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Temperature measurements with a temporal scanner: systematic review and meta-analysis
  1. Håkan Geijer1,2,
  2. Ruzan Udumyan3,
  3. Georg Lohse1,4,
  4. Ylva Nilsagård1,5
  1. 1Centre for Assessment of Medical Technology in Örebro, Region Örebro County, Örebro, Sweden
  2. 2Department of Radiology, School of Medical Sciences, Örebro University, Örebro, Sweden
  3. 3Department of Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
  4. 4Örebro Rehab Center, Örebro, Sweden
  5. 5Department of Medicine, School of Health Sciences, Örebro University, Örebro, Sweden
  1. Correspondence to Dr Håkan Geijer; hakan.geijer{at}regionorebrolan.se

Abstract

Objectives Systematic review and meta-analysis on the diagnostic accuracy of temporal artery thermometers (TAT).

Design Systematic review and meta-analysis. The index test consisted of temperature measurement with TAT. The reference test consisted of an estimation of core temperature.

Participants Clinical patients as well as healthy participants, with or without fever.

Interventions Literature search in PubMed, Embase, Cinahl and Web of Science. Three reviewers selected articles for full-text reading after which a further selection was made. Risk of bias was assessed with QUADAS-2. Pooled difference and limits of agreement (LoA) were estimated with an inverse variance weighted approach. Subgroup and sensitivity analyses were performed. Sensitivity and specificity were estimated using hierarchical models. Quality of evidence was assessed according to the GRADE system.

Primary and secondary outcome measures The primary outcome was measurement accuracy expressed as mean difference ±95% LoA. A secondary outcome was sensitivity and specificity to detect fever. If tympanic thermometers were assessed in the same population as TAT, these results were recorded as well.

Results 37 articles comprising 5026 participants were selected. Pooled difference was -0.19°C (95% LoA −1.16 to 0.77°C), with moderate quality of evidence. Pooled sensitivity was 0.72 (95% CI 0.61 to 0.81) with a specificity of 0.94 (95% CI 0.87 to 0.97). The subgroup analysis revealed a trend towards underestimation of the temperature for febrile patients. There was a large heterogeneity among included studies with wide LoA which reduced the quality of evidence.

Conclusions TAT is not sufficiently accurate to replace one of the reference methods such as rectal, bladder or more invasive temperature measurement methods. The results are, however, similar to those with tympanic thermometers, both in our meta-analysis and when compared with others. Thus, it seems that TAT could replace tympanic thermometers with the caveat that both methods are inaccurate.

Trial registration number CRD42014008832.

  • INFECTIOUS DISEASES
  • INTERNAL MEDICINE
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This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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