Selection of the Most Accurate Thermometer Devices for Clinical Practice: Part 1

Meta-Analysis of the Accuracy of Non-Core Thermometer Devices Compared to Core Body Temperature

Nancy A. Ryan-Wenger; Maureen A. Sims; Rebecca A. Patton; Jayme Williamson


Pediatr Nurs. 2018;44(3):116-133. 

In This Article


Results of this meta-analysis of the accuracy of temperatures from non-core thermometer devices compared to core body temperatures led our research team to make two recommendations:

  1. Only oral electronic and rectal electronic thermometer devices should be used to measure temperature of individuals for screening, monitoring, diagnostic, and treatment purposes.

  2. Tympanic, temporal artery, axillary chemical, and axillary electronic thermometer devices should not be used to measure body temperatures for any purpose.

We applied GRADE criteria to evaluate the strength of our recommendations:

  1. Quality of the evidence. As we reported in the quality assessment section above, the quality of the evidence was strong in that the risk of bias was very low, confidence in the estimates of effects was strong, and estimates of effects were not indirectly obtained.

  2. Desirable and undesirable consequences. Oral and rectal thermometer devices were least likely to result in clinically significant under-estimation or over-estimation of temperatures compared to the other four devices.

  3. Values and preferences of those affected. We did not evaluate this criterion.

  4. Resource use. We did not evaluate relative costs associated with the various thermometer devices. GRADE criteria 3 and 4 were outside the scope of this meta-analysis; thus, further systematic literature review research is needed.

The process used by our research and EBP team to change policy and practice according to these recommendations in a large free-standing children's hospital is described in Part 2 of this series (Sims, Patton, Williamson, & Ryan-Wenger, 2018).