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Kavlak RS, Aktaş E. Comparison of two non-invasive body temperature measurement methods for the detection of febrile neutropenia in children with cancer. J Pediatr Nurs 2024; 77:e616-e624. [PMID: 38824078 DOI: 10.1016/j.pedn.2024.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/26/2024] [Accepted: 05/26/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND This study was conducted to compare the accuracy of two noninvasive thermometers (axillary and infrared non-contact forehead thermometer) in measuring core temperature compared to the gold standard oral thermometer in the detection of fever in pediatric cancer patients with febrile neutropenia. METHODS The study was conducted with a single group of 42 children with febrile neutropenia between 23 December 2020 and 25 January 2023 in the pediatric hematology and oncology clinic of a training and research hospital, which provides a specialized environment for both medical education and advanced scientific research in the field of pediatric hematology and oncology. The participants' body temperature was measured with an oral, axillary, and non-contact infrared forehead thermometer immediately after admission to the clinic and at 5 and 10 min after admission. The inter-rater agreement for each method and inter-method agreement between axillary and non-contact infrared temperature readings and oral readings were analyzed for each time point using intraclass correlation coefficients (ICC). RESULTS The children in the study had a mean age of 11.62 ± 3.00 years and 28 (66.7%) were boys, 19 (45.2%) were younger children (5-10 years of age), and 23 (54.8%) were adolescents (11-16 years of age). In the analysis of agreement between the thermometers at admission and at 5 and 10 min after admission in children with febrile neutropenia, the highest agreement was between the oral and axillary thermometers (ICC: 0.584, 0.835, 0.536, respectively) and the lowest agreement was between the oral and non-contact infrared thermometers (ICC: 0.219, 0.022, 0.473, respectively). CONCLUSION Compared to orally measured body temperature, axillary temperature readings showed better agreement than non-contact infrared temperature readings from the forehead in pediatric patients with febrile neutropenia. PRACTICE IMPLICATIONS The research findings may guide nurses and families caring for pediatric patients with febrile neutropenia and should contribute to the prevention of false findings of fever and the reduction of its adverse consequences.
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Affiliation(s)
- Rabia Sayan Kavlak
- Atatürk State Hospital, Osmaniye Köyü Tırkışlar Mevkii Merkez/Sinop, Turkey
| | - Eda Aktaş
- University of Health Sciences, Hamidiye Faculty of Nursing Department of Pediatric Nursing, Tıbbiye Cad. No:38 Haydarpaşa, Üsküdar, Istanbul, Turkey.
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Patel DV, Barot RB, Cecil R, Phatak AG, Shinde MK, Patel AJ, Nimbalkar SM. Temperature Monitoring in Children: An Agreement Study. JOURNAL OF NEONATOLOGY 2023; 37:134-141. [DOI: 10.1177/09732179231164527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Background: Noncontact infrared thermometer (NCIT) measures temperature rapidly and noninvasively. It is commonly used at forehead, but other potential sites such as axilla and abdomen are yet to be explored. We assessed agreement of temperature recordings of axillary temperature by glass mercury thermometer (the “gold standard”) with axillary temperature by the digital thermometer as well as with NCIT at forehead, axilla, mid abdomen, and at right hypochondriac areas. Methods: Neonates and children below 5 years admitted in neonatal and pediatrics wards were enrolled in the study through convenience sampling. For each participant, temperature was measured using NCIT at forehead, mid abdomen, right hypochondrium, and right axilla as well as using digital thermometer at right axilla and using glass mercury thermometer at right axilla. The agreement between methods was presented as mean difference (95% limits of agreement) using Bland-Altman analysis. Results: Total 400 temperature readings were taken for each method from 132 participants. There was a good agreement between mercury axillary with digital axillary in both the groups, that is, neonates and children (>1 month to 5 years) (Mean difference [95% limits of agreement] = –0.046 [–0.26 to 0.169]°C and –0.028 [–0.183 to 0.128]°C, respectively). While for all the methods using NCIT, there was a poor agreement with mercury axillary temperature in both the groups. Conclusion: Agreement between axillary temperatures using digital and glass mercury thermometers was good, while agreements between the axillary temperature using glass mercury thermometer with NCIT readings at different sites were poor in neonates and children below 5 years.
