Oral Thermometry Research Articles

Accuracy, precision and diagnostic accuracy of oral thermometry in pediatric patients

PurposeTo determine the accuracy and precision of oral thermometry in pediatric patients, along with its sensitivity and specificity for detecting fever and hypothermia, with rectal thermometry as reference standard. Design and methodsThis method-comparison study enrolled patients aged between 6 and 17 years, admitted to the surgical ward during a 21-month period. KD-2150 and IVAC Temp Plus II were used for oral and rectal temperature measurements respectively. Fever and hypothermia were defined as core temperature ≥38.0 °C and ≤ 35.9 °C respectively. Accuracy and precision of oral thermometry were determined by the Bland-Altman method. Sensitivity, specificity, positive and negative predictive value, and correct classification of oral temperature cutoffs for detecting fever and hypothermia were calculated. ResultsBased on power analysis, 100 pediatric patients were enrolled. The mean difference between oral and rectal temperatures was −0.34 °C, with 95 % limits of agreement ranging between −0.52 and −0.16. Sensitivity and specificity of oral thermometry for detecting fever were 0.50 and 1.0 respectively; its sensitivity and specificity for detecting hypothermia were 1.0 and 0.88 respectively. The oral temperature value of 37.6 °C provided excellent sensitivity for detecting fever, while the value of 35.7 °C provided optimal sensitivity and specificity for detecting hypothermia. ConclusionsOral thermometry had low sensitivity for detecting fever and suboptimal specificity for detecting hypothermia; thus, temperature values <38.0 °C and <36.0 °C cannot exclude fever and confirm hypothermia respectively with high certainty. Practice implicationsDiagnostic accuracy of oral thermometry can be improved by the use of oral temperature thresholds <38.0 °C for detecting fever and <35.9 °C for detecting hypothermia.

Assessment of Alternative Body Points for Temperature Screening As Precautionary Screening During the Pandemic Using Infrared Thermometry.

The recent coronavirus disease 2019 (COVID-19) pandemic, which swept across the globe in a short period, demonstrated that disease transmission management is a critical step in preventing an outbreak, as is good viral infectious disease screening. Infrared thermography (IRT) has long been considered ideal for screening body temperatures during pandemics. Single-centre cross-sectional study with 159 participants. Using infrared thermometry, participants were subjected to temperature measurement twice daily on various sites. This was compared to oral temperature. The findings of the study revealed that infrared thermometry could be utilised as a proxy approach for screening by both individuals and medical professionals when employed at the glabella, cubits, or axillae. Temperature screening is implied as a prophylactic method during pandemics. Owing to contact limitations, oral thermometry cannot be used for mass screening during the pandemic. Infrared thermometry is a noncontact method of temperature screening that can readily be applied for mass temperature screening in congested venues such as airports, shopping malls, places of public convenience, and other similar locations.

Are all thermometers equal? A study of three infrared thermometers to detect fever in an African outpatient clinic.

Infrared thermometry has certain advantages over traditional oral thermometry including quick, non-invasive administration and an absence of required consumables. This study compared the performance of tympanic, temporal artery and forehead contactless thermometers with traditional oral electronic thermometer as the reference in measuring temperature in outpatients in a Nigerian secondary care hospital. A convenience sample of 100 male and 100 female adult patients (Mean age = 38.46 years, SD = 16.33 years) were recruited from a secondary care hospital in Kano, Nigeria. Temperature measurements were taken from each patient using the tympanic, temporal artery and contactless thermometers and oral electronic thermometer. Data was analyzed to assess bias and limits using scatterplots and Bland-Altman charts while sensitivity analysis was done using ROC curves. The tympanic and temporal artery thermometers systematically gave higher temperature readings compared to the oral electronic thermometer. The contactless thermometer gave lower readings compared to the oral electronic thermometer. The temporal artery thermometer had the highest sensitivity (88%) and specificity (88%) among the three infrared thermometers. The contactless thermometer showed a low sensitivity of 13% to detect fever greater than 38 °C. Our study shows that replacing oral thermometers with infrared thermometers must be done with caution despite the associated convenience and cost savings.

