human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS AND OBJECTIVES This study compared readings from two professional- grade , commercially available infrared ( IR ) thermometers , the ThermoScan ® PRO 4000 prewarmed tip ear thermometer and the Temporal Scanner ( ™ ) TAT-5000 temporal artery thermometer . BACKGROUND The repeatability and precision of readings from IR thermometers for professional use were question ed in the past , but in recent years , these types of thermometers have been technologically improved , so their ability to replicate st and ard temperature readings reliably should be re-examined . DESIGN Febrile and afebrile children were recruited from the emergency department , overflow treatment areas and the paediatric intensive care unit of a large hospital in Argentina . Each child had a r and omised sequence of seven temperature readings , including three from the ear , three from the forehead or behind the ear and one reference oral or rectal reading . METHODS Temperature readings were taken with the ThermoScan PRO 4000 , the Temporal Scanner TAT-5000 and the monitor mode of SureTemp ® Plus , a widely used professional- grade contact thermometer , for reference . RESULTS Of 205 children , 46 % were febrile , per reference thermometer readings . While mean ThermoScan PRO 4000 febrile measurements did not differ significantly from reference , mean Temporal Scanner TAT-5000 febrile measurements were significantly lower ( by a mean of 0·42 ° C ) than the reference . Overall bias of the ThermoScan PRO 4000 was significantly lower than that of the Temporal Scanner TAT-5000 ; repeatability was 1·5 times higher , and overall false-negative rate was about a third that of Temporal Scanner TAT-5000 , when compared to the reference . CONCLUSIONS This study indicates that the ThermoScan PRO 4000 provides measurements closer to those of a professional- grade contact thermometer when compared to the Temporal Scanner TAT-5000 . RELEVANCE TO CLINICAL PRACTICE The odds of misclassifying a febrile child as non-febrile were about threefold higher with the Temporal Scanner TAT-5000 temporal artery thermometer than with the ThermoScan ® PRO 4000 ear thermometer In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old . Such investigations are often analysed inappropriately , notably by using correlation coefficients . The use of correlation is misleading . An alternative approach , based on graphical techniques and simple calculations , is described , together with the relation between this analysis and the assessment of repeatability BACKGROUND Rectal thermometry is considered the most reliable method for measuring the temperature in the paediatric population . Recently , a new non-contact skin infrared thermometer for children was introduced in the market with excellent acceptance by parents . METHODS A prospect i ve , analytical , cross-sectional study was design ed in order to assess the effectiveness of the infrared non-contact thermometer ( Thermofocus ) in comparison with two other known methods used to measure body temperature . Children aged 1 to 48 months were included from the emergency room and inpatient unit . All patients selected were assessed with three different thermometers : ( 1 ) non-contact infrared thermometer ( Thermofocus ) ; ( 2 ) temporal artery thermometer ( Exergen ) ; and ( 3 ) rectal glass mercury thermometer . RESULTS Four hundred and thirty-four patients were eligible to complete the study . One hundred and sixty-seven were identified with fever . The mean age of the patients studied was 14.6 ± 10.7 months . Both devices were strongly correlated with the rectal temperature : r = 0.950 for Exergen and r = 0.952 for Thermofocus . The mean difference in temperature between the rectal temperature and the non-contact thermometer was 0.029 ± 0.01 ° C ( P < 0.001 ) , while the mean difference between the temporal artery thermometer and the rectal temperature was -0.20 ± 0.27 ° C ( P < 0.001 ) . The sensitivity and specificity for the non-contact thermometer is 97 % . The negative predictive value is 99 % , which is especially important to rule out fever and avoid unnecessary laboratory work-up . CONCLUSIONS The non-contact infrared thermometer is a reliable , comfortable and accurate option for measurement of temperature and is very useful for the screening of fever in the paediatric population . More studies are recommended to support the evidence found in this study and compare its accuracy with more complex devices Children undergoing anaesthesia are prone to hypothermia . Perioperative monitoring of patient temperature is , therefore , st and ard practice . Postoperative temperature is regarded as a key anaesthetic performance indicator in Australian hospitals . Many different methods and sites of temperature measurement are used perioperatively . It is unclear to what degree these methods might be interchangeable . The aim of this study was to determine the relationships between temperatures measured at different sites in anaesthetised children . Two hundred children , 0 to 17 years , undergoing general anaesthesia for elective non-cardiac surgery , were prospect ively recruited .  