A comparison between infrared tympanic thermometry, oral and axilla with rectal thermometry in neutropenic adults.
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.
Dzarr
Abu Abdullah
AA
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
Kamal
Mustafa
M
Baba
Abdul Aziz
AA
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
D000970:Antineoplastic Agents