Peripheral thermometry: Agreement between non-touch infrared versus traditional modes in an adult population.

To test whether infrared non-touch forehead thermometry (FNTT) obtains comparable temperature readings in adults compared with common, non-invasive thermometry methods such as axillary (DAT), oral (DOT) and infrared tympanic (ITT). A prospective, repeated-measures comparative diagnostic test study design was used for this study. Data were collected from a convenience sample of 169 nursing students over 3months (March 2019 to May 2019). Participants had their temperature measured once with each of the four thermometers. Agreement between thermometers was assessed using repeated-measures analysis of variance with Bonferroni post hoc testing. One hundred and sixty-one participants were included in the final analysis. A repeated-measures ANOVA showed statistically significant differences between the four thermometer temperature readings. Post hoc pairwise comparisons with Bonferroni adjustment revealed infrared non-touch forehead thermometry demonstrated statistically significant higher mean temperatures compared with digital oral thermometry MD=0.466℃ (95% CI, 0.357-0.576, p<.001) and digital axillary thermometry MD=0.897℃ (95% CI, 0.752-1.043, p<.001), but not with infrared tympanic MD=0.069℃ (95% CI, -0.025-0.162, p=.307). This study found that infrared non-touch forehead thermometry consistently produced higher temperature readings in adults compared with other common forms of peripheral thermometry. Caution should be taken when using forehead non-touch thermometer readings interchangeably with digital oral and digital axillary readings unless corrections for bias are made. More research is needed into whether infrared non-touch forehead thermometry and infrared tympanic could be used interchangeably. This study aimed to address whether non-touch forehead could be used interchangeably with other common forms of non-invasive thermometry. Our result revealed inconsistencies in temperature readings between the different thermometers. Consequently, healthcare professionals should exercise caution when monitoring temperature trends where readings have been taken by different types of peripheral thermometers. This study could impact healthcare clinicians responsible for the monitoring and recording of peripheral temperatures.

Diagnostic accuracy of oral thermometry for fever detection in adult patients: literature review and meta-analysis.

To synthesise the evidence on the accuracy and precision of oral thermometry in adult patients, as well as on its sensitivity and specificity for fever detection. Oral thermometry has long been used in various clinical settings thanks to its rapid, safe and convenient measurements, which are easy to obtain and minimally prone to operator errors. Literature review and meta-analysis that adhered to the PRISMA statement. By using key terms, literature searches were conducted in CINAHL, PubMed, Web of Science, Scopus and Cochrane Library. Method-comparison studies, which were published from January 1990 to December 2020 in English-language, peer-reviewed journals, compared oral temperature measurements with invasive thermometry ones, and were conducted on patients ≥18years, were included. Methodological quality of selected studies was evaluated with QUADAS-2. Sixteen articles were selected for inclusion. Risk of bias was assessed as low in most of them. Quantitative synthesis indicated that pooled mean oral temperature was lower than core temperature by .07℃, with 95% limits of agreement ranging between -.22℃ and .08℃. Pooled sensitivity and specificity for fever detection (defined as core temperature ≥38℃ in most studies) were .53 (95% confidence interval, .39-.66) and .98 (95% confidence interval, .97-.99), respectively. Sensitivity analysis indicated larger temperature underestimation in case rectal temperature was used as reference standard. Despite its satisfactory accuracy, precision and specificity, oral thermometry has low sensitivity for fever detection, which entails a high number of false-negative readings and uncertainty for excluding fever in patients found to be non-febrile. Oral thermometry cannot be recommended for replacing invasive thermometry methods in hospitalised adult patients, considering the high incidence of fever in them and possible negative effects of missing fever for patient diagnosis and outcomes.

