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Accuracy of a Noninvasive Temporal Artery Thermometer for Use in Infants
David S. Greenes, MD;
Gary R. Fleisher, MD
Arch Pediatr Adolesc Med. 2001;155:376-381.
Objectives To assess the accuracy of a new noninvasive temporal artery (TA) thermometer
in infants; to compare the accuracy of the TA thermometer with that of a tympanic
thermometer, using rectal thermometry as the criterion standard; and to compare
the tolerability of the TA thermometer with that of the tympanic and rectal
thermometers.
Design Prospective evaluation of the accuracy of TA and tympanic thermometry,
using rectal thermometry as the criterion standard.
Setting Emergency department of an urban pediatric hospital.
Subjects Convenience sample of 304 infants younger than 1 year presenting for
care.
Main Outcome Measures Temperatures were measured using TA, tympanic, and rectal thermometers
for all infants. Agreement between TA or tympanic and rectal temperatures
was assessed. The sensitivity and specificity of TA or tympanic thermometers
for detecting rectal fever were determined. Discomfort scores, using a standardized
scale, were assessed by trained observers after each temperature measurement
was made.
Results Linear regression analysis of the relation between TA and rectal temperatures
yielded a model with a slope of 0.79 (vs a slope of 0.68 for tympanic vs rectal
temperature; P = .02) and an r of 0.83 (vs r = 0.75 for tympanic vs rectal
temperature; P<.001). Among 109 patients with
a rectal temperature of 38°C or higher, the TA thermometer had a sensitivity
of 0.66 compared with the tympanic thermometer's sensitivity of 0.49 (P<.001). Discomfort scores with TA thermometry were
significantly lower than with rectal thermometry (P
= .007).
Conclusions The TA thermometer has limited sensitivity for detecting cases of rectal
fever in infants. However, the TA thermometer is more accurate than the tympanic
thermometer in infants, and it is better tolerated by infants than rectal
thermometry.
From the Division of Emergency Medicine, Children's Hospital, Harvard
Medical School, Boston, Mass.
Corresponding author and reprints: David S. Greenes, MD, Division
of Emergency Medicine, Children's Hospital, 300 Longwood Ave, Boston, MA 02115
(e-mail: david.greenes{at}tch.harvard.edu).
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