or hypothermia), may contribute to a certain misunderstanding or mislead, since the aural temperature is likely to be different from the temperatures measured in other traditional body sites (mouth, rectum and armpit) (McKenzie 1995, Pransky 1991.…”