Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability
<p><strong>Background</strong> Guidelines recommend measuring temperature in children presenting with fever using electronic axillary or tympanic thermometers. Non-contact thermometry offers advantages, yet has not been tested against recommended methods in primary care.</p>...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2020
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| _version_ | 1797061743209349120 |
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| author | Hayward, G Verbakel, JY Ismail, FA Edwards, G Wang, K Fleming, S Holtman, GA Glogowska, M Morris, E Curtis, K van den Bruel, A |
| author_facet | Hayward, G Verbakel, JY Ismail, FA Edwards, G Wang, K Fleming, S Holtman, GA Glogowska, M Morris, E Curtis, K van den Bruel, A |
| author_sort | Hayward, G |
| collection | OXFORD |
| description | <p><strong>Background</strong> Guidelines recommend measuring temperature in children presenting with fever using electronic axillary or tympanic thermometers. Non-contact thermometry offers advantages, yet has not been tested against recommended methods in primary care.</p>
<p><strong>Aim</strong> To compare two different non-contact infrared thermometers (NCITs) to axillary and tympanic thermometers in children aged ≤5 years visiting their GP with an acute illness.</p>
<p><strong>Design and setting</strong> Method comparison study with nested qualitative component.</p>
<p><strong>Method</strong> Temperature measurements were taken with electronic axillary (Welch Allyn SureTemp®), electronic tympanic (Braun Thermoscan®), NCIT Thermofocus® 0800, and NCIT Firhealth Forehead. Parents rated acceptability and discomfort. Qualitative interviews explored parents’ experiences of the thermometers.</p>
<p><strong>Results</strong> In total, 401 children were recruited (median age 1.6 years, 50.62% male). Mean difference between the Thermofocus NCIT and axillary thermometer was −0.14°C (95% confidence interval [CI] = −0.21 to −0.06°C); lower limit of agreement was −1.57°C (95% CI = −1.69 to −1.44°C) and upper limit 1.29°C (95% CI = 1.16 to 1.42°C). A second NCIT (Firhealth) had similar levels of agreement; however, the limits of agreement between tympanic and axillary thermometers were also wide. Parents expressed a preference for the practicality and comfort of NCITs, and were mostly negative about their child’s experience of axillary thermometers. But there was willingness to adopt whichever device was medically recommended.</p>
<p><strong>Conclusion</strong> In a primary care paediatric population, temperature measurements with NCITs varied by >1°C compared with axillary and tympanic approaches. But there was also poor agreement between tympanic and axillary thermometers. Since clinical guidelines often rely on specific fever thresholds, clinicians should interpret peripheral thermometer readings with caution and in the context of a holistic assessment of the child.</p> |
| first_indexed | 2024-03-06T20:35:38Z |
| format | Journal article |
| id | oxford-uuid:3287239c-c40a-43a9-aa42-33a054d9bec9 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T20:35:38Z |
| publishDate | 2020 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:3287239c-c40a-43a9-aa42-33a054d9bec92022-03-26T13:14:41ZNon-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptabilityJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3287239c-c40a-43a9-aa42-33a054d9bec9EnglishSymplectic ElementsRoyal College of General Practitioners2020Hayward, GVerbakel, JYIsmail, FAEdwards, GWang, KFleming, SHoltman, GAGlogowska, MMorris, ECurtis, Kvan den Bruel, A<p><strong>Background</strong> Guidelines recommend measuring temperature in children presenting with fever using electronic axillary or tympanic thermometers. Non-contact thermometry offers advantages, yet has not been tested against recommended methods in primary care.</p> <p><strong>Aim</strong> To compare two different non-contact infrared thermometers (NCITs) to axillary and tympanic thermometers in children aged ≤5 years visiting their GP with an acute illness.</p> <p><strong>Design and setting</strong> Method comparison study with nested qualitative component.</p> <p><strong>Method</strong> Temperature measurements were taken with electronic axillary (Welch Allyn SureTemp®), electronic tympanic (Braun Thermoscan®), NCIT Thermofocus® 0800, and NCIT Firhealth Forehead. Parents rated acceptability and discomfort. Qualitative interviews explored parents’ experiences of the thermometers.</p> <p><strong>Results</strong> In total, 401 children were recruited (median age 1.6 years, 50.62% male). Mean difference between the Thermofocus NCIT and axillary thermometer was −0.14°C (95% confidence interval [CI] = −0.21 to −0.06°C); lower limit of agreement was −1.57°C (95% CI = −1.69 to −1.44°C) and upper limit 1.29°C (95% CI = 1.16 to 1.42°C). A second NCIT (Firhealth) had similar levels of agreement; however, the limits of agreement between tympanic and axillary thermometers were also wide. Parents expressed a preference for the practicality and comfort of NCITs, and were mostly negative about their child’s experience of axillary thermometers. But there was willingness to adopt whichever device was medically recommended.</p> <p><strong>Conclusion</strong> In a primary care paediatric population, temperature measurements with NCITs varied by >1°C compared with axillary and tympanic approaches. But there was also poor agreement between tympanic and axillary thermometers. Since clinical guidelines often rely on specific fever thresholds, clinicians should interpret peripheral thermometer readings with caution and in the context of a holistic assessment of the child.</p> |
| spellingShingle | Hayward, G Verbakel, JY Ismail, FA Edwards, G Wang, K Fleming, S Holtman, GA Glogowska, M Morris, E Curtis, K van den Bruel, A Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability |
| title | Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability |
| title_full | Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability |
| title_fullStr | Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability |
| title_full_unstemmed | Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability |
| title_short | Non-contact infrared versus axillary and tympanic thermometers in children attending primary care: a mixed-methods study of accuracy and acceptability |
| title_sort | non contact infrared versus axillary and tympanic thermometers in children attending primary care a mixed methods study of accuracy and acceptability |
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