An initial study on the agreement of body temperatures measured by infrared cameras and oral thermometry

The COVID-19 pandemic has led to the rapid adoption and rollout of thermal camera-based Infrared Thermography (IRT) systems for fever detection. These systems use facial infrared emissions to detect individuals exhibiting an elevated core-body temperature, which is present in many symptomatic presentations of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the rollout of these systems, there is little independent research supporting their efficacy. The primary objective of this study was to assess the precision and accuracy of IRT screening solutions in a real-world scenario. The method used was a single-centre, observational study investigating the agreement of three IRT systems compared to digital oral thermometer measurements of body temperature. Over 5 days, 107 measurements were taken from individuals wearing facial masks. During each entry, two measurements of the subject’s body temperature were made from each system to allow for the evaluation of the measurement precision, followed by an oral thermometer measurement. Each participant also answered a short demographic survey. This study found that the precision of the IRT systems was wider than 0.3 °C claimed accuracy of two of the systems. This study also found that the IRT measurements were only weakly correlated to those of the oral temperature. Additionally, it was found that demographic characteristics (age, gender, and mask-type) impacted the measurement error. This study indicates that using IRT systems in front-line scenarios poses a potential risk, where a lack of measurement accuracy could possibly allow febrile individuals to pass through undetected. Further research is required into methods which could increase accuracy and improve the techniques viability.

Clinical evaluation of fever-screening thermography: impact of consensus guidelines and facial measurement location

.Significance: Infrared thermographs (IRTs) have been used for fever screening during infectious disease epidemics, including severe acute respiratory syndrome, Ebola virus disease, and coronavirus disease 2019 (COVID-19). Although IRTs have significant potential for human body temperature measurement, the literature indicates inconsistent diagnostic performance, possibly due to wide variations in implemented methodology. A standardized method for IRT fever screening was recently published, but there is a lack of clinical data demonstrating its impact on IRT performance.Aim: Perform a clinical study to assess the diagnostic effectiveness of standardized IRT-based fever screening and evaluate the effect of facial measurement location.Approach: We performed a clinical study of 596 subjects. Temperatures from 17 facial locations were extracted from thermal images and compared with oral thermometry. Statistical analyses included calculation of receiver operating characteristic (ROC) curves and area under the curve (AUC) values for detection of febrile subjects.Results: Pearson correlation coefficients for IRT-based and reference (oral) temperatures were found to vary strongly with measurement location. Approaches based on maximum temperatures in either inner canthi or full-face regions indicated stronger discrimination ability than maximum forehead temperature (AUC values of 0.95 to 0.97 versus 0.86 to 0.87, respectively) and other specific facial locations. These values are markedly better than the vast majority of results found in prior human studies of IRT-based fever screening.Conclusion: Our findings provide clinical confirmation of the utility of consensus approaches for fever screening, including the use of inner canthi temperatures, while also indicating that full-face maximum temperatures may provide an effective alternate approach.

Comparison of Temperature Acquisition Methods in the ED

In a study of 987 emergency department (ED) patients (mean age 55 years, 65% female) who received a rectal temperature measurement as part of routine care, researchers assessed the accuracy of oral, tympanic membrane, and temporal artery thermometry. Overall, the noninvasive temperature readings were inaccurate; …

Comparison of Infrared Thermal Detection Systems for mass fever screening in a tropical healthcare setting

