Set number Term searched or sets combined 1 PAEDIATRIC in TI,AB,MESH 2 PEDIATRIC in TI,AB,MESH 3 explode “Pediatrics”/ all subheadings 4 p*ediatric* 5 child* 6 infant* 7 baby or babies 8 neonat* 9 newborn* 10 toddler* 11 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 12 THERMOMETER in TI,AB,MESH 13 explode “Thermometers”/ all subheadings 14 thermometer* 15 TEMPERATURE in TI,AB,MESH 16 temperature 17 12 or 13 or 14 or 15 or 16 18 ear* 19 aural 20 EAR in TI,AB,MESH 21 explode “Ear-External”/ all subheadings 22 explode
ArticlesInfrared ear thermometry compared with rectal thermometry in children: a systematic review
Introduction
Accurate temperature measurement is important, especially in neonates1 and immune-compromised children2 in whom suspicion of infection could result in investigations, administration of antibiotics, and even hospital admission. Temperature measurement can be difficult in children, particularly when they are uncooperative or restless. Infrared thermometers that enable temperature to be measured at the external ear canal have become available in the past 15 years, and have been introduced into widespread clinical use.3, 4, 5 Because the ear is easily accessible and the procedure is very quick, this method is acceptable for use in children. The infrared detector senses electromagnetic radiation emissions from tissue within view of the probe. A microprocessor calculates the temperature value of the observed structures. Depending on the mode selected, a numerical constant, known as an offset, is added to the measured temperature to generate estimated core, tympanic, oral, or rectal temperatures with which clinicians may be more familiar.31
In another systematic review,32 we showed that agreement between temperature measured at the axilla and rectum in children was low. This poor concurrence has implications for clinical management when temperature needs to be measured accurately. Infrared ear thermometry is now commonly used in children, both in hospital and in the community. In the USA, 64% of paediatricians and 65% of family practice physicians use this method.3 In this systematic review, we investigate the agreement between temperature measured at the ear and at the rectum in children.
Section snippets
Study identification
A single reviewer (JVC) used a comprehensive strategy to search Medline (1966 to January, 2000), CINAHL (1982 to December, 1999), British Nursing Index (to June 1999), the Cochrane Library (2000 Disk Issue 1), the ASLIB Index to theses Great Britain and Ireland (1970–99), the National Research Register (2000 Disk Issue 2), and Bath Information and Data Services Index to Scientific and Technological Proceedings (1982–2000). Authors and suppliers of clinical thermometers were asked for details of
Description of studies
Our preliminary search identified 101 studies. There was initial agreement between the two reviewers on study eligibility in all but six studies, and on methodological quality in all but nine. 44 studies (39 in English) that described 56 comparisons were eligible for the review. One additional eligible unpublished study and one eligible unpublished comparison were identified (personal communications with authors of two studies: K R Powell23 and R J Yetman16). The studies included 5935 children.
Discussion
Temperature measured at the ear has obvious advantages over temperature measured at the rectum, such that if the two methods agree sufficiently well, then the ear-based method could replace the rectal method. In this study we noted small mean differences, but wide limits of agreement, between the two temperature sites. The pooled mean difference was smallest when the ear device was used in the rectal mode, but the limits of agreement remained wide. For example, if temperature measured at the
Search strategy
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