title: Performance of non-contact infrared thermometer for detecting febrile children in hospital and ambulatory settings.
abstract: OBJECTIVE
  To assess the performance of the non-contact infrared thermometer compared with mercury-in-glass thermometer in children; to assess the diagnostic accuracy of non-contact infrared thermometer for detecting children with fever; to compare the discomfort caused by the two procedures in children aged > one month.
  
  
  BACKGROUND
  Non-contact infrared thermometer is a quick and non-invasive method to measure body temperature, not requiring sterilisation or disposables. It is a candidate for temperature recording in children.
  
  
  METHODS
  Prospective multicenter study.
  
  
  METHODS
  Body temperature readings were taken from every child consecutively admitted to the Pediatric Emergency Departments or Pediatric Clinics participating in the study. Two bilateral axillary temperature measurements using the mercury-in-glass thermometers and three mid-forehead temperature measurements using the non-contact infrared thermometer were performed.
  
  
  RESULTS
  Two hundred and fifty-one children were enrolled in the study. Mean body temperature obtained by mercury-in-glass thermometer and non-contact infrared thermometer was 37.18 (SD 0.96) °C and 37.30 (SD 0.92) °C, respectively (p = 0.153). Non-contact infrared thermometer clinical repeatability was 0.108 (SD 0.095) °C, similar to that of the mercury-in-glass thermometer (0.11 SD 01 °C; p = 0.517). Bias was 0.0150 (SD 0.09) °C. The proportion of outliers >1 °C was 4/251 children (1.59%). A significant correlation between temperature values obtained with the two procedures was observed (r(2) = 0.84; p < 0.0001). The limits of agreement, by the Bland and Altman method, were -0.62 (95% CI: -0.47 to -0.67) and 0.76 (95% CI: 0.61-0.91). No significant correlation was evidenced between the difference of the body temperature values recorded by the two methods and age (p = 0.226), or room temperature (p = 0.756). Calculating the receiver operating characteristic curve to determine the best threshold for axillary temperature >38.0 °C, for a non-contact infrared thermometer temperature = 37.98 °C the sensitivity was 88.7% and the specificity 89.9%. Mean distress score (on a 5-point scale) was significantly lower using the non-contact infrared thermometer than using the mercury-in-glass thermometer (1.92 SD 0.56 and 2.40 SD0.93, respectively; p < 0.0001).
  
  
  CONCLUSIONS
  Non-contact infrared thermometer showed a good performance in our study population, has the advantage of measuring body temperature in two seconds and is comfortable for children.
  
  
  CONCLUSIONS
  Non-contact infrared thermometer may be taken into consideration when assessing body temperature in children aged > one month in hospital or ambulatory.
authors.affiliation: Department of Paediatrics, Florence University, Florence, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.forename: Sara
authors.initials: S
authors.lastname: Sollai
authors.forename: Riccardo
authors.initials: R
authors.lastname: Longhi
authors.forename: Liana
authors.initials: L
authors.lastname: Morandini
authors.forename: Anna
authors.initials: A
authors.lastname: Laghi
authors.forename: Catia Emilia
authors.initials: CE
authors.lastname: Osio
authors.forename: Mario
authors.initials: M
authors.lastname: Persiani
authors.forename: Silvia
authors.initials: S
authors.lastname: Lonati
authors.forename: Raffaella
authors.initials: R
authors.lastname: Picchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonsignori
authors.forename: Francesco
authors.initials: F
authors.lastname: Mannelli
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
mesh_terms: D000553:Ambulatory Care; D002648:Child; D005334:Fever / Q000175:diagnosis*; D006761:Hospitals; D006801:Humans; D011446:Prospective Studies; D013821:Thermometers