ObjectivesFever screening systems, such as Infrared Thermal Detection Systems (ITDS), have been used for rapid identification of potential cases during respiratory disease outbreaks for public health management. ITDS detect a difference between the subject and ambient temperature, making deployment in hot climates more challenging. This study, conducted in Singapore, a tropical city, evaluates the accuracy of three different ITDS for fever detection compared with traditional oral thermometry and self-reporting in a clinical setting. Study designThis study is a prospective operational evaluation conducted in the Singapore military on all personnel seeking medical care at a high-volume primary healthcare centre over a one week period in February 2014. MethodsThree ITDS, the STE Infrared Fever Screening System (IFSS), the Omnisense Sentry MKIII and the handheld Quick Shot Infrared Thermoscope HT-F03B, were evaluated. Temperature measurements were taken outside the healthcare centre, under a sheltered walkway and compared to oral temperature. Subjects were asked if they had fever. ResultsThere were 430 subjects screened, of whom 34 participants (7.9%) had confirmed fever, determined by oral thermometer measurement. The handheld infrared thermoscope had a very low sensitivity (29.4%), but a high specificity (96.8%). The STE ITDS had a moderate sensitivity (44.1%), but a very high specificity (99.1%). Self-reported fevers showed good sensitivity (88.2%) and specificity (93.9%). The sensitivity of the Omnisense ITDS (89.7%) was the highest among the three methods with good specificity (92.0%). ConclusionThe new generation Omnisense ITDS displayed a relatively high sensitivity and specificity for fever. Though it has a lower sensitivity, the old generation STE ITDS system showed a very high specificity. Self-reporting of fever was reliable. The handheld thermograph should not be used as a fever-screening tool under tropical conditions.

Conundrum of contagions causing cold in the old: not everybody's got the fever.

Conundrum of contagions causing cold in the old: not everybody's got the fever.

Oral and Tympanic Membrane Temperatures are Inaccurate to Identify Fever in Emergency Department Adults

Introduction Identifying fever can influence management of the emergency department (ED) patient, including diagnostic testing, treatment, and disposition. We set out to determine how well oral and tympanic membrane (TM) temperatures compared with rectal measurements.MethodsA convenience sample of consecutively adult ED patients had oral, TM, and rectal temperatures performed within several minutes of each other. Descriptive statistics, Bland–Altman agreement matrices with 95% confidence interval (CI), and measures of test performance, including sensitivity, specificity, predictive values, and interval likelihood ratios were performed.ResultsA total of 457 patients were enrolled with an average age of 64 years (standard deviation: 19 years). Mean temperatures were: oral (98.3°F), TM (99.6°F), and rectal (99.4°F). The mean difference in rectal and oral temperatures was 1.1°F, although there was considerable lack of agreement between oral and rectal temperatures, with the oral temperature as much as 2.91°F lower or 0.74°F higher than the rectal measurement (95% CI). Although the difference in mean temperature between right TM and rectal temperature was only 0.22°F, the right TM was lower than rectal by up to 1.61°F or greater by up to 2.05°F (95% CI). Test performance varied as the positive predictive value of the oral temperature was 97% and for tympanic temperature was 55% (relative to a rectal temperature of 100.4°F or higher). Comparative findings differed even at temperatures considered in the normal range; among patients with an oral temperature of 98.0 to 98.9, 38% (25/65) were found to have a rectal temperature of 100.4 or higher, while among patients with a TM of 98.0 to 98.9, only 7% (10/134) were found to have a rectal temperature of 100.4 or higher.ConclusionThe oral and tympanic temperature readings are not equivalent to rectal thermometry readings. Oral thermometry frequently underestimates the temperature relative to rectal readings, and TM values can either under- or overestimate the rectal temperature. The clinician needs to be aware of the varying relationship between oral, TM, and rectal temperatures when interpreting readings.

Temperature Measurement in Patients Undergoing Colorectal Surgery and Gynecology Surgery: A Comparison of Esophageal Core, Temporal Artery, and Oral Methods

