Temperature measurements with a temporal scanner: systematic review and meta-analysis

Objectives Systematic review and meta-analysis on the diagnostic accuracy of temporal artery thermometers (TAT).Design Systematic review and meta-analysis. The index test consisted of temperature measurement with TAT. The reference test consisted of an estimation of core temperature.Participants Cli...

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Main Authors: Ruzan Udumyan, Håkan Geijer, Georg Lohse, Ylva Nilsagård
Format: Article
Language:English
Published: BMJ Publishing Group 2016-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/6/3/e009509.full
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author Ruzan Udumyan
Håkan Geijer
Georg Lohse
Ylva Nilsagård
author_facet Ruzan Udumyan
Håkan Geijer
Georg Lohse
Ylva Nilsagård
author_sort Ruzan Udumyan
collection DOAJ
description Objectives Systematic review and meta-analysis on the diagnostic accuracy of temporal artery thermometers (TAT).Design Systematic review and meta-analysis. The index test consisted of temperature measurement with TAT. The reference test consisted of an estimation of core temperature.Participants Clinical patients as well as healthy participants, with or without fever.Interventions Literature search in PubMed, Embase, Cinahl and Web of Science. Three reviewers selected articles for full-text reading after which a further selection was made. Risk of bias was assessed with QUADAS-2. Pooled difference and limits of agreement (LoA) were estimated with an inverse variance weighted approach. Subgroup and sensitivity analyses were performed. Sensitivity and specificity were estimated using hierarchical models. Quality of evidence was assessed according to the GRADE system.Primary and secondary outcome measures The primary outcome was measurement accuracy expressed as mean difference ±95% LoA. A secondary outcome was sensitivity and specificity to detect fever. If tympanic thermometers were assessed in the same population as TAT, these results were recorded as well.Results 37 articles comprising 5026 participants were selected. Pooled difference was -0.19°C (95% LoA −1.16 to 0.77°C), with moderate quality of evidence. Pooled sensitivity was 0.72 (95% CI 0.61 to 0.81) with a specificity of 0.94 (95% CI 0.87 to 0.97). The subgroup analysis revealed a trend towards underestimation of the temperature for febrile patients. There was a large heterogeneity among included studies with wide LoA which reduced the quality of evidence.Conclusions TAT is not sufficiently accurate to replace one of the reference methods such as rectal, bladder or more invasive temperature measurement methods. The results are, however, similar to those with tympanic thermometers, both in our meta-analysis and when compared with others. Thus, it seems that TAT could replace tympanic thermometers with the caveat that both methods are inaccurate.Trial registration number CRD42014008832.
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spelling doaj-art-3c6e5dc4f98c4bceac3996d30fba5d4e2025-02-09T11:00:10ZengBMJ Publishing GroupBMJ Open2044-60552016-03-016310.1136/bmjopen-2015-009509Temperature measurements with a temporal scanner: systematic review and meta-analysisRuzan Udumyan0Håkan Geijer1Georg Lohse2Ylva Nilsagård3research assistant1Centre for Assessment of Medical Technology in Örebro, Region Örebro County, Örebro, Sweden1Centre for Assessment of Medical Technology in Örebro, Region Örebro County, Örebro, Sweden1Centre for Assessment of Medical Technology in Örebro, Region Örebro County, Örebro, SwedenObjectives Systematic review and meta-analysis on the diagnostic accuracy of temporal artery thermometers (TAT).Design Systematic review and meta-analysis. The index test consisted of temperature measurement with TAT. The reference test consisted of an estimation of core temperature.Participants Clinical patients as well as healthy participants, with or without fever.Interventions Literature search in PubMed, Embase, Cinahl and Web of Science. Three reviewers selected articles for full-text reading after which a further selection was made. Risk of bias was assessed with QUADAS-2. Pooled difference and limits of agreement (LoA) were estimated with an inverse variance weighted approach. Subgroup and sensitivity analyses were performed. Sensitivity and specificity were estimated using hierarchical models. Quality of evidence was assessed according to the GRADE system.Primary and secondary outcome measures The primary outcome was measurement accuracy expressed as mean difference ±95% LoA. A secondary outcome was sensitivity and specificity to detect fever. If tympanic thermometers were assessed in the same population as TAT, these results were recorded as well.Results 37 articles comprising 5026 participants were selected. Pooled difference was -0.19°C (95% LoA −1.16 to 0.77°C), with moderate quality of evidence. Pooled sensitivity was 0.72 (95% CI 0.61 to 0.81) with a specificity of 0.94 (95% CI 0.87 to 0.97). The subgroup analysis revealed a trend towards underestimation of the temperature for febrile patients. There was a large heterogeneity among included studies with wide LoA which reduced the quality of evidence.Conclusions TAT is not sufficiently accurate to replace one of the reference methods such as rectal, bladder or more invasive temperature measurement methods. The results are, however, similar to those with tympanic thermometers, both in our meta-analysis and when compared with others. Thus, it seems that TAT could replace tympanic thermometers with the caveat that both methods are inaccurate.Trial registration number CRD42014008832.https://bmjopen.bmj.com/content/6/3/e009509.full
spellingShingle Ruzan Udumyan
Håkan Geijer
Georg Lohse
Ylva Nilsagård
Temperature measurements with a temporal scanner: systematic review and meta-analysis
BMJ Open
title Temperature measurements with a temporal scanner: systematic review and meta-analysis
title_full Temperature measurements with a temporal scanner: systematic review and meta-analysis
title_fullStr Temperature measurements with a temporal scanner: systematic review and meta-analysis
title_full_unstemmed Temperature measurements with a temporal scanner: systematic review and meta-analysis
title_short Temperature measurements with a temporal scanner: systematic review and meta-analysis
title_sort temperature measurements with a temporal scanner systematic review and meta analysis
url https://bmjopen.bmj.com/content/6/3/e009509.full
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