Temperature measurements  were taken in the operating theatre concurrently at the nasopharynx , tympanic membranes , temporal artery , axilla and skin ( chest ) . Patient age and weight were documented .  Temperatures varied according to site of measurement . The mean difference from nasopharyngeal temperature to temperatures at left and right tympanic , temporal , axillary and cutaneous sites were + 0.24 ° C , + 0.24 ° C , + 0.35 ° C , −0.38 ° C and −1.70 ° C , respectively . Levels of agreement to nasopharyngeal temperature were similar at tympanic , temporal and axillary sites . Tympanic and temporal temperatures were superior to axillary temperatures for detection of mild hypothermia ( < 36 ° C ) . Skin temperature showed a large variation from nasopharyngeal measurements . Our findings indicate that measured temperatures vary between sites . Underst and ing these variations is important for interpreting temperature readings Objective : To determine whether infrared tympanic thermometry ( ITT ) measurements more accurately reflect core body temperatures than axillary , forehead , or rectal measurements during fever cycles in children . Design : Prospect i ve cohort study . Setting : Pediatric and cardiac intensive care units at a tertiary care children ’s hospital . Patients : Critically ill children < 7 yrs of age with indwelling bladder catheters . Interventions : Simultaneous temperatures were recorded during both febrile and nonfebrile periods using ITT , indwelling bladder ( core ) , axillary , forehead , and indwelling rectal measurements in 36 children . Measurements and Main Results : Overall ITT measurements were 0.03 ± 1.43 ° F less than core temperature measurements . In comparison , rectal , forehead , and axillary measurements averaged 0.62 ± 1.44 , 0.56 ± 1.81 , and 1.25 ± 1.73 ° F less than core temperature measurements . ITT measurements had better agreement with core measurements during increasing and decreasing temperature cycles . Receiver operating characteristic analysis performed on increasing and decreasing temperature cycle data revealed that ITT measurements performed well , with an area under the curve of 0.855 ( 95 % confidence interval , 0.797–0.913 ) in comparison with rectal measurement area under the curve of 0.777 ( 95 % confidence interval , 0.701–0.853 ) , forehead measurement area under the curve of 0.710 ( 95 % confidence interval , 0.715–0.888 ) , and axillary measurement area under the curve of 0.664 ( 95 % confidence interval , 0.579–0.750 ) . Conclusions : ITT measurements more accurately reflect core temperatures than any other measurement site during febrile and nonfebrile periods in children . ITT measurements are a reproducible and relatively noninvasive substitute for bladder or rectal measurements in febrile children Introduction Body temperature measurement in children is of clinical relevance . Although rectal measurement is the gold st and ard , less invasive tools have become available . We aim ed to describe the accuracy of tympanic , infrared skin , or temporal artery scan thermometers compared with rectal measurement to reflect core temperature . Methods Rectal ( Filac 3000 ; Covidien , Mechelen , Belgium ) , tympanic ( AccuSystem Genius2 Typmanic Infrared Ear Thermometer , Covidien , Mechelen , Belgium ) , temporal artery scan ( Exergen , Exergen Corp , Watertown , Massachusetts ) , and infrared ( ThermoFlash Contactless Medical Electronic Thermometer , Visiomedlab , Paris , France ) body temperature measurements were r and omly performed and readings were collected once . Temperature readings were described as median and range , and observations were compared with rectal temperature readings ( using Wilcoxon , Bl and -Altman , sensitivity , and specificity tests ) . The child ’s comfort was assessed by the child , parent , and nurse ( using Likert scales ) and ease of use was assessed by nurses ( using visual analog scale ) . Results Based on observations in 294 ( median age = 3.2 years , range = 0.02–17 years ) children , the mean difference was 0.49 ° C ( tympanic scan ; P < 0.0001 ) , 0.34 ° C ( infrared skin scan ; P < 0.0001 ) , and 0 ° C ( temporal artery scan ; P = 0.9288 ) , respectively , when compared with rectal temperature readings . Based on visual inspection of Bl and -Altman plots , all tools overestimated the temperature at lower body temperature and underestimated the temperature at higher body temperature , result ing in a sensitivity of 22 % to 41 % and a specificity of 98 % to 100 % for rectal temperatures above 38 ° C . The Likert scale scores and the visual analog scale scores for rectal measurement were only slightly higher when compared with the other methods . Conclusions All noninvasive techniques underperformed compared with rectal measurement . The temporal artery scan deviations were smallest , but all noninvasive techniques overestimate lower temperatures and underestimate higher temperatures compared with rectal measurement . In our h and s , temporal artery scan measurement seems to be second best , but not yet ideal BACKGROUND Rectal thermometry correlates with core temperature and represents the criterion st and ard of measuring temperatures in young children . However , it has numerous disadvantages , and thus , an alternative method of measuring temperature with similar agreement with the core temperature as rectal thermometry is desired . A new , noninvasive temporal artery ( TA ) thermometer synthesizes the skin surface and ambient temperatures to produce an arterial temperature . OBJECTIVE To examine the agreement between the TA and esophageal core thermometers , and to compare it with that between rectal and esophageal temperatures . METHODS In the present prospect i ve , cross-sectional agreement study , intubated surgical out patients younger than 18 years of age had temperatures measured with esophageal and rectal probes , and rectal electronic and TA thermometers . The agreement between esophageal versus rectal and TA thermometers was analyzed by intraclass correlation coefficients and by differences between esophageal versus TA and rectal temperatures with 95 % CIs . The esophageal-rectal and esophageal-TA slopes were compared by Student 's t test . RESULTS In 80 enrolled children , the intraclass correlation coefficients for the esophageal probe versus rectal probe , rectal electronic thermometer and TA thermometer were 0.91 , 0.95 and 0.88 , respectively . The mean esophageal-rectal difference was 0.00+/-0.18 degrees C and esophageal-TA difference was 0.14+/-0.20 degrees C. Linear regression analysis of the relation between esophageal probe versus rectal probe , rectal thermometer and TA thermometer yielded slopes of 0.93 , 0.94 and 0.89 , respectively . The slopes were neither different from each other ( P=0.70 ) nor from the value of 1 . CONCLUSION The TA and esophageal thermometers agree well , and the esophageal-TA and esophageal-rectal temperature agreements are not significantly different Background and Aims : 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 . Methods : The study design was a prospect i ve , 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 . Results and conclusions : Mean temperature of all measurements was : PAC : 37.1 ° C ( SD : 0.87 ) , TAT : 37.0 ° C ( SD : 0.68 ) and axillary thermometer : 36.6 ° C ( SD : 0.94 ) . The measurements of the TAT and the PAC were not significantly different ( mean difference : 0.14 ° C ; SD : 0.51 ; p= 0.33 ) ; whereas the measurements of the PAC and the AT differed significantly ( mean difference : 0.46 ° C ; SD : 0.39 ; p < 0.001 ) . Mean difference in PAC versus TAT analyses , between patients with vasopressor therapy ( 0.12 ° C ; SD : 0.55 ) , and without vasopressor therapy ( 0.19 ° C ; SD : 0.48 ) was not statistically significant 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS AND OBJECTIVES This study compared readings from two professional- grade , commercially available infrared ( IR ) thermometers , the ThermoScan ® PRO 4000 prewarmed tip ear thermometer and the Temporal Scanner ( ™ ) TAT-5000 temporal artery thermometer . BACKGROUND The repeatability and precision of readings from IR thermometers for professional use were question ed in the past , but in recent years , these types of thermometers have been technologically improved , so their ability to replicate st and ard temperature readings reliably should be re-examined . DESIGN Febrile and afebrile children were recruited from the emergency department , overflow treatment areas and the paediatric intensive care unit of a large hospital in Argentina . Each child had a r and omised sequence of seven temperature readings , including three from the ear , three from the forehead or behind the ear and one reference oral or rectal reading . METHODS Temperature readings were taken with the ThermoScan PRO 4000 , the Temporal Scanner TAT-5000 and the monitor mode of SureTemp ® Plus , a widely used professional- grade contact thermometer , for reference . RESULTS Of 205 children , 46 % were febrile , per reference thermometer readings . While mean ThermoScan PRO 4000 febrile measurements did not differ significantly from reference , mean Temporal Scanner TAT-5000 febrile measurements were significantly lower ( by a mean of 0·42 ° C ) than the reference . Overall bias of the ThermoScan PRO 4000 was significantly lower than that of the Temporal Scanner TAT-5000 ; repeatability was 1·5 times higher , and overall false-negative rate was about a third that of Temporal Scanner TAT-5000 , when compared to the reference . CONCLUSIONS This study indicates that the ThermoScan PRO 4000 provides measurements closer to those of a professional- grade contact thermometer when compared to the Temporal Scanner TAT-5000 . RELEVANCE TO CLINICAL PRACTICE The odds of misclassifying a febrile child as non-febrile were about threefold higher with the Temporal Scanner TAT-5000 temporal artery thermometer than with the ThermoScan ® PRO 4000 ear thermometer In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old . Such investigations are often analysed inappropriately , notably by using correlation coefficients . The use of correlation is misleading . An alternative approach , based on graphical techniques and simple calculations , is described , together with the relation between this analysis and the assessment of repeatability BACKGROUND Rectal thermometry is