ISMJ

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Background: Rectal route is a gold standard method of measuring fever, but it is invasive and stressful for parents and children. A recently used method is tympanic that has the advantages of safety, speed and compatibility but its accuracy is under question. Methods: In order to assess the accuracy of tympanic thermometry, 220 children within 3 months to 6 years old were selected and temperature was checked by rectal, axillary and tympanic methods. Results: The mean rectal temperature, compared with tympanic and axillary, was higher (0.3oc and 0.1oc, respectively). There was a good correlation between right and left tympanic measurements (r=0.87, P<0.001), rectal and right tympanic (r=0.76, P<0.005), axillary and right tympanic (r=0.80, P<0.001), and axillary and rectal methods (r=0.74, P<0.001). The sensitivity, specificity and accuracy of tympanic method (with 38ocas cut off point) were 46.4%, 97.2 % and 90.9%. ROC curve analysis showed that the best cut off point for fever was 37 oc the sensitivity, specificity and accuracy were increased 92.9%, 90.1% and 90.4%, respectively, using this cut off point. Kappa coefficient showed a good correlation between rectal and tympanic methods. Conclusion: Tympanic thermometry, in comparison to axillary and rectal thermometry is an accurate, rapid, safe and comfortable method and the best cut off point for defining fever is 37oc.

Keywords: fever, tympanic, axillary, rectal, thermometer

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