Cost minimisation analysis of thermometry in two different hospital systems

Are all thermometers equal? A study of three infrared thermometers to detect fever in an African outpatient clinic

Infrared thermometry has certain advantages over traditional oral thermometry including quick, non-invasive administration and an absence of required consumables. This study compared the performance of tympanic, temporal artery and forehead contactless thermometers with traditional oral electronic thermometer as the reference in measuring temperature in outpatients in a Nigerian secondary care hospital. A convenience sample of 100 male and 100 female adult patients (Mean age = 38.46 years, SD = 16.33 years) were recruited from a secondary care hospital in Kano, Nigeria. Temperature measurements were taken from each patient using the tympanic, temporal artery and contactless thermometers and oral electronic thermometer. Data was analyzed to assess bias and limits using scatterplots and Bland-Altman charts while sensitivity analysis was done using ROC curves. The tympanic and temporal artery thermometers systematically gave higher temperature readings compared to the oral electronic thermometer. The contactless thermometer gave lower readings compared to the oral electronic thermometer. The temporal artery thermometer had the highest sensitivity (88%) and specificity (88%) among the three infrared thermometers. The contactless thermometer showed a low sensitivity of 13% to detect fever greater than 38 °C. Our study shows that replacing oral thermometers with infrared thermometers must be done with caution despite the associated convenience and cost savings.