title: A comparison between infrared tympanic thermometry, oral and axilla with rectal thermometry in neutropenic adults.
abstract: BACKGROUND
  This study assessed the agreement between infrared tympanic membrane (TM), axillary, corrected axillary (+0.5 degrees C), oral, and corrected oral (+0.3 degrees C) to rectal thermometry as reference standard in neutropenic adults. The sensitivity and specificity of the mentioned thermometries in detecting rectal fever (> or =38 degrees C) were also analysed.
  
  
  METHODS
  This is a comparative diagnostic test study. A total of 400 sets of blinded simultaneous temperature readings were measured from 21 haemato-oncology in-patients with neutropenia following chemotherapy. Three-hundred sets were then randomly sampled. Agreements were analysed using random two-way intraclass correlation (ICC). Sensitivity and specificity were analysed using contingency 2x2 table.
  
  
  RESULTS
  Both right and left TM thermometry have good correlation with rectal thermometry; 0.810 (95% CI, 0.748-0.855) and 0.770 (95% CI, 0.713-0.815) respectively. Axilla thermometry has weak agreement (ICC 0.486 (95% CI, 0.118-0.689)) with rectal thermometry. The sensitivity (sn) and specificity (sp) in detecting rectal fever (> or =38 degrees C) were: right TM (sn) 0.712 (95% CI, 0.586-0.814), (sp) 0.957 (95% CI, 0.920-0.978); oral (sn) 0.561 (95% CI, 0.433-0.681), (sp) 0.983 (95% CI, 0.954-0.995); and axilla (sn) 0.348 (95% CI, 0.238-0.477), (sp) 0.996 (95% CI, 0.973-0.999).
  
  
  CONCLUSIONS
  Single tympanic membrane thermometry is in good agreement with rectal thermometry. It is more sensitive than oral or axillary thermometry in detecting rectal fever.
authors.affiliation: Haematology Unit, Department of Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Jalan Sultanah Zainab II, 16150 Kota Bharu, Kelantan, Malaysia. abudzarr@hematologi.net
authors.forename: Abu Abdullah
authors.initials: AA
authors.lastname: Dzarr
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kamal
authors.forename: Abdul Aziz
authors.initials: AA
authors.lastname: Baba
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000009:adverse effects; D001365:Axilla; D015400:Clinical Nursing Research; D003428:Cross Infection / Q000139:chemically induced / Q000382:microbiology; D005334:Fever / Q000139:chemically induced / Q000175:diagnosis* / Q000382:microbiology; D019337:Hematologic Neoplasms / Q000188:drug therapy; D006801:Humans; D009055:Mouth; D009503:Neutropenia / Q000139:chemically induced; D009730:Nursing Assessment; D011446:Prospective Studies; D012007:Rectum; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013817:Thermography / Q000295:instrumentation / Q000379:methods* / Q000451:nursing / Q000592:standards; D013821:Thermometers / Q000592:standards
chemical_list: D000970:Antineoplastic Agents