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Original Article

Reliability and Accuracy of Infrared Temperature: A Systematic Review

Seong-Hi Park
Korean Journal of Adult Nursing 2014;26(6):668-680.
Published online: December 31, 2014

School of Nursing, Pai Chai University, Daejeon, Korea.

Corresponding author: Park, Seong-Hi. School of Nursing Science, Pai Chai University, 155-40 Baejae-ro, Seo-gu, Daejeon 302-735, Korea. Tel: +82-42-520-5104, Fax: +82-70-4362-6291, shpark@pcu.ac.kr
• Received: August 20, 2014   • Revised: November 30, 2014   • Accepted: December 1, 2014

© 2014 Korean Society of Adult Nursing

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  • Purpose
    The aim of this study was to investigate the accuracy of infrared temperature measurements compared to axillary temperature in order to detect fever in patients.
  • Methods
    Studies published between 1946 and 2012 from periodicals indexed in Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected using the following key words: “infrared thermometer.” QUADAS-II was utilized to assess the internal validity of the diagnostic studies. Selected studies were analyzed through a meta-analysis using MetaDisc 1.4.
  • Results
    Twenty-one diagnostic studies with high methodological quality were included representing 3,623 subjects in total. Results of the meta-analysis showed that the pooled sensitivity, specificity, and area under the curve (AUC) of infrared tympanic thermometers were 0.73 (95% CI 0.70~0.75), 0.92 (95% CI 0.91~0.92), and 0.90, respectively. For axillary temperature readings, the pooled sensitivity was 0.67 (95% CI 0.62~0.73), the pooled specificity was 0.87 (95% CI 0.85~0.90), and the AUC was 0.80.
  • Conclusion
    Infrared tympanic temperature can predict axillary temperature in normothermic and in febrile patients with an acceptable level of diagnostic accuracy. However, further research is necessary to substantiate this finding in patients with hyperthermia.
  • Key Words: Thermometers; Fever; Sensitivity and specificity; Meta-analysis

This study was supported by grant No. 2013A0003 from the Pai Chai University Research Fund of Korea in 2013.

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APPENDIX
a1. Edelu BO, Ojinnaka NC, Ikefuna AN. Fever detection in under 5 children in a tertiary health facility using the infrared tympanic thermometer in the oral mode. Italian Journal of Pediatrics. 2011;37:8. http://dx.doi.org/10.1186/1824-7288-37-8
a2. Dzarr AA, Kamal M, Baba AA. A comparison between infrared tympanic thermometry, oral and axilla with rectal thermometry in neutropenic adults. European Journal of Oncology Nursing. 2009;13(4):250-4. http://dx.doi.org/10.1016/j.ejon.2009.03.006
a3. Smitz S, Van de Winckel A, Smitz MF. Reliability of infrared ear thermometry in the prediction of rectal temperature in older inpatients. Journal of Clinical Nursing 2009;18(3):451-6. http://dx.doi.org/10.1111/j.1365-2702.2008.02565.x
a4. Duberg T, Lundholm C, Holmberg H. Ear thermometer not an adequate alternative to rectal thermometer. Lakartidningen. 2007;104(19):1479-82.
a5. Nordås TG, Leiren S, Hansen KS. Can ear temperature measurement be used in a hospital? Tidsskr Nor Laegeforen. 2005; 125(20):2763-5.
a6. Jean-Mary MB, Dicanzio J, Shaw J, Bernstein HH. Limited accuracy and reliability of infrared axillary and aural thermometers in a pediatric outpatient population. Journal of Pediatrics. 2002;141(5):671-6.
a7. Varney SM, Manthey DE, Culpepper VE, Creedon JFJ. A comparison of oral, tympanic, and rectal temperature measurement in the elderly. Journal of Emergency Medicine. 2002;22(2):153-7. http://dx.doi.org/10.1016/S0736-4679(01)00457-7
a8. Greenes DS, Fleisher GR. Accuracy of a noninvasive temporal artery thermometer for use in infants. Archives of Pediatrics & Adolescent Medicine. 2001;155(3):376-81.
a9. Smitz S, Giagoultsis T, Dewe W, Albert A. Comparison of rectal and infrared ear temperatures in older hospital inpatients. Journal of American Geriatric Society. 2000;48(1):63-6.
a10. Valle PC, Kildahl-Andersen O, Steinvoll K. A comparative study of infrared tympanic thermometry and rectal mercury thermometry. Scandinavian Journal of Infectious Disease. 1999;31(1):105-6.
a11. Lanham DM, Walker B, Klocke E, Jennings M. Accuracy of tympanic temperature readings in children under 6 years of age. Pediatric Nursing. 1999;25(1):39-42.
a12. Wilshaw R, Beckstrand R, Waid D, Schaalje GB. A comparison of the use of tympanic, axillary and rectal thermometers in infants. Journal of Pediatric Nursing. 1999;14(2):88-93.
a13. Sohng KY, Kang SS, Hwang JS, Kim MJ. Accuracy of temperature measurements, nursing time for measuring temperature and the validity of fever detection. Journal of Korean Academy of Korean Fundamentals of Nursing. 1998;5(1):33-45.
a14. Brennan DF. Falk JL, Rothrock, SG. Kerr RB. Reliability of infrared T thermometry in the detection of R fever in children. Annals of Emergency Medicine. 1995;25(1):21-30. http://dx.doi.org/10.1016/S0196-0644(95)70350-0
a15. Christensen PM, Christensen VB, Matzen LE. Evaluation of ear temperature measurements in a geriatric department. Ugeskr Laeger. 1998;160(36):5175-7.
a16. Hwang JS, Sohng KY. Comparison of rectal temperature with axillary and tympanic temperature. Journal of Korean Academy of Korean Fundamentals of Nursing. 1997;4(2):351-8.
a17. Petersen MH, Hauge HN, Petersen MH, Hauge HN. Can training improve the results with infrared tympanic thermometers? Acta Anaesthesiologica Scandinavica. 1997;41(8):1066-70.
a18. Lee WH, Jung SP. The validity of the tympanic membrane thermometer in detecting fever of the children. Journal of the Korean Academy of Family Medicine. 1995;16(8):531-6.
a19. Yaron M, Lowenstein SR, Koziol-McLain J. Measuring the accuracy of the infrared tympanic thermometer: correlation does not signify agreement. The Journal of Emergency Medicine. 1995;13(5):617-21.
a20. Selfridge J, Shea SS. The accuracy of the T membrane thermometer in detecting fever in infants aged 3 months and younger in the emergency department setting. Journal of Emergency Nursing. 1993;19(2):127-30.
a21. Chamberlain JM, Grandner J, Rubinoff JL, Klein BL, Waisman Y, Huey M, et al. Comparison of a tympanic thermometer to rectal and oral thermometers in a pediatric emergency department. Clinical Pediatrics. 1991;30(4 suppl):24-9.
Figure 1

