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Annette Pluddemann - One of the best experts on this subject based on the ideXlab platform.
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non contact infrared Thermometers for measuring temperature in children primary care diagnostic technology update
British Journal of General Practice, 2014Co-Authors: Kay Wang, Peter J Gill, Jane Wolstenholme, Christopher P Price, Matthew Thompson, Carl Heneghan, Annette PluddemannAbstract:Temperature is an important vital sign for assessing acutely unwell children, and is measured frequently in primary care. However, measuring temperature accurately can be challenging. Oral and rectal Thermometers are invasive and poorly tolerated, while axillary Thermometers require parents or healthcare professionals to undress the child and hold the Thermometer in the axilla for 30 seconds or longer. Infrared tympanic Thermometers are easier to use, but can be inaccurate due to ear wax or insufficient straightening of the ear canal. Non-contact infrared Thermometers (NCITs) are designed to measure temperature rapidly and non-invasively with negligible cross-infection risk. This update compares the accuracy and utility of NCITs with conventional Thermometers in children. #### Clinical Question What is the accuracy and utility of non-contact infrared Thermometers compared to conventional Thermometers in children? Table 1 summarises characteristics of a range of NCITs. Based on a search conducted in December 2013, over 20 models are available for use in community and/or healthcare settings. The Thermofocus and Syner-Med VeraTemp Thermometers are FDA approved and CE marked. This report found six studies comparing three NCIT devices (Standard ST 88121, Thermofocus 08002,3 and Thermofocus 015004–6) to conventional Thermometers in children. View this table: Table 1. Characteristics of non-contact infrared Thermometers NCITs may be used to measure temperature in children presenting with acute illness in primary …
Kay Wang - One of the best experts on this subject based on the ideXlab platform.
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Non-contact infrared Thermometers compared with current approaches in primary care for children aged 5 years and under: a method comparison study.
Health technology assessment (Winchester England), 2020Co-Authors: Ann Van Den Bruel, Kay Wang, Jan Y Verbakel, Susannah Fleming, Gea A. Holtman, Margaret Glogowska, Elizabeth Morris, George Edwards, Fatene Abakar Ismail, Kathryn CurtisAbstract:BACKGROUND: Current options for temperature measurement in children presenting to primary care include either electronic axillary or infrared tympanic Thermometers. Non-contact infrared Thermometers could reduce both the distress of the child and the risk of cross-infection. OBJECTIVES: The objective of this study was to compare the use of non-contact Thermometers with the use of electronic axillary and infrared tympanic Thermometers in children presenting to primary care. DESIGN: Method comparison study with a nested qualitative study. SETTING: Primary care in Oxfordshire. PARTICIPANTS: Children aged ≤ 5 years attending with an acute illness. INTERVENTIONS: Two types of non-contact infrared Thermometers [i.e. Thermofocus (Tecnimed, Varese, Italy) and Firhealth (Firhealth, Shenzhen, China)] were compared with an electronic axillary Thermometer and an infrared tympanic Thermometer. MAIN OUTCOME MEASURES: The primary outcome was agreement between the Thermofocus non-contact infrared Thermometer and the axillary Thermometer. Secondary outcomes included agreement between all other sets of Thermometers, diagnostic accuracy for detecting fever, parental and child ratings of acceptability and discomfort, and themes arising from our qualitative interviews with parents. RESULTS: A total of 401 children (203 boys) were recruited, with a median age of 1.6 years (interquartile range 0.79-3.38 years). The readings of the Thermofocus non-contact infrared Thermometer differed from those of the axillary Thermometer by -0.14 °C (95% confidence interval -0.21 to -0.06 °C) on average with the lower limit of agreement being -1.57 °C (95% confidence interval -1.69 to -1.44 °C) and the upper limit being 1.29 °C (95% confidence interval 1.16 to 1.42 °C). The readings of the Firhealth non-contact infrared Thermometer differed from those of the axillary Thermometer by -0.16 °C (95% confidence interval -0.23 to -0.09 °C) on average, with the lower limit of agreement being -1.54 °C (95% confidence interval -1.66 to -1.41 °C) and the upper limit being 1.22 °C (95% confidence interval 1.10 to 1.34 °C). The difference between the first and second readings of the Thermofocus was -0.04 °C (95% confidence interval -0.07 to -0.01 °C); the lower limit was -0.56 °C (95% confidence interval -0.60 to -0.51 °C) and the upper limit was 0.47 °C (95% confidence interval 0.43 to 0.52 °C). The difference between the first and second readings of the Firhealth Thermometer was 0.01 °C (95% confidence interval -0.02 to 0.04 °C); the lower limit was -0.60 °C (95% confidence interval -0.65 to -0.54 °C) and the upper limit was 0.61 °C (95% confidence interval 0.56 to 0.67 °C). Sensitivity and specificity for the Thermofocus non-contact infrared Thermometer were 66.7% (95% confidence interval 38.4% to 88.2%) and 98.0% (95% confidence interval 96.0% to 