considered the most reliable method for measuring the temperature in the paediatric population . Recently , a new non-contact skin infrared thermometer for children was introduced in the market with excellent acceptance by parents . METHODS A prospect i ve , analytical , cross-sectional study was design ed in order to assess the effectiveness of the infrared non-contact thermometer ( Thermofocus ) in comparison with two other known methods used to measure body temperature . Children aged 1 to 48 months were included from the emergency room and inpatient unit . All patients selected were assessed with three different thermometers : ( 1 ) non-contact infrared thermometer ( Thermofocus ) ; ( 2 ) temporal artery thermometer ( Exergen ) ; and ( 3 ) rectal glass mercury thermometer . RESULTS Four hundred and thirty-four patients were eligible to complete the study . One hundred and sixty-seven were identified with fever . The mean age of the patients studied was 14.6 ± 10.7 months . Both devices were strongly correlated with the rectal temperature : r = 0.950 for Exergen and r = 0.952 for Thermofocus . The mean difference in temperature between the rectal temperature and the non-contact thermometer was 0.029 ± 0.01 ° C ( P < 0.001 ) , while the mean difference between the temporal artery thermometer and the rectal temperature was -0.20 ± 0.27 ° C ( P < 0.001 ) . The sensitivity and specificity for the non-contact thermometer is 97 % . The negative predictive value is 99 % , which is especially important to rule out fever and avoid unnecessary laboratory work-up . CONCLUSIONS The non-contact infrared thermometer is a reliable , comfortable and accurate option for measurement of temperature and is very useful for the screening of fever in the paediatric population . More studies are recommended to support the evidence found in this study and compare its accuracy with more complex devices Children undergoing anaesthesia are prone to hypothermia . Perioperative monitoring of patient temperature is , therefore , st and ard practice . Postoperative temperature is regarded as a key anaesthetic performance indicator in Australian hospitals . Many different methods and sites of temperature measurement are used perioperatively . It is unclear to what degree these methods might be interchangeable . The aim of this study was to determine the relationships between temperatures measured at different sites in anaesthetised children . Two hundred children , 0 to 17 years , undergoing general anaesthesia for elective non-cardiac surgery , were prospect ively recruited .  Temperature measurements  were taken in the operating theatre concurrently at the nasopharynx , tympanic membranes , temporal artery , axilla and skin ( chest ) . Patient age and weight were documented .  Temperatures varied according to site of measurement . The mean difference from nasopharyngeal temperature to temperatures at left and right tympanic , temporal , axillary and cutaneous sites were + 0.24 ° C , + 0.24 ° C , + 0.35 ° C , −0.38 ° C and −1.70 ° C , respectively . Levels of agreement to nasopharyngeal temperature were similar at tympanic , temporal and axillary sites . Tympanic and temporal temperatures were superior to axillary temperatures for detection of mild hypothermia ( < 36 ° C ) . Skin temperature showed a large variation from nasopharyngeal measurements . Our findings indicate that measured temperatures vary between sites . Underst and ing these variations is important for interpreting temperature readings Objective : To determine whether infrared tympanic thermometry ( ITT ) measurements more accurately reflect core body temperatures than axillary , forehead , or rectal measurements during fever cycles in children . Design : Prospect i ve cohort study . Setting : Pediatric and cardiac intensive care units at a tertiary care children ’s hospital . Patients : Critically ill children < 7 yrs of age with indwelling bladder catheters . Interventions : Simultaneous temperatures were recorded during both febrile and nonfebrile periods using ITT , indwelling bladder ( core ) , axillary , forehead , and indwelling rectal measurements in 36 children . Measurements and Main Results : Overall ITT measurements were 0.03 ± 1.43 ° F less than core temperature measurements . In comparison , rectal , forehead , and axillary measurements averaged 0.62 ± 1.44 , 0.56 ± 1.81 , and 1.25 ± 1.73 ° F less than core temperature measurements . ITT measurements had better agreement with core measurements during increasing and decreasing temperature cycles . Receiver operating characteristic analysis performed on increasing and decreasing temperature cycle data revealed that ITT measurements performed well , with an area under the curve of 0.855 ( 95 % confidence interval , 0.797–0.913 ) in comparison with rectal measurement area under the curve of 0.777 ( 95 % confidence interval , 0.701–0.853 ) , forehead measurement area under the curve of 0.710 ( 95 % confidence interval , 0.715–0.888 ) , and axillary measurement area under the curve of 0.664 ( 95 % confidence interval , 0.579–0.750 ) . Conclusions : ITT measurements more accurately reflect core temperatures than any other measurement site during