Diagnostic test accuracy of new generation tympanic thermometry in children under different cutoffs: a systematic review and meta-analysis

Shi, Dan; Zhang, Liyuan; Li, Haixia

doi:10.1186/s12887-020-02097-7

Cited by 3 publications

(10 citation statements)

References 34 publications

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“…This procedural guideline for nurses is intended for highly dependent or critically ill infant or children who require body temperature monitoring, and according to our interpretation is applicable to the current COVID‐19 pandemic situation. This notion was also supported by a recent systematic review and meta‐analysis conducted by Shi et al (2020) that concluded that tympanic thermometry has a high diagnostic accuracy and is a good alternative for screening of the temperature in paediatric patients. The blood supply of the tympanic membrane from the common carotid artery is shared with the hypothalamus.…”

Section: Discussionmentioning

confidence: 68%

“…A large‐scale systematic review and meta‐analysis of tympanic temperature measurements involving 12 diagnostic studies that pooled 4639 paediatric patients had found that a new generation of tympanic thermometry has high diagnostic accuracy and can be a good alternative for fever screening in children (Shi et al, 2020). According to the practical guidelines recommended by the Global Heat Health Information Network, measurement of tympanic temperature, although arguably not accurate especially during the hot heat season, still has some value (Daanen et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…A large-scale systematic review and meta-analysis of tympanic temperature measurements involving 12 diagnostic studies that pooled 4639 paediatric patients had found that a new generation of tympanic thermometry has high diagnostic accuracy and can be a good alternative for fever screening in children (Shi et al, 2020).…”

Section: Ta B L E 4 Discriminant Validity Of the Three Temperatures A...mentioning

confidence: 99%

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Clinical accuracy and agreement between tympanic and forehead body temperature measurements for screening of patients with COVID‐19

Nia

Chong

Chan

et al. 2021

Journal of Clinical Nursing

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Aim To investigate the accuracy, reliability and agreement between infrared forehead thermometers versus infrared tympanic thermometers temperature, a cross‐sectional study was conducted in April 2020. Methods The forehead and tympanic temperatures of 615 subjects were measured simultaneously in three exposed SARS‐COV‐2 groups at one hospital in Iran, during April 2020. These comparisons were evaluated by Bland–Altman Plot, repeatability, Passing–Bablok regression and Lin's concordance correlation coefficient. The receiver operating characteristic (ROC) analysis was done to describe the discrimination accuracy of a diagnostic test. The study adhered to STROBE checklist for cross‐sectional studies. Results A Bland–Altman plot indicated that the limits of agreement between the forehead and tympanic temperature were −0.259 to +0.19°C. Passing–Bablok regression analysis illustrated that the infrared forehead was not linearly related to tympanic temperatures (reference method), with a slope estimate that was significantly different from 1.00. The infrared forehead thermometer showed poor precision and lower accuracy than the tympanic. The forehead temperature readings had 60.0% sensitivity and 44.4% specificity (p > .05) to predict disease. Conclusion According to the results of study, there is no evidence that the assessment of temperature by infrared forehead thermometer could discriminate between the two groups (positive and negative).

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Ta B L E 4 Discriminant Validity Of the Three Temperatures A...mentioning

confidence: 99%

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Clinical accuracy and agreement between tympanic and forehead body temperature measurements for screening of patients with COVID‐19

Nia

Chong

Chan

et al. 2021

Journal of Clinical Nursing

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“…Although not convenient for repeated use, the rectal thermometer is generally considered an accurate reflection of the body’s core temperature[ 5 - 11 ]. Choosing the instrument for accurate measurement can be difficult.…”

Section: Introductionmentioning

confidence: 99%

Fever assessment in children under five: Are we following the guidelines?

