Temperature measured at the axilla compared with rectum in children and young people: systematic reviewBMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7243.1174 (Published 29 April 2000) Cite this as: BMJ 2000;320:1174
- Term searched or sets (numbers) combined of Medline search strategy for identifying studies of temperature measurement (format shown is for Silver Platter version 3.10C upper case denotes medical subject (MeSH) terms, and lower case denotes free text)
1: PAEDIATRIC in TI,AB,MESH
2: PEDIATRIC in TI,AB,MESH
3: explode "Pediatrics"/ all subheadings
11: 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10
12: THERMOMETER in TI,AB,MESH
13: explode "Thermometers"/ all subheadings
15: TEMPERATURE in TI,AB,MESH
17: 12 or 13 or 14 or 15 or 16
18: AXILLA in TI,AB,MESH
19: explode "Axilla"/ all subheadings
21: 18 or 19 or 20
22: RECTUM in TI,AB,MESH
23: explode "Rectum"/ all subheadings
25: 22 or 23 or 24 or 25
26: 11 and 17 and 21 and 25
Studies included in meta-analysis
W1 Akinbami FO, Sowunmi A. Body temperature in the Nigerian neonateC comparison of axillary and rectal temperatures. Afr J Med Med Sci 1991;20:49-52.
W2 Bliss Holtz J. Comparison of rectal, axillary, and inguinal temperatures in full-term newborn infants. Nurs Res 1989;38:85-7.
W3 Eoff MJ, Meier RS, Miller C. Temperature measurement in infants. Nurs Res 1974;23:457-60.
W4 Eoff MJ, Joyce B. Temperature measurements in children. Am J Nurs 1981;81:1010-1.
W5 Haddock B, Vincent P, Merrow D. Axillary and rectal temperatures of full-term neonates: are they different? Neonatal Network 1986;5:36-40.
W6 Khan MN, Ahmad SH, Fakhir S. Comparison of temperatures at different sites in term and pre-term neonates. Indian Pediatr 1990;27:807-9.
W7 Kunnel MT, O’Brien C, Munro BH, Medoff CB. Comparisons of rectal, femoral, axillary, and skin-to-mattress temperatures in stable neonates. Nurs Res 1988;37:162-4.
W8 Mayfield SR, Bhatia J, Nakamura KT, Rios GR, Bell EF. Temperature measurement in term and preterm neonates. J Pediatr 1984;104:271-5.
W9 Morley CJ, Hewson PH, Thornton AJ, Cole TJ. Axillary and rectal temperature measurements in infants. Arch Dis Child 1992;67:122-5.
W10 Schiffman RF. Temperature monitoring in the neonate: a comparison of axillary and rectal temperatures. Nurs Res 1982;31:274-7.
W11 Barrus DH. A comparison of rectal and axillary temperatures by electronic thermometer measurement in preschool children. Pediatr Nurs 1983;9:424-5.
W12 Cusson RM, Madonia JA, Taekman JB. The effect of environment on body site temperatures in full-term neonates. Nurs Res 1997;46:202-7.
W13 Jones RJ, O’Dempsey TJ, Greenwood BM. Screening for a raised rectal temperature in Africa. Arch Dis Child 1993;69:437-9.
W14 Martyn KK, Urbano MT, Hayes JS, von Windeguth B, Sherrin T. Comparison of axillary, rectal and skin-based temperature assessment in preschoolers. Nurse Pract 1988;13:31-6.
W15 Muma BK, Treloar DJ, Wurmlinger K, Peterson E, Vitae A. Comparison of rectal, axillary, and tympanic membrane temperatures in infants and young children. Ann Emerg Med 1991;20:41-4.
W16 Ogren JM. The inaccuracy of axillary temperatures measured with an electronic thermometer. Am J Dis Child 1990;144:109-11.
W17 Shann F, Mackenzie A. Comparison of rectal, axillary, and forehead temperatures. Arch Pediatr Adolesc Med 1996;150:74-8.
W18 Weisse ME, Reagen MS, Boule L, France N. Axillary vs rectal temperatures in ambulatory and hospitalized children. Pediatr Infect Dis J 1991;10:541-2.