febrile and nonfebrile periods in children . ITT measurements are a reproducible and relatively noninvasive substitute for bladder or rectal measurements in febrile children Introduction Body temperature measurement in children is of clinical relevance . Although rectal measurement is the gold st and ard , less invasive tools have become available . We aim ed to describe the accuracy of tympanic , infrared skin , or temporal artery scan thermometers compared with rectal measurement to reflect core temperature . Methods Rectal ( Filac 3000 ; Covidien , Mechelen , Belgium ) , tympanic ( AccuSystem Genius2 Typmanic Infrared Ear Thermometer , Covidien , Mechelen , Belgium ) , temporal artery scan ( Exergen , Exergen Corp , Watertown , Massachusetts ) , and infrared ( ThermoFlash Contactless Medical Electronic Thermometer , Visiomedlab , Paris , France ) body temperature measurements were r and omly performed and readings were collected once . Temperature readings were described as median and range , and observations were compared with rectal temperature readings ( using Wilcoxon , Bl and -Altman , sensitivity , and specificity tests ) . The child ’s comfort was assessed by the child , parent , and nurse ( using Likert scales ) and ease of use was assessed by nurses ( using visual analog scale ) . Results Based on observations in 294 ( median age = 3.2 years , range = 0.02–17 years ) children , the mean difference was 0.49 ° C ( tympanic scan ; P < 0.0001 ) , 0.34 ° C ( infrared skin scan ; P < 0.0001 ) , and 0 ° C ( temporal artery scan ; P = 0.9288 ) , respectively , when compared with rectal temperature readings . Based on visual inspection of Bl and -Altman plots , all tools overestimated the temperature at lower body temperature and underestimated the temperature at higher body temperature , result ing in a sensitivity of 22 % to 41 % and a specificity of 98 % to 100 % for rectal temperatures above 38 ° C . The Likert scale scores and the visual analog scale scores for rectal measurement were only slightly higher when compared with the other methods . Conclusions All noninvasive techniques underperformed compared with rectal measurement . The temporal artery scan deviations were smallest , but all noninvasive techniques overestimate lower temperatures and underestimate higher temperatures compared with rectal measurement . In our h and s , temporal artery scan measurement seems to be second best , but not yet ideal BACKGROUND Rectal thermometry correlates with core temperature and represents the criterion st and ard of measuring temperatures in young children . However , it has numerous disadvantages , and thus , an alternative method of measuring temperature with similar agreement with the core temperature as rectal thermometry is desired . A new , noninvasive temporal artery ( TA ) thermometer synthesizes the skin surface and ambient temperatures to produce an arterial temperature . OBJECTIVE To examine the agreement between the TA and esophageal core thermometers , and to compare it with that between rectal and esophageal temperatures . METHODS In the present prospect i ve , cross-sectional agreement study , intubated surgical out patients younger than 18 years of age had temperatures measured with esophageal and rectal probes , and rectal electronic and TA thermometers . The agreement between esophageal versus rectal and TA thermometers was analyzed by intraclass correlation coefficients and by differences between esophageal versus TA and rectal temperatures with 95 % CIs . The esophageal-rectal and esophageal-TA slopes were compared by Student 's t test . RESULTS In 80 enrolled children , the intraclass correlation coefficients for the esophageal probe versus rectal probe , rectal electronic thermometer and TA thermometer were 0.91 , 0.95 and 0.88 , respectively . The mean esophageal-rectal difference was 0.00+/-0.18 degrees C and esophageal-TA difference was 0.14+/-0.20 degrees C. Linear regression analysis of the relation between esophageal probe versus rectal probe , rectal thermometer and TA thermometer yielded slopes of 0.93 , 0.94 and 0.89 , respectively . The slopes were neither different from each other ( P=0.70 ) nor from the value of 1 . CONCLUSION The TA and esophageal thermometers agree well , and the esophageal-TA and esophageal-rectal temperature agreements are not significantly different Background and Aims : 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 . Methods : The study design was a prospect i ve , 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 . Results and conclusions : Mean temperature of all measurements was : PAC : 37.1 ° C ( SD : 0.87 ) , TAT : 37.0 ° C ( SD : 0.68 ) and axillary thermometer : 36.6 ° C ( SD : 0.94 ) . The measurements of the TAT and the PAC were not significantly different ( mean difference : 0.14 ° C ; SD : 0.51 ; p= 0.33 ) ; whereas the measurements of the PAC and the AT differed significantly ( mean difference : 0.46 ° C ; SD : 0.39 ; p < 0.001 ) . Mean difference in PAC versus TAT analyses , between patients with vasopressor therapy ( 0.12 ° C ; SD : 0.55 ) , and without vasopressor therapy ( 0.19 ° C ; SD : 0.48 ) was not statistically significant 
    Output:
    