99.2%), respectively. For the Firhealth non-contact infrared Thermometer, sensitivity was 12.5% (95% confidence interval 1.6% to 38.3%) and specificity was 99.4% (95% confidence interval 98.0% to 99.9%). The majority of parents found all methods to be acceptable, although discomfort ratings were highest for the axillary Thermometer. The non-contact Thermometers required fewer readings than the comparator Thermometers. LIMITATIONS: A method comparison study does not compare new methods against a reference standard, which in this case would be central thermometry requiring the placement of a central line, which is not feasible or acceptable in primary care. Electronic axillary and infrared tympanic Thermometers have been found to have moderate agreement themselves with central temperature measurements. CONCLUSIONS: The 95% limits of agreement are > 1 °C for both non-contact infrared Thermometers compared with electronic axillary and infrared tympanic Thermometers, which could affect clinical decision-making. Sensitivity for fever was low to moderate for both non-contact Thermometers. FUTURE WORK: Better methods for peripheral temperature measurement that agree well with central thermometry are needed. TRIAL REGISTRATION: Current Controlled Trials ISRCTN15413321. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 53. See the NIHR Journals Library website for further project information.
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non contact infrared Thermometers for measuring temperature in children primary care diagnostic technology update
British Journal of General Practice, 2014Co-Authors: Kay Wang, Peter J Gill, Jane Wolstenholme, Christopher P Price, Matthew Thompson, Carl Heneghan, Annette PluddemannAbstract:Temperature is an important vital sign for assessing acutely unwell children, and is measured frequently in primary care. However, measuring temperature accurately can be challenging. Oral and rectal Thermometers are invasive and poorly tolerated, while axillary Thermometers require parents or healthcare professionals to undress the child and hold the Thermometer in the axilla for 30 seconds or longer. Infrared tympanic Thermometers are easier to use, but can be inaccurate due to ear wax or insufficient straightening of the ear canal. Non-contact infrared Thermometers (NCITs) are designed to measure temperature rapidly and non-invasively with negligible cross-infection risk. This update compares the accuracy and utility of NCITs with conventional Thermometers in children. #### Clinical Question What is the accuracy and utility of non-contact infrared Thermometers compared to conventional Thermometers in children? Table 1 summarises characteristics of a range of NCITs. Based on a search conducted in December 2013, over 20 models are available for use in community and/or healthcare settings. The Thermofocus and Syner-Med VeraTemp Thermometers are FDA approved and CE marked. This report found six studies comparing three NCIT devices (Standard ST 88121, Thermofocus 08002,3 and Thermofocus 015004–6) to conventional Thermometers in children. View this table: Table 1. Characteristics of non-contact infrared Thermometers NCITs may be used to measure temperature in children presenting with acute illness in primary …
Paul Symonds - One of the best experts on this subject based on the ideXlab platform.
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can the distress Thermometer be improved by additional mood domains part ii what is the optimal combination of emotion Thermometers
Psycho-oncology, 2010Co-Authors: Elena A Bakerglenn, Bert Park, Lorraine Granger, Alex J. Mitchell, Paul SymondsAbstract:Purpose: To examine the added value of an algorithmic combination of visual-analogue Thermometers compared with the Distress Thermometer (DT) when attempting to detect depression, anxiety or distress in early cancer. Methods: We report Classification and Regression Tree and logistic regression analyses of the new five-domain Emotion Thermometers tool. This is a combination of five visual-analogue scales in the form of four mood domains (distress, anxiety, depression, anger) as well as need for help. 130 patients attending for their first chemotherapy treatment were assessed. We calculated optimal accuracy for each domain alone and in combination against several criterion standards. Results: When attempting to diagnose depression the Depression Thermometer (DepT) used alone was the optimal approach, but when attempting to detect broadly defined distress or anxiety then a combination of Thermometers was most accurate. The DepT was significantly more accurate in detecting depression than the DT. For broadly defined distress a combination of depression, anger and help Thermometers was more accurate than the DT alone. For anxiety, while the anxiety Thermometer (AnxT) improves upon the DT alone, a combination of the DepT and AnxT are optimal. In each case the optimal strategy allowed the detection of at least an additional 9% of individuals. However, combinations are more laborious to score. In settings where the simplest possible option is preferred the most accurate single Thermometer might be preferable as a first stage assessment. Conclusion: The DT can be improved by specific combinations of simple Thermometers that incorporate depression, anxiety, anger and help. Copyright © 2009 John Wiley & Sons, Ltd.
