title: Comparison of temple temperatures with rectal temperatures in children under two years of age.
abstract: We assessed the agreement between rectal and noninvasive temporal artery temperature measurements in infants and children. We also evaluated the temple thermometer as a screening tool for rectal fever in this age group. Finally, we compared the performance of parents with that of nurses in using the temple thermometer. The 95% limits of agreement between the difference in rectal and average temple temperature were -1.03 and +1.52 degrees C. Mean temple temperatures obtained by parents and by nurses were similar (95% limits of agreement, -0.6 degrees C to +0.7 degrees C). A maximum temple temperature cutoff of 37.2 degrees C (99.0 degrees F) distinguished children with rectal fever of > or =38.0 degrees C with 91% sensitivity and 53% specificity. A cutoff of 37.8 degrees C (100.0 degrees F) distinguished moderate rectal fevers (> or =38.5 degrees C) with 97% sensitivity and 84% specificity. A cutoff of 38.3 degrees C (101.0 degrees F) distinguished a high rectal fever (> or =39.0 degrees C) with a sensitivity of 95% and specificity of 95%. In conclusion, temple temperatures do not reliably predict rectal temperatures, but the temple thermometer can be used as an effective screen for clinically important rectal fever in children 3-24 months old. The findings do not support use of temple temperatures to screen young infants for rectal fever > or =38.0 degrees C. Temperatures obtained by parents were comparable to those obtained by nurses.
authors.affiliation: Department of Pediatrics, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: George K
authors.initials: GK
authors.lastname: Siberry
authors.forename: Marie
authors.initials: M
authors.lastname: Diener-West
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Schappell
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Karron
mesh_terms: D001831:Body Temperature / Q000502:physiology*; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D004581:Electronics; D004867:Equipment Design; D005260:Female; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D012007:Rectum; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012881:Skin Temperature / Q000502:physiology*; D013699:Temporal Arteries; D013817:Thermography / Q000295:instrumentation* / Q000379:methods; D013821:Thermometers / Q000592:standards*