title: Accuracy and feasibility of daily infrared tympanic membrane temperature measurements in the identification of fever in children.
abstract: BACKGROUND
  Fever is an important physical sign in infectious diseases in childhood. Daily assessment of fever may be used to monitor the occurrence of infections for research purposes. The infrared tympanic membrane thermometer (ITT) seems ideal for measuring central body temperature. Its accuracy, however, is still debated, and the feasibility of daily temperature measurements with an ITT has not been described.
  
  
  OBJECTIVE
  To determine the accuracy and feasibility of daily infrared tympanic membrane temperature measurements at home.
  
  
  METHODS
  Tympanic membrane temperature was measured by the Braun Pro 3000, rectal temperature by the Omron MC 63. To establish the accuracy of the ITT, rectal and tympanic membrane temperature measurements were performed in 41 children, aged 2-10 years. To establish the feasibility of daily infrared tympanic temperature measurements at home, parents of 21 children performed daily measurements for 2 weeks.
  
  
  RESULTS
  With fever defined as a body temperature of > or =38.0 degrees C, sensitivity was 93.3%, specificity 92%, positive predictive value 87.5%, negative predictive value 95.8%, and the concordance rate 92.5%. Most of the parents found the instructions for the use of the ITT clear (93%) and the ITT easy to use (86%). During the test period of 2 weeks the technique of the tympanic membrane temperature measurements remained adequate in 93% of the parents.
  
  
  CONCLUSIONS
  The tympanic membrane temperature measured by the Braun Pro 3000 accurately reflects rectal temperature, validly assesses the presence of fever in children, and is easy to use. The Braun ITT therefore is an adequate tool to assess fever and may be used both in a clinical setting and for research purposes.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center (stratenum 6.131), PO Box 85060, 3508 AB Utrecht, The Netherlands. b.k.vanstaaij@med.uu.nl
authors.forename: Birgit K
authors.initials: BK
authors.lastname: van Staaij
authors.forename: Maroeska M
authors.initials: MM
authors.lastname: Rovers
authors.forename: Anne G
authors.initials: AG
authors.lastname: Schilder
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
mesh_terms: D001831:Body Temperature / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D007259:Infrared Rays; D008297:Male; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000193:education / Q000523:psychology; D011237:Predictive Value of Tests; D012007:Rectum; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013817:Thermography / Q000295:instrumentation*; D013821:Thermometers; D014432:Tympanic Membrane / Q000502:physiology*