2.50
Hdl Handle:
http://hdl.handle.net/10755/166098
Category:
Abstract
Type:
Presentation
Title:
Accuracy And Reliability Of Tympanic Membrane Thermometry
Author(s):
Holtzclaw, Barbara
Author Details:
Barbara Holtzclaw, PhD, Director, Office of Nursing Research, University of Texas Health Science Center at San Antonio, School of Nursing, San Antonio, Texas, USA, email: HOLTZCLAW@uthscsa.edu
Abstract:
Introduction: Radiation thermometry, used extensively in industry for imaging and inspection purposes, was only recently introduced to clinical settings. Heat radiated from the tympanic membrane (TM) as infrared energy is measured by an electronic sensor in the device. For research, this offer the advantages of speed in measurement without direct contact. A hand-held otoscope shaped ink light reflectance thermometer (FirstTemp, Intelligent Medical Systems, Inc. Carlsbad, CA) was the first such instrument to be used clinically. Today there are at least a dozen versions, marketed by competing manufacturers, claiming to offer greater speed, accuracy, and precision than the prototype. Several studies have compared TM temperatures to other standard reference sites, such as pulmonary artery temperature, to test their accuracy and "validity" as true reflections of "core temperature." Unfortunately, clinical temperature measurement studies must deal with two moderating variables that make interpretation difficult: measurement technique and subject variation. The instrument itself needs careful evaluation in-vitro to determine the instrument's limitations. Commercial evaluation has been limited to a relatively narrow range of accuracy and linearity. Then, inter-rater reliability must be determined along with the effects of instruction and placement technique. The purposes of this study were l) to compare 7 infra-red thermometers on the following factors: accuracy, or the confidence that a particular measurement reflects the "true" existing temperature; reliability, or stability of the instrument in repeated measurements over time; linearity, or the ability of the measurement to accurately represent temperature over the entire extent of its specified range; precision, or the device's ability to detect small changes in temperature, and yield the same results with repeated measurement; and time needed for the thermometer to achieve a thermal reading; and 2) to determine inter-rater reliability, using the choice instrument, with and without instructional/procedural elements. Methods: A stirred water-bath, with temperature verified by a certified scientific glass thermometer national Bureau of Standards) created temperature changes ranging from 28( to 42(C. Temperatures were measured from a floating black cone-shaped chamber in the water bath, using each thermometer, 3 times at each 0.5 degree increment. Replicate measurements were compared for similarity to the fixed temperature and to each of the triplicate readings. Precision was determined by closeness of the readings to the reference temperature. Linearity was plotted for each thermometer, at each temperature interval. Time to equilibrate and register were noted for each device. Ten investigators were tested for inter-rater consistency using the Genius thermometer on 5 subjects, before and after instruction. Results: There was variation among the thermometers in reliability with triplicate readings. While most thermometers tracked the reference temperature well in the middle ranges, upper and lower ranges were not accurate. Use of the "offset" temperatures in some TM thermometers to estimate rectal, oral, or other temperatures, are consistent in-vitro but cannot be used to extrapolate to clinical situations affecting heat distribution. Inter-rater reliability between investigators was poor prior to instruction. Temperatures were higher when ear tug was used. Findings of this study provide useful baseline measures for clinical investigations.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleAccuracy And Reliability Of Tympanic Membrane Thermometryen_GB
dc.contributor.authorHoltzclaw, Barbaraen_US
dc.author.detailsBarbara Holtzclaw, PhD, Director, Office of Nursing Research, University of Texas Health Science Center at San Antonio, School of Nursing, San Antonio, Texas, USA, email: HOLTZCLAW@uthscsa.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166098-
dc.description.abstractIntroduction: Radiation thermometry, used extensively in industry for imaging and inspection purposes, was only recently introduced to clinical settings. Heat radiated from the tympanic membrane (TM) as infrared energy is measured by an electronic sensor in the device. For research, this offer the advantages of speed in measurement without direct contact. A hand-held otoscope shaped ink light reflectance thermometer (FirstTemp, Intelligent Medical Systems, Inc. Carlsbad, CA) was the first such instrument to be used clinically. Today there are at least a dozen versions, marketed by competing manufacturers, claiming to offer greater speed, accuracy, and precision than the prototype. Several studies have compared TM temperatures to other standard reference sites, such as pulmonary artery temperature, to test their accuracy and "validity" as true reflections of "core temperature." Unfortunately, clinical temperature measurement studies must deal with two moderating variables that make interpretation difficult: measurement technique and subject variation. The instrument itself needs careful evaluation in-vitro to determine the instrument's limitations. Commercial evaluation has been limited to a relatively narrow range of accuracy and linearity. Then, inter-rater reliability must be determined along with the effects of instruction and placement technique. The purposes of this study were l) to compare 7 infra-red thermometers on the following factors: accuracy, or the confidence that a particular measurement reflects the "true" existing temperature; reliability, or stability of the instrument in repeated measurements over time; linearity, or the ability of the measurement to accurately represent temperature over the entire extent of its specified range; precision, or the device's ability to detect small changes in temperature, and yield the same results with repeated measurement; and time needed for the thermometer to achieve a thermal reading; and 2) to determine inter-rater reliability, using the choice instrument, with and without instructional/procedural elements. Methods: A stirred water-bath, with temperature verified by a certified scientific glass thermometer national Bureau of Standards) created temperature changes ranging from 28( to 42(C. Temperatures were measured from a floating black cone-shaped chamber in the water bath, using each thermometer, 3 times at each 0.5 degree increment. Replicate measurements were compared for similarity to the fixed temperature and to each of the triplicate readings. Precision was determined by closeness of the readings to the reference temperature. Linearity was plotted for each thermometer, at each temperature interval. Time to equilibrate and register were noted for each device. Ten investigators were tested for inter-rater consistency using the Genius thermometer on 5 subjects, before and after instruction. Results: There was variation among the thermometers in reliability with triplicate readings. While most thermometers tracked the reference temperature well in the middle ranges, upper and lower ranges were not accurate. Use of the "offset" temperatures in some TM thermometers to estimate rectal, oral, or other temperatures, are consistent in-vitro but cannot be used to extrapolate to clinical situations affecting heat distribution. Inter-rater reliability between investigators was poor prior to instruction. Temperatures were higher when ear tug was used. Findings of this study provide useful baseline measures for clinical investigations.en_GB
dc.date.available2011-10-27T14:40:09Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:40:09Z-
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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