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Affiliation(s)
- Dipen V. Patel
- Department of Neonatology, Bhaikaka University, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - Rushi B. Barot
- Department of Pediatrics, Bhaikaka University, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - Rashmin Cecil
- Department of Pediatrics, Bhaikaka University, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - Ajay G. Phatak
- Central Research Services, Shree Krishna Hospital, Bhaikaka University, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - Mayur K. Shinde
- Central Research Services, Shree Krishna Hospital, Bhaikaka University, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - Arya J. Patel
- Pramukhswami Medical College, Bhaikaka University, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
| | - Somashekhar M. Nimbalkar
- Department of Neonatology, Bhaikaka University, Charutar Arogya Mandal, Karamsad, Anand, Gujarat, India
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Clinical Accuracy of Non-Contact Forehead Infrared Thermometer Measurement in Children: An Observational Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091389. [PMID: 36138700 PMCID: PMC9497495 DOI: 10.3390/children9091389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/11/2022] [Accepted: 09/11/2022] [Indexed: 11/21/2022]
Abstract
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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Lai F, Li X, Wang Q, Luo Y, Wang X, Huang X, Zhang J, Peng J, Wang Q, Fan L, Li W, Huo J, Liu T, Li Y, Lin Y, Yang X. Reliability of Non-Contact Infrared Thermometers for Fever Screening Under COVID-19. Healthc Policy 2022; 15:447-456. [PMID: 35300277 PMCID: PMC8922455 DOI: 10.2147/rmhp.s357567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/03/2022] [Indexed: 12/25/2022] Open
Abstract
Purpose Fever is one of the most typical clinical symptoms of coronavirus disease 2019 (COVID-19), and non-contact infrared thermometers (NCITs) are commonly used to screen for fever. However, there is a lack of authoritative data to define a “fever” when an NCIT is used and previous studies have shown that NCIT readings fluctuate widely depending on ambient temperatures and the body surface site screened. The aim of this study was to establish cut-off points for normal temperatures of different body sites (neck, forehead, temples, and wrist) and investigate the accuracy of NCITs at various ambient temperatures to improve the standardization and accuracy of fever screening. Patients and Methods A prospective investigation was conducted among 904 participants in the outpatient and emergency departments of Chengdu Women’s and Children’s Central Hospital. Body temperature was measured using NCITs and mercury axillary thermometers. A receiver operating characteristic curve was used to determine the accuracy of body temperature detection at the four body surface sites. Data on participant characteristics were also collected. Results Among the four surface sites, the neck temperature detection group had the highest accuracy. When the neck temperature was 37.35°C as the optimum fever diagnostic threshold, the sensitivity was 0.866. The optimum fever diagnostic thresholds for forehead, temporal, and wrist temperature were 36.65°C, 36.65°C, and 36.75°C, respectively. Moreover, triple neck temperature detection had the highest sensitivity, up to 0.998, whereas the sensitivity of triple wrist temperature detections was 0.949. Notably, the accuracy of NCITs significantly reduced when the temperature was lower than 18°C. Conclusion Neck temperature had the highest accuracy among the four NCIT temperature measurement sites, with an optimum fever diagnostic threshold of 37.35°C. Considering the findings reported in our study, we recommend triple neck temperature detection with NCITs as the fever screening standard for COVID-19.