Studies with insufficient data for inclusion in meta-analysis
W19 Bissonnette B, Sessler DI, LaFlamme P. Intraoperative temperature monitoring sites in infants and children and the effect of inspired gas warming on esophageal temperature. Anesth Analg 1989;69:192-6.
W20 Davis K. The accuracy of tympanic temperature measurement in children. Pediatr Nurs 1993;19:267-72.
W21 Erickson RS, Woo TM. Accuracy of infrared ear thermometry and traditional temperature methods in young children. Heart Lung 1994;23:181-95.
W22 Leon JE, Bissonnette B, Lerman J. Liquid crystalline temperature monitoring: does it estimate core temperature in anaesthetised paediatric patients? Can J Anaesth 1990;37:S98.
W23 Pituch K, Klein MD. Axillary or rectal temperatures in children. Lancet 1981;Jul 4:43.
W24 Roll C, Wallot M, Hanssler L. Axillary versus rectal temperature measurement in premature and newborn infants. Z Geburtshilfe Neonatol 1998;202:207-11.
W25 Weiss ME, Poeltler D, Gocka I. Infrared tympanic thermometry for neonatal temperature assessment. J Obstet Gynecol Neonatal Nurs 1994;23:798-804.
W26 Weiss ME, Richards MT. Accuracy of electronic axillary temperature measurement in term and preterm neonates. Neonatal Network 1994;13:35-40.
W27 Anagnostakis D, Matsaniotis N, Grafakos S, Sarafidou E. Rectal-axillary temperature difference in febrile and afebrile infants and children. Clin Pediatr Phila 1993;32:268-72.
W28 Brown RD, Kearns G, Eichler VF, Wilson JT. A probability nomogram to predict rectal temperature in children. Clin Pediatr Phila 1992;31:523-31.
W29 Zengeya ST, Blumenthal I. Modern electronic and chemical thermometers used in the axilla are inaccurate. Eur J Pediatr 1996;155:1005-8.
W30 Britton GR. Early mother-infant contact and infant stabilisation. J Obstet Gynecol Neonatal Nurs 1980;Mar/Apr:84-6.
W31 Buntain WL, Pregler M, O’Brien PC, Lynn HB. Axillary versus rectal temperature: a comparative study. J La State Med Soc 1977;129:5-8.
W32 Goehner E, Halvorson M, Heron M, Tanner A. A comparison of the accuracy, reliability, and efficacy of electronic and single-use clinical thermometers in children one to six years of age. Unpublished manuscript available from PyMaH Corporation, Flemington, NJ, USA, 1990.
W33 Haddock BJ, Merrow DL, Swanson MS. The falling grace of axillary temperatures. Pediatr Nurs 1996;22:121-5.
W34 Jirapaet V. The accuracy of rectal, axillary, abdominal skin and tympanic temperature measurements in term and preterm neonates. [Abstract.] London: Centennial Conference of the International Council of Nurses, 27 Jun-1 Jul, 1999.
W35 Kresch MJ. Axillary temperature as a screening test for fever in children. J Pediatr 1984;104:596-9.
W36 Ovali F. Comparison of tympanic and axillary temperature measurements. J Perinatol 1997;17:419.
W37 Yetman RJ, Coody DK, West MS, Montgomery D, Brown M. Comparison of temperature measurements by an aural infrared thermometer with measurements by traditional rectal and axillary techniques. J Pediatr 1993;122:769-73.
Table A Eligible studies with missing or inappropriate data
Reasons for exclusion from meta-analysis No of studies (reference) Repeated measurements taken on same child but standard deviation did not account for this 8 studies: Bissonnette et al 1989w19, Davis 1993w20,
Erickson and Woo 1994w21, Leon et al 1990w22, Pituch and Klein 1981w23,
Roll et al 1998w24, Weiss et al 1994w25, Weiss and Richards 1994w26
Replicate measurements taken and mean of the two used in study but standard deviation did not account for this 3 studies: Anagnostakis et al 1993w27, Brown et al 1992w28, Zengeya and Blumenthal 1996w29 Insufficient results reported for example correlation or mean rectal or axillary measurements only 9 studies: Britton 1980w30, Buntain et al 1977w31 (2 studies), Goehner et al 1990w32, Haddock et al 1996w33, Jirapaet 1999w34, Kresch 1984w35, Ovali 1997w36, Yetman et al 1993w37
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