A comparison between infrared tympanic thermometry, oral and axilla with rectal thermometry in neutropenic adults

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society 2009-09, Vol.13 (4), p.250-254
• Main Authors: Dzarr, Abu Abdullah, Kamal, Mustafa, Baba, Abdul Aziz
• Format: Article
• Language: English
• Subjects: Adult; Analysis of Variance; Antineoplastic Agents - adverse effects; Axilla; Chemotherapy; Clinical Nursing Research; Contingencies; Cross Infection - chemically induced; Cross Infection - microbiology; Febrile; Fever - chemically induced; Fever - diagnosis; Fever - microbiology; Fevers; Hematologic Neoplasms - drug therapy; Hematology, Oncology and Palliative Medicine; Humans; Mouth; Neutropenia; Neutropenia - chemically induced; Nursing Assessment; Prospective Studies; Rectum; Sensitivity; Sensitivity and Specificity; Single-Blind Method; Specificity; Temperature; Thermography - instrumentation; Thermography - methods; Thermography - nursing; Thermography - standards; Thermometers - standards; Tympanic membrane thermometer
• ISSN: 1462-3889; 1532-2122
• DOI: 10.1016/j.ejon.2009.03.006

Abstract Background This study assessed the agreement between infrared tympanic membrane (TM), axillary, corrected axillary (+0.5 °C), oral, and corrected oral (+0.3 °C) to rectal thermometry as reference standard in neutropenic adults. The sensitivity and specificity of the mentioned thermometries in detecting rectal fever (≥38 °C) were also analysed. Method This is a comparative diagnostic test study. A total of 400 sets of blinded simultaneous temperature readings were measured from 21 haemato-oncology in-patients with neutropenia following chemotherapy. Three-hundred sets were then randomly sampled. Agreements were analysed using random two-way intraclass correlation (ICC). Sensitivity and specificity were analysed using contingency 2 × 2 table. Findings Both right and left TM thermometry have good correlation with rectal thermometry; 0.810 (95% CI, 0.748–0.855) and 0.770 (95% CI, 0.713–0.815) respectively. Axilla thermometry has weak agreement (ICC 0.486 (95% CI, 0.118–0.689)) with rectal thermometry. The sensitivity (sn) and specificity (sp) in detecting rectal fever (≥38 °C) were: right TM (sn) 0.712 (95% CI, 0.586–0.814), (sp) 0.957 (95% CI, 0.920–0.978); oral (sn) 0.561 (95% CI, 0.433–0.681), (sp) 0.983 (95% CI, 0.954–0.995); and axilla (sn) 0.348 (95% CI, 0.238–0.477), (sp) 0.996 (95% CI, 0.973–0.999). Interpretation Single tympanic membrane thermometry is in good agreement with rectal thermometry. It is more sensitive than oral or axillary thermometry in detecting rectal fever.