Is the temporal artery thermometer a reliable instrument for detecting fever in children?

Aims and objective. We aimed to study the diagnostic accuracy of the temporal artery thermometer vs. rectal temperature in a large group of children with and without fever, aged 0–18 years. Background. Many have studied the diagnostic accuracy of the temporal artery thermometer in children compared with a reference method, with contradictory outcomes. No studies have been carried out in a large group of children of all ages. Design. Diagnostic accuracy/validation study. Method. Children (0–18 years) with fever (T > 38·0 °C) were recruited through the emergency department and children with normal temperatures through the day‐care department of the Children’s Hospital. All children routinely had rectal temperature recordings. Temporal artery temperature was recorded shortly after the rectal recording. The mean absolute difference in temperature, the level of agreement (intraclass correlation coefficient) and the sensitivity and specificity of detecting fever were calculated. Results. A total number of 198 children (121 boys) participated, with a mean age of 5·1 (SD 4·7) years. Of those children, 81 had fever according to the rectal recording. Mean difference between temporal artery temperature and rectal temperature was −0·11 (SD 0·63) °C, with an agreement of 0·812. The sensitivity and specificity of the temporal artery thermometer for detecting fever were 67·9 and 98·3%, respectively. Conclusions. The diagnostic accuracy of the temporal artery thermometer in detecting fever in children of all ages is low. Relevance to clinical practice. We do not recommend replacement of standard clinical thermometers with temporal artery thermometers.