Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, Maryland, United States.
University of Maryland, Department of Mechanical Engineering, Baltimore County, Maryland, United States.
J Biomed Opt. 2020 Sep;25(9). doi: 10.1117/1.JBO.25.9.097002.
Infrared thermographs (IRTs) have been used for fever screening during infectious disease epidemics, including severe acute respiratory syndrome, Ebola virus disease, and coronavirus disease 2019 (COVID-19). Although IRTs have significant potential for human body temperature measurement, the literature indicates inconsistent diagnostic performance, possibly due to wide variations in implemented methodology. A standardized method for IRT fever screening was recently published, but there is a lack of clinical data demonstrating its impact on IRT performance.
Perform a clinical study to assess the diagnostic effectiveness of standardized IRT-based fever screening and evaluate the effect of facial measurement location.
We performed a clinical study of 596 subjects. Temperatures from 17 facial locations were extracted from thermal images and compared with oral thermometry. Statistical analyses included calculation of receiver operating characteristic (ROC) curves and area under the curve (AUC) values for detection of febrile subjects.
Pearson correlation coefficients for IRT-based and reference (oral) temperatures were found to vary strongly with measurement location. Approaches based on maximum temperatures in either inner canthi or full-face regions indicated stronger discrimination ability than maximum forehead temperature (AUC values of 0.95 to 0.97 versus 0.86 to 0.87, respectively) and other specific facial locations. These values are markedly better than the vast majority of results found in prior human studies of IRT-based fever screening.
Our findings provide clinical confirmation of the utility of consensus approaches for fever screening, including the use of inner canthi temperatures, while also indicating that full-face maximum temperatures may provide an effective alternate approach.
红外热像仪（IRTs）已在传染病流行期间（包括严重急性呼吸系统综合征、埃博拉病毒病和 2019 年冠状病毒病（COVID-19））用于发热筛查。尽管 IRTs 具有人体体温测量的重要潜力，但文献表明其诊断性能不一致，这可能是由于实施方法的广泛差异所致。最近发布了一种标准化 IRT 发热筛查方法，但缺乏临床数据表明其对 IRT 性能的影响。
进行一项临床研究，评估基于标准化 IRT 的发热筛查的诊断效果，并评估面部测量位置的影响。
我们对 596 名受试者进行了临床研究。从热图像中提取 17 个面部位置的温度，并与口腔测温进行比较。统计分析包括计算接收者操作特征（ROC）曲线和曲线下面积（AUC）值，以检测发热受试者。
IRT 与参考（口腔）温度之间的皮尔逊相关系数发现与测量位置密切相关。基于内眼角或整个面部区域的最大温度的方法比额部最大温度（AUC 值分别为 0.95 至 0.97 与 0.86 至 0.87）以及其他特定面部位置具有更强的区分能力。这些值明显优于之前基于 IRT 的发热筛查的大多数人类研究中发现的绝大多数结果。
我们的发现为共识方法（包括使用内眼角温度）在发热筛查中的实用性提供了临床证实，同时也表明全脸最大温度可能提供一种有效的替代方法。
