Private Paediatric Practice, Langnau i.E, Switzerland.
Acta Paediatr. 2014 Feb;103(2):e80-3. doi: 10.1111/apa.12464. Epub 2013 Nov 18.
To compare infrared tympanic and infrared contact forehead thermometer measurements with traditional rectal digital thermometers.
A total of 254 children (137 girls) aged one to 24 months (median 7 months) consulting a private paediatric practice because of fever were prospectively recruited. Body temperature was measured using the three different devices.
The median and interquartile range for rectal, tympanic and forehead thermometers were 37.6 (37.1-38.4)°C, 37.5 (37.0-38.1)°C and 37.5 (37.1-37.9)°C, respectively (p < 0.01). The limits of agreement in the Bland-Altman plots were -0.73 to +1.04°C for the tympanic thermometer and -1.18 to +1.64°C for the forehead thermometer. The specificity of both the tympanic and forehead thermometers for detecting fever above 38°C was good, but sensitivity was low. Forehead measurements were susceptible to the use of a radiant warmer.
Both the tympanic and forehead devices recorded lower temperatures than the rectal thermometers. The limits of agreement were particularly wide for the forehead thermometer and considerable for the tympanic thermometer. In the absence of valid alternatives, because of the ease to use and little degree of discomfort, tympanic thermometers can still be used with some reservations. Forehead thermometers should not be used in paediatric practice.
比较红外鼓膜和红外接触额温计与传统直肠数字体温计的测量结果。
共前瞻性招募了 254 名（女 137 名）1 至 24 个月（中位数 7 个月）龄因发热就诊于私人儿科诊所的儿童。使用三种不同的设备测量体温。
直肠、鼓膜和额温计的中位数和四分位间距分别为 37.6（37.1-38.4）°C、37.5（37.0-38.1）°C 和 37.5（37.1-37.9）°C（p<0.01）。Bland-Altman 图中的一致性界限分别为鼓膜温度计为-0.73 至+1.04°C，额温计为-1.18 至+1.64°C。鼓膜和额温计检测 38°C 以上发热的特异性均较好，但敏感性较低。额部测量易受辐射取暖器的影响。
鼓膜和额部设备记录的温度均低于直肠温度计。额温计的一致性界限特别宽，鼓膜温度计的界限也相当宽。在没有有效替代方法的情况下，由于使用方便且不适感较小，鼓膜温度计仍可谨慎使用。额温计不应在儿科实践中使用。
