title: Accuracy of infrared ear thermometry in children: a meta-analysis and systematic review.
abstract: BACKGROUND
  Accurate determination of temperature is important, especially in the diagnosis and treatment of febrile illnesses in the pediatric population. False negative measurement can lead to miss febrile and false positive measurement can cause excessive medical care. Temperatures can be measured at various sites, but we have not found the ideal thermometer yet. As a relatively new and popular alternative over traditional methods, infrared ear thermometry has many advantages, but its accuracy remains a major concern.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Medline, Ovid, Elsevier, Google Scholar, Cochrane Library.
  
  
  METHODS
  Cross-sectional, prospective design.
  
  
  METHODS
  Two investigators independently assessed selected studies and extracted data. Disagreements were resolved by discussion with other reviewers.
  
  
  RESULTS
  Mean tympanic temperature was always lower than rectal temperature. The overall pooled (random effects) mean difference between tympanic and rectal temperature was 0.22°C (95% limits of agreement -0.44°C to 1.30°C), which is similar to the within rectal device groups (mercury, 0.21°C, -0.44°C to 1.27°C; electronic, 0.24°C, -0.46°C to 1.34°C). In febrile children group, the pooled mean temperature difference between tympanic and rectal temperature was 0.15°C (95% limits of agreement -0.32°C to 1.10°C).
  
  
  CONCLUSIONS
  The mean difference was large and the 95% limits of agreement was wide. The accuracy of infrared ear thermometry in children is poor, and it cannot replace rectal thermometry in clinical practice of children.
authors.affiliation: Capital Institute of Pediatrics, Beijing, People's Republic of China Peking University, Beijing, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Zhen
authors.affiliation: Peking University, Beijing, People's Republic of China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Xia
authors.affiliation: Capital Institute of Pediatrics, Beijing, People's Republic of China lilong676767@163.com.
authors.forename: Li
authors.initials: L
authors.lastname: Long
authors.affiliation: Capital Institute of Pediatrics, Beijing, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Pu
mesh_terms: D002648:Child; D004431:Ear, External / Q000502:physiology*; D006801:Humans; D007259:Infrared Rays; D012007:Rectum / Q000502:physiology; D062125:Thermometry / Q000592:standards*
keywords: children; infrared ear thermometry; meta-analysis; rectal thermometry; systematic review