Maintaining perioperative normothermia reduces postoperative complications. An accurate, noninvasive method to take temperatures representative of core temperature is needed. Oral thermometry is accepted as the most accurate means of non-core temperature assessment, but poses challenges in patients who are intubated or wearing oxygen masks. The purpose of this study was to determine the difference, if any, between core temperature as measured by an esophageal thermometer and temperatures measured by oral and temporal artery methods in patients undergoing colorectal or gynecology surgery. A repeated-measures design was used with a convenience sample of 23 patients undergoing colorectal or gynecology surgery. Two series of intraoperative temperatures were taken (oral and temporal artery thermometry) and compared with core temperature measured by esophageal probe. Repeated-measures analysis of variance tested for biases of oral or temporal temperatures versus core temperatures. Bland-Altman plots were drawn to test dependence of bias on actual core temperature. A priori, a temperature difference >0.4 degrees C was defined as clinically significant. Oral temperature was biased high relative to esophageal temperature by 0.12 degrees C on average (P = .0008; 95% confidence interval [0.061, 0.187]). Temporal artery temperature was biased high relative to esophageal, by 0.074 degrees C on average (P = .03; 95% confidence interval [0.010, 0.133]). Differences between core (esophageal) thermometry and oral or temporal artery thermometry were statistically significant but much smaller than the 0.4 degrees C identified as clinically acceptable. Oral and temporal artery temperatures are within the 0.4 degrees C of core (esophageal) temperatures, a difference that is considered clinically acceptable. Temperatures taken orally or by temporal artery thermometry are acceptable as noninvasive core measures for adult patients undergoing colorectal or gynecology surgery.

Noninvasive Temperature Monitoring in Postanesthesia Care Units

Initial postoperative core temperature is a physician and hospital performance measure. However, the extent to which core temperature changes during emergence from anesthesia and transport from the operating room to the postanesthesia care unit (PACU) remains unknown. Similarly, the accuracy of many noninvasive temperature-monitoring methods used in the PACU has yet to be quantified. This study, therefore, quantified the change in core temperature occurring during emergence and transport and evaluated the accuracy and precision of eight noninvasive thermometers in the PACU. In 50 patients having laparoscopic surgery, the authors measured temperatures upon PACU arrival and 30 and 60 min thereafter. Monitoring methods included oral, axillary, temporal artery, forehead skin-surface, forehead liquid-crystal display, infrared aural canal, deep forehead, and deep chest. Bladder temperature was used as the reference and was also measured at the end of surgery. The primary outcome was agreement between individual temperatures from each method and bladder temperature in the PACU. A priori, the authors chose 0.5 degrees C as a clinically important temperature deviation. Bladder temperature increased 0.2 +/- 0.3 degrees C (95% confidence interval 0.1 to 0.3 degrees C), P < 0.001, during transport. None of the tested noninvasive thermometers was consistently within 0.5 degrees C of bladder temperature. However, oral, deep forehead, and temporal artery temperatures were significantly better than other methods and agreed reasonably well with bladder temperature. Invasive temperature monitoring available intraoperatively is more accurate than any generally available postoperative methods. Physician performance measures should therefore not be based exclusively on postoperative temperatures. Among the generally available postoperative monitoring methods, electronic oral thermometry appears to be the best.

Temporal Artery Scanning Falls Short as a Secondary, Noninvasive Thermometry Method for Trauma Patients

Oral and mandibular trauma pose barriers to oral thermometry. We sought to determine whether temporal artery (TA) scanning thermometry could be an accurate, noninvasive back up method of thermometry in patients with these types of traumatic injury. We compared 3 techniques of TA scanning, axillary thermometry, and oral thermometry in critical care patients. Our results indicate that TA scanning methods were, at best, comparable with axillary measurements. In addition, the performance of the TA scanners varied with body mass index, whereas axillary readings did not.