Flow diagram of article selection.

kjan-26-668-g001.jpg
Figure 2

Diagnostic test accuracy of Infrared tympanic temperature.

kjan-26-668-g002.jpg
Figure 3

Diagnostic test accuracy of axillary temperature.

kjan-26-668-g003.jpg
Table 1

Characteristics of the Selected Studies

kjan-26-668-i001.jpg

TP=True positive; FP=False positive; FN=False negative; TN=True negative; SN=Sensitivity; SP=Specificity; PLR=Positive likelihood ratio; NLR=Negative likelihood ratio; DOR=Diagnosis odds ratio; ITT=Infrared tympanic thermometer; A=Axillary thermometer; †Year of publication.

Table 2

Summary Results of Meta-analysis

kjan-26-668-i002.jpg

PLR=positive likelihood ratio; NLR=negative likelihood ratio; DOR=diagnosis odds ratio; AUC=area under the curve; SE=standard error.

Figure & Data

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      Reliability and Accuracy of Infrared Temperature: A Systematic Review
      Korean J Adult Nurs. 2014;26(6):668-680.   Published online December 31, 2014
      DOI: https://doi.org/10.7475/kjan.2014.26.6.668
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      Reliability and Accuracy of Infrared Temperature: A Systematic Review
      Korean J Adult Nurs. 2014;26(6):668-680.   Published online December 31, 2014
      DOI: https://doi.org/10.7475/kjan.2014.26.6.668
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      Reliability and Accuracy of Infrared Temperature: A Systematic Review
      Image Image Image
      Figure 1 Flow diagram of article selection.
      Figure 2 Diagnostic test accuracy of Infrared tympanic temperature.
      Figure 3 Diagnostic test accuracy of axillary temperature.

      Figure 1

      Figure 2

      Figure 3

      Reliability and Accuracy of Infrared Temperature: A Systematic Review

      Characteristics of the Selected Studies

      TP=True positive; FP=False positive; FN=False negative; TN=True negative; SN=Sensitivity; SP=Specificity; PLR=Positive likelihood ratio; NLR=Negative likelihood ratio; DOR=Diagnosis odds ratio; ITT=Infrared tympanic thermometer; A=Axillary thermometer; †Year of publication.

      Summary Results of Meta-analysis

      PLR=positive likelihood ratio; NLR=negative likelihood ratio; DOR=diagnosis odds ratio; AUC=area under the curve; SE=standard error.
      Table 1 Characteristics of the Selected Studies

      TP=True positive; FP=False positive; FN=False negative; TN=True negative; SN=Sensitivity; SP=Specificity; PLR=Positive likelihood ratio; NLR=Negative likelihood ratio; DOR=Diagnosis odds ratio; ITT=Infrared tympanic thermometer; A=Axillary thermometer; †Year of publication.

      Table 2 Summary Results of Meta-analysis

      PLR=positive likelihood ratio; NLR=negative likelihood ratio; DOR=diagnosis odds ratio; AUC=area under the curve; SE=standard error.

      Table 1

      Table 2

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