Kongpanichkul A, Bunjongpak S
Department of Pediatrics, Nakhon Pathom Hospital, Thailand.
J Med Assoc Thai. 2000 Sep;83(9):1068-76.
This study was carried out to assess the accuracy of three devices namely, liquid crystal forehead, digital electronic axillary and infrared tympanic thermometer, using a glass-mercury rectal thermometer as the control. The subjects were two hundred children aged 0-48 months. The mean rectal temperature was 38.0 +/- 0.91 degrees C; forehead, 37.83 +/- 0.94 degrees C; tympanic, 37.77 +/- 0.95 degrees C, and axillary, 37.71 +/- 0.86 degrees C. Compared to the rectal temperature, all values were significantly lower (p < 0.05). Forehead, tympanic and axillary temperature differed from rectal temperature by at least 0.5 degrees C in 33.33 per cent, 23.5 per cent and 31.5 per cent of subjects, and at least 1 degrees C in 22 per cent, 1 per cent and 6 per cent of subjects respectively. Accuracy in detection of fever was 79 per cent for forehead, 85.5 per cent for tympanic and 84 per cent for axillary thermometry. Sensitivity of the three devices was 67-83 per cent in detection of fever and 64-77 per cent in detection of high fever. Tympanic thermometry had the best performance while forehead thermometry had the poorest. After using revised diagnostic threshold temperature by ROC curves, sensitivity of each device improved but accuracy was nearly the same. It is concluded that the three devices are not suitable as a substitute for a glass-mercury rectal thermometer in assessment of fever in infants and young children.
本研究旨在评估三种体温计的准确性，这三种体温计分别为液晶额头体温计、数字电子腋下体温计和红外鼓膜体温计，以玻璃汞柱直肠体温计作为对照。研究对象为200名年龄在0至48个月的儿童。直肠平均温度为38.0±0.91摄氏度；额头温度为37.83±0.94摄氏度；鼓膜温度为37.77±0.95摄氏度；腋下温度为37.71±0.86摄氏度。与直肠温度相比，所有数值均显著较低（p<0.05）。在33.33%、23.5%和31.5%的受试者中，额头、鼓膜和腋下温度与直肠温度相差至少0.5摄氏度；在22%、1%和6%的受试者中，分别相差至少1摄氏度。额头体温计检测发热的准确率为79%，鼓膜体温计为85.5%，腋下体温计为84%。这三种体温计检测发热的敏感度为67 - 83%，检测高热的敏感度为64 - 77%。鼓膜体温计表现最佳，额头体温计表现最差。通过ROC曲线使用修订后的诊断阈值温度后，各体温计的敏感度有所提高，但准确率基本相同。结论是，在评估婴幼儿发热时，这三种体温计均不适合替代玻璃汞柱直肠体温计。