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Affiliation(s)
- Fan Lai
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Xin Li
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Qi Wang
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Yingjuan Luo
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Xin Wang
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Xiuhua Huang
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Jiajia Zhang
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Jieru Peng
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Qin Wang
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Li Fan
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Wen Li
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Junrong Huo
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Tianjiao Liu
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Yalan Li
- The Fourth People’s Hospital of Chengdu, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Yonghong Lin
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
| | - Xiao Yang
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, People’s Republic of China
- Correspondence: Xiao Yang; Yonghong Lin, Chengdu Women’s and Children’s Central Hospital, 1617 Riyue Avenue, Qingyang District, Chengdu, 611731, Sichuan, People’s Republic of China, Tel +86 13882288881; +86 13808031895, Email ;
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Zhang Z, Cao Z, Deng F, Yang Z, Ma S, Guan Q, Liu R, He Z. Infrared Thermal Imaging of Patients With Acute Upper Respiratory Tract Infection: Mixed Methods Analysis. Interact J Med Res 2021; 10:e22524. [PMID: 34420912 PMCID: PMC8414296 DOI: 10.2196/22524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/10/2020] [Accepted: 08/27/2020] [Indexed: 01/30/2023] Open
Abstract
Background Upper respiratory tract infection is a common disease of the respiratory system. Its incidence is very high, and it can even cause pandemics. Infrared thermal imaging (IRTI) can provide an objective and quantifiable reference for the visual diagnosis of people with acute respiratory tract infection, and it can function as an effective indicator of clinical diagnosis. Objective The aims of this study are to observe and analyze the infrared expression location and characteristics of patients with acute upper respiratory tract infection through IRTI technology and to clearly express the quantification of temperature, analyze the role of IRTI in acute upper respiratory tract diagnostic research, and understand the impact of IRTI in qualitative and quantitative research. Methods From December 2018 to February 2019, 154 patients with acute upper respiratory tract infection were randomly selected from the emergency department of the First Affiliated Hospital of Guangzhou Medical University. Among these patients, 73 were men and 81 were women. The subjects were divided into two groups according to the presence of fever, namely, fever and nonfever groups. Qualitative and quantitative analyses of the infrared thermal images were performed to compare the results before and after application of the technology. Results Using the method described in this paper, through the analysis of experimental data, we elucidated the role of IRTI in the diagnosis of acute upper respiratory tract infection, and we found that qualitative and quantitative IRTI analyses play important roles. Through the combination of theory and experimental data, the IRTI analysis showed good results in identifying acute upper respiratory tract infection. Conclusions IRTI technology plays an important role in identifying the infrared expression location and characteristics of patients with acute upper respiratory tract infection as well as in the quantification of clear expression of body temperature, and it provides an objective and quantifiable reference basis for elucidating the pathogenesis of these patients.
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Affiliation(s)
- Zuopeng Zhang
- Emergency Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - ZanFeng Cao
- Emergency Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Fangge Deng
- State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhanzheng Yang
- Emergency Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Sige Ma
- The First Clinical College, Guangzhou Medical University, Guangzhou, China
| | - Qianting Guan
- The First Clinical College, Guangzhou Medical University, Guangzhou, China
| | - Rong Liu
- Emergency Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhuosen He
- Emergency Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Morris E, Glogowska M, Ismail FA, Edwards G, Fleming S, Wang K, Verbakel JY, Van den Bruel A, Hayward G. Parents' concerns and beliefs about temperature measurement in children: a qualitative study. BMC FAMILY PRACTICE 2021; 22:9. [PMID: 33413158 PMCID: PMC7791980 DOI: 10.1186/s12875-020-01355-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/16/2020] [Indexed: 11/23/2022]
Abstract
Background Nearly 40% of parents with children aged 6 to 17 months consult a healthcare professional when their child has a high temperature. Clinical guidelines recommend temperature measurement in these children, but little is known about parents’ experiences of and beliefs about temperature measurement. This study aimed to explore parents’ concerns and beliefs about temperature measurement in children. Methods Semi-structured qualitative interviews were conducted from May 2017 to June 2018 with 21 parents of children aged 4 months to 5.5 years, who were purposively sampled from the METRIC study (a method comparison study comparing non-contact infrared thermometers to axillary and tympanic thermometers in acutely ill children). Data analysis followed a thematic approach. Results Parents described the importance of being able to detect fever, in particular high fevers, and how this then influenced their actions. The concept of “accuracy” was valued by parents but the aspects of performance which were felt to reflect accuracy varied. Parents used numerical values of temperature in four main ways: determining precision of the thermometer on repeat measures, detecting a “bad” fever, as an indication to administer antipyretics, or monitoring response to treatment. Family and social networks, the internet, and medical professionals and resources, were all key sources of advice for parents regarding fever, and guiding thermometer choice. Conclusions Temperature measurement in children has diagnostic value but can either empower, or cause anxiety and practical challenges for parents. This represents an opportunity for both improved communication between parents and healthcare professionals, and technological development, to support parents to manage febrile illness with greater confidence in the home. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-020-01355-y.
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Affiliation(s)
- Elizabeth Morris
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK.
| | - Margaret Glogowska
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK
| | - Fatene Abakar Ismail
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, 18 Alexandra Parade, Glasgow, G31 2ER, UK
| | - George Edwards
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK
| | - Susannah Fleming
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK
| | - Kay Wang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK
| | - Jan Y Verbakel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK.,Academic Centre for Primary Care, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33 J, 3000, Leuven, Belgium
| | - Ann Van den Bruel
- Academic Centre for Primary Care, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33 J, 3000, Leuven, Belgium
| | - Gail Hayward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK
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