ACCURACY OF INFRARED EAR THERMOMETRY IN ADULT PATIENTS

Objective: To assess (1) the agreement between infrared ear thermometr y and core reference temperature (in the pulmonary artery), (2) the ag reement between measurements in the right and left ears, and (3) the s creening validity of infrared tympanic thermometry in detecting rectal fever. Design: Temperatures were measured in both ears with an infrar ed thermometer, in one group of patients by simultaneous measurements with thermistors inserted in the pulmonary artery, esophagus, and rect um, and in the other group with a rectal glass-mercury thermometer. Se tting: An intensive care unit and a department of internal medicine in a secondary care hospital. Patients ann participants: Two samples: 16 adult patients admitted to the intensive care unit and 103 consecutiv e patients admitted to the department of medicine. Measurements: The m ajor outcome measures were (a) the agreement between infrared ear ther mometry and thermistor pulmonary artery temperature and (b) the sensit ivity and specificity for detecting fever, using rectal measurement as reference. Results: Both rectal and esophageal thermistor measurement s showed better agreement with the pulmonary artery reference temperat ure than single ear tympanic thermometry. The sensitivity and specific ity of ear thermometry for detecting fever (greater than or equal to 3 8.0 degrees C rectal reference) were 0.58 and 0.94, respectively. Doub le ear thermometry had a sensitivity of 0.61 and a specificity of 0.95 , when using the mean value. Conclusions: Both rectal and esophageal t hermistor measurements showed better agreement with pulmonary artery t emperature than single ear thermometry. Using the mean of two ear meas urements improves the agreement and screening validity for detecting f ever by rectal temperature. If temperature measurements are critical, esophageal measurements achieve excellent agreement with pulmonary art ery temperatures.