The Influence of Mucositis on Oral Thermometry: When Fever May Not Reflect Infection

The mouth is the most common site for measuring temperature. Oral mucositis may affect up to 40% of patients who receive chemotherapy. Thus far, mucositis has not been studied with regard to accurate thermometry. One hundred consecutive patients (25 per group) were self-referred on the basis of perception of mucositis, temperature measurement at home, or malaise or were referred by a nurse on the basis of an assessment of a potential infectious process and/or mucositis. Oral and tympanic temperature were assessed simultaneously in patients with no fever and no mucositis (group A), those with mucositis (group B), those with fever and no mucositis (group C), and those with neutropenia but not fever or mucositis (group D). The 4 groups of patients had higher oral temperatures than tympanic temperatures (group A, 36.9 degrees C vs. 36.8 degrees C [delta = 0.12 degrees C; P = .062]; group B, 38.0 degrees C vs. 37.1 degrees C [delta = 0.89 degrees C; P < .001]; group C, 38.7 degrees C vs. 38.4 degrees C [delta = 0.27 degrees C; P < .001]; and group D, 37.0 degrees C vs. 36.7 degrees C [delta = 0.27 degrees C; P < .001]). Scheffe a-posteriori test revealed that only the delta temperature in group B differed significantly (95% confidence limits, -2.471, -1.584; P < .001). A linear regression model that examined the effect of other variables on the delta temperature found that only mucositis was a significant factor (95% confidence limits, 0.582, 0.820; P < .001). Mucositis causes an increase in oral temperature but does not elevate systemic body temperature, thereby casting doubt on the diagnosis of infection. Conceivably, mucositis may provide an "inflammation bias" that could lead to the overuse of antibiotics and growth factors in 20%-40% of patients with cancer. When one considers issues of antimicrobial resistance and cost, this concern should be tested and clarified in a prospective study based on accurate temperature measurement.

316: Infrared Thermography of Facial Skin Temperatures Compared with Oral Thermometry: A Device for Syndromic Surveillance by Remote Detection

Syndromic surveillance with fever detection is a useful tool for detecting outbreaks such as severe acute respiratory syndrome (SARS), avian flu, influenza, and detecting weaponized bioterrorism agents. With the high prevalence of world travel and threat of terrorism, rapid screening for pyrexia in highly populated places such as airports may be an important tool to protect the public health. Fever detection is usually done with oral, aural or rectal thermometers. Infrared (IR) cameras are noninvasive, quick, detect temperatures remotely, and may offer an alternative.

Accuracy of Noninvasive Core Temperature Measurement in Acutely Ill Adults: The State of the Science

Accurate temperature measurement is critical to the assessment and management of temperature fluctuation in the acutely ill adult. Unfortunately, an accurate, noninvasive method to measure core temperature has yet to be established, and current instruments produce a wide range of temperatures for any given patient. This article provides an integrative review of studies comparing selected invasive and noninvasive temperature measurement methods in acutely ill, hospitalized adult patients. Medline and CINAHL databases were searched to locate published studies on temperature measurement in the adult hospitalized patient. A partial list of primary search terms included core temperature measurement, oral temperature measurement, temporal artery thermometry, and tympanic thermometers. Studies that were data based and included comparison of a tympanic, temporal artery, and/or oral noninvasive temperature measurement to a pulmonary artery or esophageal invasive core measurement in an adult population were included in the analysis. The search method produced 223 publications and abstracts for initial review; 23 (10%) met the inclusion criteria. The only study evaluating the use of temporal artery thermometry in the adult population found the instrument to be unreliable. Results also indicate that high-quality evidence supporting the accuracy of tympanic thermometry, the preferred instrument for noninvasive core temperature measurement in many acute care settings, is lacking, and in fact, the most recent high-quality studies evaluating the accuracy of this instrument fail to show support for its use. Evidence does, however, support the use of oral thermometry as an accurate means of temperature assessment in the adult, acutely ill population.

Temporal thermometer use for monitoring bone marrow transplantation patients: Comparison with oral thermometer

Monitoring Bone Marrow Transplant (BMT) patients for fever is essential assessment data for early recognition of infection. The current method of monitoring is oral thermometry (OT). However, a significant number of BMT patients experience oral mucositis, making fever monitoring uncomfortable. Mucositis pain may prevent patients from being able to correctly place the thermometer, affecting the accuracy of the readings. The temporal thermometer (TT) is an alternative method of assessment. The purpose of this project is to explore the differences between TT and OT monitoring in BMT patients and to assess patient comfort associated with each method.