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can the distress Thermometer be improved by additional mood domains part i initial validation of the emotion Thermometers tool
Psycho-oncology, 2010Co-Authors: Alex J. Mitchell, Elena A Bakerglenn, Lorraine Granger, Paul SymondsAbstract:Purpose: To examine the value of a new screening instrument in a visual-analogue format. Methods: We report the design and validation of a new five-dimensional tool called the Emotion Thermometers (ET). This is a combination of five visual-analogue scales in the form of four predictor domains (distress, anxiety, depression, anger) and one outcome domain (need for help). Between March and August 2007, 130 patients attending the chemotherapy suite for their first chemotherapy treatment were asked to complete several questionnaires with validation for distress, anxiety and depression. Results: Of 81 with low distress on the Distress Thermometer (DT), 51% recorded emotional difficulties on the new ET tool, suggesting added value beyond the DT alone. Of those with a broadly defined emotional complication, 93.3% could be identified using the Anxiety Thermometer (AnxT) alone, compared with 54.4% who would be recognized using the DT alone. Using a cut-off of 3v4 on all Thermometers against the total Hospital Anxiety and Depression Scale (HADS) score (cut-off 14v15), the optimal Thermometer was the Anger Thermometer (sensitivity 61%, specificity 92%). Against HADS anxiety scale, the optimal Thermometer was AnxT (sensitivity 92%, specificity 61%) and against the HADS depression scale, the optimal Thermometer was the Depression Thermometer (DepT; sensitivity 60%, specificity 78%). Finally, against DSM-IV major depression, the optimal Thermometer was the DepT (sensitivity 80%, specificity 79%). Further improvements may be possible by using a combination of Thermometers or by repeating the screen. Conclusion: The diagnostic accuracy of the DT can be improved by the inclusion of simple addition linear domains without substantially increasing the time needed to apply the test. Copyright © 2009 John Wiley & Sons, Ltd.
Alex J. Mitchell - One of the best experts on this subject based on the ideXlab platform.
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can the distress Thermometer be improved by additional mood domains part ii what is the optimal combination of emotion Thermometers
Psycho-oncology, 2010Co-Authors: Elena A Bakerglenn, Bert Park, Lorraine Granger, Alex J. Mitchell, Paul SymondsAbstract:Purpose: To examine the added value of an algorithmic combination of visual-analogue Thermometers compared with the Distress Thermometer (DT) when attempting to detect depression, anxiety or distress in early cancer. Methods: We report Classification and Regression Tree and logistic regression analyses of the new five-domain Emotion Thermometers tool. This is a combination of five visual-analogue scales in the form of four mood domains (distress, anxiety, depression, anger) as well as need for help. 130 patients attending for their first chemotherapy treatment were assessed. We calculated optimal accuracy for each domain alone and in combination against several criterion standards. Results: When attempting to diagnose depression the Depression Thermometer (DepT) used alone was the optimal approach, but when attempting to detect broadly defined distress or anxiety then a combination of Thermometers was most accurate. The DepT was significantly more accurate in detecting depression than the DT. For broadly defined distress a combination of depression, anger and help Thermometers was more accurate than the DT alone. For anxiety, while the anxiety Thermometer (AnxT) improves upon the DT alone, a combination of the DepT and AnxT are optimal. In each case the optimal strategy allowed the detection of at least an additional 9% of individuals. However, combinations are more laborious to score. In settings where the simplest possible option is preferred the most accurate single Thermometer might be preferable as a first stage assessment. Conclusion: The DT can be improved by specific combinations of simple Thermometers that incorporate depression, anxiety, anger and help. Copyright © 2009 John Wiley & Sons, Ltd.