Isa,

Alnasheet

et al. 2024

World J Clin Pediatr

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BACKGROUND Fever is a common cause of medical consultation and hospital admission, particularly among children. Recently, the United Kingdom’s National Institute for Health and Care Excellence (NICE) updated its guidelines for assessing fever in children under five years of age. The efficient assessment and management of children with fever are crucial for improving patient outcomes. AIM To evaluate fever assessment in hospitalized children and to assess its adherence with the NICE Fever in under 5s guideline. METHODS We conducted a retrospective cohort review of the electronic medical records of children under five years of age at the Department of Pediatrics, Salmaniya Medical Complex, Bahrain, between June and July 2023. Demographic data, vital signs during the first 48 h of admission, route of temperature measurement, and indications for admission were gathered. Fever was defined according to the NICE guideline. The children were divided into five groups according to their age (0-3 months, > 3-6 months, > 6-12 months, > 12-36 months, and > 36-60 months). Patients with and without fever were compared in terms of demography, indication for admission, route of temperature measurement, and other vital signs. Compliance with the NICE Fever in the under 5s guideline was assessed. Full compliance was defined as > 95%, partial compliance as 70%-95%, and minimal compliance as ≤ 69%. Pearson’s χ 2, Student’s t test, the Mann-Whitney U test, and Spearman’s correlation coefficient (rs) were used for comparison. RESULTS Of the 136 patients reviewed, 80 (58.8%) were boys. The median age at admission was 14.2 [interquartile range (IQR): 1.7-44.4] months, with the most common age group being 36-60 months. Thirty-six (26.4%) patients had fever, and 100 (73.6%) were afebrile. The commonest age group for febrile patients (> 12-36 months) was older than the commonest age group for afebrile patients (0-3 months) (P = 0.027). The median weight was 8.3 (IQR: 4.0-13.3) kg. Patients with fever had higher weight than those without fever [10.2 (IQR: 7.3-13.0) vs 7.1 (IQR: 3.8-13.3) kg, respectively] (P = 0.034). Gastrointestinal disease was the leading indication for hospital admission (n = 47, 34.6%). Patients with central nervous system diseases and fever of unknown etiology were more likely to be febrile (P = 0.030 and P = 0.011, respectively). The mean heart rate was higher in the febrile group than the afebrile group (140 ± 24 vs 126 ± 20 beats per minute, respectively) [P = 0.001 (confidence interval: 5.8-21.9)] with a positive correlation between body temperature and heart rate, r = 0.242, n = 136, P = 0.004. A higher proportion of febrile patients received paracetamol (n = 35, 81.3%) compared to the afebrile patients (n = 8, 18.6%) (P < 0.001). The axillary route was the most commonly used for temperature measurements (n = 40/42, 95.2%), followed by the rectal route (n = 2/42, 4.8%). The department demonstrated full compliance with the NICE guideline for five criteria: the type of thermometer used, route and frequency of temperature measurement, frequency of heart rate measurement, and use of antipyretics as needed. Partial compliance was noted for two criteria, the threshold of fever at 38 °C or more, and the respiratory rate assessment in febrile patients. Minimal compliance or no record was observed for the remaining three criteria; routine assessment of capillary refill, temperature reassessment 1-2 h after each antipyretic intake, and refraining from the use of tepid sponging. CONCLUSION This study showed that fever assessment in hospitalized children under five years of age was appropriate, but certain areas of adherence to the NICE guideline still need to be improved.

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“…An infrared tympanic thermometer (IRTT) is often used in children because its use is easy and rapid, and it shows a value close to the rectal temperature [ 7 ]. However, its use is restricted to children aged < 2 years because of the anatomy of the external auditory meatus [ 8 ], and its accuracy is affected by the presence of earwax in this structure [ 9 ]. In addition, using an IRTT can be stressful for children, parents, and nurses because direct contact with the thermometer disturbs sleep or provokes anxiety and fear in the child.…”

Section: Introductionmentioning

confidence: 99%

Clinical Accuracy of Non-Contact Forehead Infrared Thermometer Measurement in Children: An Observational Study

et al. 2022

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We evaluated the clinical reliability and utility of temperature measurements using no-contact forehead infrared thermometers (NCFITs) by comparing their temperature measurements with those obtained using infrared tympanic thermometers (IRTTs) in children. In this observational, prospective, and cross-sectional study, we enrolled 255 children (aged 1 month to 18 years) from the pediatric surgery ward at a tertiary medical center in Korea. The mean age of the children was 9.05 ± 5.39 years, and 54.9% were boys. The incidence rate of fever, defined as an IRTT reading of ≥38.0 °C, was 15.7%. The ICC coefficient for the assessment of agreement between temperatures recorded by the NCFIT and IRTT was 0.87, and the κ-coefficient was 0.83. The bias and 95% limits of agreement were 0.15 °C (−0.43 to 0.73). For an accurate diagnosis of fever (≥38 °C), the false-negative rate was much lower, but the false-positive rate was higher, especially in 6-year-old children. Therefore, NCFITs can be used to screen children for fever. However, a secondary check is required using another thermometer when the child’s temperature is >38 °C. NCFITs are proposed for screening but not for measuring the temperature. For the latter, an accurate and reliable thermometer shall be used.

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Diagnostic test accuracy of new generation tympanic thermometry in children under different cutoffs: a systematic review and meta-analysis

Cited by 3 publications

References 34 publications

Clinical accuracy and agreement between tympanic and forehead body temperature measurements for screening of patients with COVID‐19

Clinical accuracy and agreement between tympanic and forehead body temperature measurements for screening of patients with COVID‐19

Fever assessment in children under five: Are we following the guidelines?

Clinical Accuracy of Non-Contact Forehead Infrared Thermometer Measurement in Children: An Observational Study

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