title: Measurement accuracy of fever by tympanic and axillary thermometry.
abstract: As the basic sciences develop, temperature measurement methods and devices were improved. For hundreds of years both in clinics and home, mercury-in-glass thermometer was the standard of human temperature measurements. In this study, we aimed to compare tympanic infrared thermometers with the conventional temperature option, mercury-in-glass thermometer, which is historical standard in the clinical conditions.
  
  
  METHODS
  A total of 102 randomly selected pediatric patients who admitted to our hospital were enrolled, and simultaneous temperature measurements were performed via axilla and external auditory canal with 3 different techniques. For external auditory recordings, infrared tympanic First Temp Genius for clinical use and Microlife IR 1DA1 for home usage were used. Classic mercury-in-glass thermometers were used for axillary recording. For each method, 886 measurements were performed.
  
  
  RESULTS
  The mean results of the axillary mercury-in-glass thermometers, infrared tympanic First Temp Genius, and Microlife IR 1DA1 were 36.8 +/- 0.7, 37.5 +/- 0.9, 36.9 +/- 0.8, respectively. The Bland-Altman plot of differences suggests that 95% of the infrared tympanic clinical use thermometer readings were within the limits of agreement, which is +0.27 and -1.75 degrees C range of mercury-in-glass thermometer. The Bland-Altman plot of differences suggests that 95% of the tympanic home-use thermometer readings were within the limits of agreement, which is +0.98 and -1.27 degrees C range of mercury-in-glass thermometer. In our group, 15% of the patients were misdiagnosed as febrile with home-use tympanic thermometer, whereas this percentage was 4% with clinical tympanic thermometer. Also, 5% and 31% of febrile patients were misdiagnosed as afebrile with clinical tympanic and home-use tympanic thermometer, if axillary mercury-in-glass thermometer recording defines fever.
  
  
  CONCLUSIONS
  Our results showed that there is a significant difference in each recording with different thermometers, and this variance was present in both higher and lower readings. We recommend thathome-use infrared tympanic thermometer could be used for screening but must not be considered as a tool to decide patients follow-up.
authors.affiliation: Pediatric Infectious Disease Unit, Department of Pediatrics, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Devrim
authors.forename: Ateş
authors.initials: A
authors.lastname: Kara
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ceyhan
authors.forename: Hasan
authors.initials: H
authors.lastname: Tezer
authors.forename: Ali Kerem
authors.initials: AK
authors.lastname: Uludağ
authors.forename: Ali Bülent
authors.initials: AB
authors.lastname: Cengiz
authors.forename: Inci
authors.initials: I
authors.lastname: Yiğitkanl
authors.forename: Gülten
authors.initials: G
authors.lastname: Seçmeer
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001365:Axilla; D001831:Body Temperature; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012680:Sensitivity and Specificity; D013821:Thermometers; D014432:Tympanic Membrane