Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
Advertisement
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
Advertisement
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
The Back Pages

Evidence in practice — number 6: tympanic membrane thermometers

Katherine Greenwood
British Journal of General Practice 2005; 55 (511): 152.
Katherine Greenwood
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info
  • eLetters
  • PDF
Loading

Clinical question — during the examination of children in general practice does an infrared tympanic thermometer accurately measure fever when compared with a mercury thermometer?

THE EVIDENCE

Craig JV, Lancaster GA, Taylor S, et al. Infrared ear thermometry compared with rectal thermometry in children: a systematic review. Lancet 2002; 360: 603–609.

BACKGROUND

The assessment of unwell children is a fundamental part of general practice and measurement of temperature is often necessary. My concern regarding the choice of equipment stems from an occasion when I used a tympanic membrane thermometer to measure the temperature of a child who appeared febrile. The first reading was recorded as normal, yet the reading from the other ear was elevated.

After the consultation, I was able to demonstrate a similar discrepancy on measuring my own tympanic membrane temperature on both sides. This caused me concern as I had presumed the reading that the thermometer gave me was accurate and reproducible. I decided to look for evidence about the use of tympanic membrane thermometers and their accuracy.

STUDY DESIGN

This study was a systematic review with a clear set of inclusion criteria for studies and a comprehensive search strategy. Two reviewers independently appraised the methodological quality of the studies. Thirty-one studies were included in the meta-analysis, looking at 4441 children, and there is clear information provided about the age, number of children, population and the type of thermometer used.

OUTCOME MEASURE

The detection of fever using a tympanic membrane thermometer compared to the temperature measured rectally with a mercury thermometer (taken as the reference standard).

RESULTS

These are presented in a Cochrane plot and display the mean temperature difference between the tympanic and rectal temperature. The tympanic membrane thermometers were used in several modes in the different studies. (This means that the temperature recorded at the tympanic membrane is transformed to correspond with the temperature that would be recorded at a particular site in the body, for example rectal, core, oral, tympanic.) The results were separated out according to this and then pooled. There was significant heterogeneity between the studies which affects the pooling of the results.

The overall pooled mean temperature difference (random effects due to large heterogeneity between the studies) was 0.29°C. The 95% confidence interval for agreement was wide — from −0.74°C to 1.32°C — indicating that the tympanic membrane thermometer was as likely to record a temperature above the rectal temperature as to record a temperature below. The pooled mean difference of temperature was smallest when the ear thermometer was used in rectal mode, giving a potential range of temperatures from 37.04°C to 39.20°C for a rectal temperature of 38°C.

COMMENTARY

This study included children in a range of settings including A&E, paediatric clinics and the community. There is no strong reason to suggest that these children would be significantly different from the patients I see in general practice, although the children seen in the A&E department may be more seriously ill; possibly with hypothermia, an uncommon presentation in general practice. These results create difficulties in my practice, as I use a tympanic membrane thermometer, but the temperature it records has poor agreement with the rectal temperature. It is not as practical or acceptable to use a mercury thermometer to measure temperature.

Having considered the evidence, I will continue to use my tympanic thermometer, as it is acceptable to patients and convenient to use. However, I will maintain awareness that it may not always be accurate.

BOTTOM LINE

Tympanic membrane thermometry has poor correlation with rectal temperature measured using a mercury thermometer.

  • © British Journal of General Practice, 2005.
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 55 (511)
British Journal of General Practice
Vol. 55, Issue 511
February 2005
  • Table of Contents
  • Index by author
Download PDF
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Evidence in practice — number 6: tympanic membrane thermometers
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Evidence in practice — number 6: tympanic membrane thermometers
Katherine Greenwood
British Journal of General Practice 2005; 55 (511): 152.

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Evidence in practice — number 6: tympanic membrane thermometers
Katherine Greenwood
British Journal of General Practice 2005; 55 (511): 152.
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • THE EVIDENCE
    • BACKGROUND
    • STUDY DESIGN
    • OUTCOME MEASURE
    • RESULTS
    • COMMENTARY
    • BOTTOM LINE
  • Info
  • eLetters
  • PDF

More in this TOC Section

The Back Pages

  • How to protect general practice from child protection
  • Who Is My Patient?
  • Working with vulnerable families in deprived areas
Show more The Back Pages

Resources

  • Evidence in practice — number 8. What is the prognosis of optic neuritis?
  • EBM, the once and future paradigm
  • Evidence in practice — number 7 Can postpartum depression be prevented?
Show more Resources

Related Articles

Cited By...

Advertisement

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers
  • RCGP e-Portfolio

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7679
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2021 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242