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can the distress Thermometer be improved by additional mood domains part i initial validation of the emotion Thermometers tool
Psycho-oncology, 2010Co-Authors: Alex J. Mitchell, Elena A Bakerglenn, Lorraine Granger, Paul SymondsAbstract:Purpose: To examine the value of a new screening instrument in a visual-analogue format. Methods: We report the design and validation of a new five-dimensional tool called the Emotion Thermometers (ET). This is a combination of five visual-analogue scales in the form of four predictor domains (distress, anxiety, depression, anger) and one outcome domain (need for help). Between March and August 2007, 130 patients attending the chemotherapy suite for their first chemotherapy treatment were asked to complete several questionnaires with validation for distress, anxiety and depression. Results: Of 81 with low distress on the Distress Thermometer (DT), 51% recorded emotional difficulties on the new ET tool, suggesting added value beyond the DT alone. Of those with a broadly defined emotional complication, 93.3% could be identified using the Anxiety Thermometer (AnxT) alone, compared with 54.4% who would be recognized using the DT alone. Using a cut-off of 3v4 on all Thermometers against the total Hospital Anxiety and Depression Scale (HADS) score (cut-off 14v15), the optimal Thermometer was the Anger Thermometer (sensitivity 61%, specificity 92%). Against HADS anxiety scale, the optimal Thermometer was AnxT (sensitivity 92%, specificity 61%) and against the HADS depression scale, the optimal Thermometer was the Depression Thermometer (DepT; sensitivity 60%, specificity 78%). Finally, against DSM-IV major depression, the optimal Thermometer was the DepT (sensitivity 80%, specificity 79%). Further improvements may be possible by using a combination of Thermometers or by repeating the screen. Conclusion: The diagnostic accuracy of the DT can be improved by the inclusion of simple addition linear domains without substantially increasing the time needed to apply the test. Copyright © 2009 John Wiley & Sons, Ltd.
Matthew Thompson - One of the best experts on this subject based on the ideXlab platform.
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assessing the appropriateness of information on childhood fever in Thermometer package leaflets a systematic audit of Thermometers available in the uk
British Journal of General Practice, 2015Co-Authors: José Hernández, Brian D Nicholson, Matthew ThompsonAbstract:Background Thermometers are found in most parents’ homes, but little is known about the quality and accuracy of the information they provide, nor its consistency with current guidelines for managing fever. Aim To compare information included with commonly available Thermometers with National Institute for Health and Care Excellence (NICE) guidance for management of feverish illness in children. Design and setting Systematic Thermometer sampling from UK retailers between February 2013 and May 2013. Method Information was extracted from device packaging and leaflets on details and type of Thermometer, instructions for use, normal ranges, and fever thresholds cited. This was compared with key parental recommendations from the 2013 NICE guidance on feverish illness in children. Associations were explored between cost of device and level of information. Results There were 123 Thermometers identified (ranging from £0.99 to £69.99), none of which made explicit reference to NICE guidance. Most ( n = 81, 65.9%) recommended use at a body site consistent with NICE guidance, but only 17 (13.8%) defined fever using the correct threshold (≥38.0°C), and few ( n = 12, 9.8%) included advice on fever management, of which four suggested actions not advised by NICE. There was no association between Thermometer cost and provision of information consistent with NICE guidance. Conclusion Parents and caregivers have access to a large number of Thermometers, yet they lack evidence-based information about fever detection and management, and in some cases contain misleading information. This represents a missed opportunity to disseminate best practices from guidelines for management of fever in children, and Thermometer manufacturers are urged to include information consistent with current guidance.
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non contact infrared Thermometers for measuring temperature in children primary care diagnostic technology update
British Journal of General Practice, 2014Co-Authors: Kay Wang, Peter J Gill, Jane Wolstenholme, Christopher P Price, Matthew Thompson, Carl Heneghan, Annette PluddemannAbstract:Temperature is an important vital sign for assessing acutely unwell children, and is measured frequently in primary care. However, measuring temperature accurately can be challenging. Oral and rectal Thermometers are invasive and poorly tolerated, while axillary Thermometers require parents or healthcare professionals to undress the child and hold the Thermometer in the axilla for 30 seconds or longer. Infrared tympanic Thermometers are easier to use, but can be inaccurate due to ear wax or insufficient straightening of the ear canal. Non-contact infrared Thermometers (NCITs) are designed to measure temperature rapidly and non-invasively with negligible cross-infection risk. This update compares the accuracy and utility of NCITs with conventional Thermometers in children. #### Clinical Question What is the accuracy and utility of non-contact infrared Thermometers compared to conventional Thermometers in children? Table 1 summarises characteristics of a range of NCITs. Based on a search conducted in December 2013, over 20 models are available for use in community and/or healthcare settings. The Thermofocus and Syner-Med VeraTemp Thermometers are FDA approved and CE marked. This report found six studies comparing three NCIT devices (Standard ST 88121, Thermofocus 08002,3 and Thermofocus 015004–6) to conventional Thermometers in children. View this table: Table 1. Characteristics of non-contact infrared Thermometers NCITs may be used to measure temperature in children presenting with acute illness in primary …
