J Korean Acad Nurs.  2012 Jun;42(3):424-433. 10.4040/jkan.2012.42.3.424.

Accuracy, Precision, and Validity of Fever Detection using Non-invasive Temperature Measurement in Adult Coronary Care Unit Patients with Pulmonary Catheters

• Joo G
• Sohng KY

• KMID: 1785227
• DOI: http://doi.org/10.4040/jkan.2012.42.3.424

Abstract

PURPOSE
To investigate the accuracy, precision and validity of fever detection of tympanic membrane (TM), temporal artery (TA) and axillary temperature (AT) compared with pulmonary artery temperature (PA).
METHODS
Repeated-measures design was conducted for one year on 83 adult cardiac care unit patients with pulmonary artery catheters after open heart surgery. Sequential temperature measurements were taken three times at 20-minute intervals. Accuracy, precision, repeatability, and validity of fever detection were analyzed.
RESULTS
Mean pulmonary artery temperature was 37.04degrees C (SD 0.70degrees C). The mean (SD) offsets from PA, with the mean reflecting accuracy and SD reflecting precision, were -1.31degrees C (0.75degrees C) for TA, -0.20degrees C (0.24degrees C) for TM, and -0.97degrees C (0.64degrees C) for AT. Percentage of pairs with differences within +/-0.5degrees C was 9.6% for TA, 19.7% for AT, and 91.6% for TM. Repeated measurements with all three methods had mean SD values within 0.04degrees C. Sensitivity, specificity, and positive and negative predictive values of tympanic measurements were 0.76, 1.0, and 1.0, and 0.90, respectively.
CONCLUSION
Results show that TM best reflects PA, and is most consistent, accurate, and precise. AT tends to underestimate PA, and TA is least accurate and precise. Therefore tympanic membrane measurement is a reliable alternative to other non-invasive methods of measuring temperatures.

Keyword

Body temperature; Thermometer

MeSH Terms

Aged
Axilla/physiology
Body Mass Index
*Body Temperature
Cardiac Care Facilities
Catheterization, Swan-Ganz
Female
Fever/*diagnosis
Heart Diseases/surgery
Humans
Male
Middle Aged
Pulmonary Artery/physiology
Temporal Arteries/physiology
Thermometers
Tympanic Membrane/physiology

Figure

• 

  Figure 1 Bland-Altman plots comparing the difference between pulmonary temperature and temperature measurements from other methods.

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