Temporal Scanner Thermometry: A New Method of Core Temperature Estimation in ICU Patients

Temperature measurement is a routine task of patient care, with considerable clinical impact, especially in the ICU. This study was conducted to evaluate the accuracy and variability of the Temporal Artery Thermometer (TAT) in ICU-patients. Therefore, a convenience sample of 57 adult patients, with indwelling pulmonary artery catheters (PAC) in a 40-bed intensive care unit in a university teaching hospital was used. The study design was a prospective, descriptive comparative analysis. Body temperature was thereby measured simultaneously with the TAT and the Axillary Thermometer (AT), and was compared with the temperature recording of the PAC. The use of vasoactive medication was recorded. Mean temperature of all measurements was: PAC: 37.1 degrees C (SD: 0.87), TAT 37.0 degrees C (SD: 0.68) and axillary thermometer: 36.6 degrees C (SD: 0.94). The measurements of the TAT and the PAC were not significantly different (man differnce: 0.14 degrees C; SD: 0.51; p = 0.33); whereas the measurements of the PAC and the AT differed significantly (mean difference: 0.46 degerees C; SD: 0.39; p < 0.001). Mean diference in PAC versus TAT analyses, between patients with vasopressor therapy (0.12 degrees C; SD: 0.55), and without vasopressor therapy (0.19 degrees C; SD: 0.48) was not statistically significant (p = 0.47). We can conclude that the temporal scanner has a relatively good reliability with an acceptable accuracy and variability in patients with normothermia. The results are comparable to those of the AT, but they do not seem to be sufficient to prove any substantial benefit compared to rectal, oral or bladder thermometry.

Feasibility and utility of infrared thermography as a thermometer: Comparison with oral and tympanic thermometry

Study objectives: We determine the relationship between infrared thermography (IRT) acquired body surface temperature (BST) values and temperature values obtained by conventional measures (oral and tympanic). Methods: IRT images using a ThermaCAM P60 (FLIR Systems, North Billerica, MA) were obtained for 20 consecutive adult emergency department (ED) patients, regardless of complaint, in a tertiary care center. Patients also had their oral and tympanic temperature measured within 1 minute of IRT imaging. The camera has a spatial resolution of 320×240 pixels in focal plane array, scan integration rate of 60 Hz, and thermal sensitivity of 0.08°C per pixel. Focal distance was 1 m, with a sed in JPEG format. The mean BST using IRT over an area 4 cm 2 was collected and recorded for each patient in 3 distinct anatomic areas using specialized software. Body areas imaged with IRT were the glabella, the abdomen centered at the umbilicus, and the dorsum of a hand. The skin of the abdomen was exposed and allowed to equilibrate with the environment for 2 minutes before IRT, and the imaged hand was contralateral to any intravenous line. The temperature difference (ΔT) for tympanic thermometry and IRT was calculated against oral temperatures (where ΔT=oral temperature – mean BST by IRT for each body region per patient), and the mean ΔT±SD are reported. The coefficient of determination ( R 2 ) was also calculated for each IRT region data set. The institutional review board approved the study, and informed consent was obtained on all patients. All temperatures were recorded in °C. Results: For ΔT-tympanic, the mean was –0.2±0.5°C (SD), the ΔT-glabella mean was 2.2±0.7°C, the ΔT-abdomen mean was 3.3±1.6°C, and for ΔT-hand the mean was 4.4±1.7°C. R 2 values were tympanic 0.629, glabella 0.405, abdomen 0.163, and hand 0.035. Conclusion: With the exception of IRT images of the glabellar region, IRT regional mean BST values appear to correlate poorly with oral thermometry. Some of the variance may be due to technique and environmental temperature interference. Because IRT is fast and easy to obtain, is not associated with radiation, and may convey other important information, additional study to refine IRT technique is warranted.