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Volume 16, Number 11—November 2010

Research

Comparison of 3 Infrared Thermal Detection Systems and Self-Report for Mass Fever Screening

An V. Nguyen, Nicole J. CohenComments to Author , Harvey Lipman1, Clive M. Brown, Noelle-Angelique Molinari, William L. Jackson, Hannah Kirking, Paige Szymanowski, Todd W. Wilson, Bisan A. Salhi, Rebecca R. Roberts, David W. Stryker, and Daniel B. Fishbein
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (A.V. Nguyen, N.J. Cohen, H. Lipman, C.M. Brown, N.A. Molinari, W.L. Jackson, H. Kirking, P. Szymanowski, T.W. Wilson, D.B. Fishbein); Council of State and Territorial Epidemiologists, Atlanta (A.V. Nguyen); Emory University, Atlanta (P. Szymanowski, B.A. Salhi); John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, USA (R.R. Roberts); Presbyterian Healthcare Services, Albuquerque, New Mexico, USA (D.W. Stryker); 1Deceased.

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Table 1

Comparisons of 3 infrared thermal detection system results and self-reported fever with oral temperature among patients in 3 emergency departments, USA, 2008–2009*

Characteristics OptoTherm,
n = 2,507 patients FLIR,
n = 2,515 patients Wahl,
n = 2,061 patients Self-reported fever,
n = 2,389 patients
Mean temperature, °F (SD) 94.3 (1.26) 95.7 (1.38) 89.4 (2.56)
Optimal fever threshold, °F
95.3
96.4
89.3

Fever (oral temperature >100°F)
No. (%) identified as febrile by each method 275 (11.0) 247 (9.8) 577 (28.0) 404 (16.9)
Sensitivity (95% CI) 91.0 (85.0–97.0) 90.0 (84.0–97.0) 80.0 (76.0–85.0) 75.0 (64.4–85.6)
Specificity (95% CI) 86.0 (81.0–90.0) 80.0 (76.0–84.0) 65.0 (61.0–69.0) 84.7 (83.4–86.1)
Positive predictive value (95% C) 17.9 (13.6–22.2) 18.4 (13.7–23.0) 5.7 (4.1–7.3) 10.1 (7.4–12.8)
Negative predictive value (95% CI)
99.6 (99.3–99.8)
99.5 (99.1–99.7)
99.1 (98.6–99.5)
99.3 (98.9–99.6)
Febrile by either ITDS or self-report
No. (%) identified as febrile by each method 597 (23.8) 586 (23.3) 793 (38.5)
Sensitivity (95% CI) 93.8 (87.8–99.7) 89.1 (81.4–96.7) 93.8 (87.8–99.7)
Specificity (95% CI) 78.0 (76.4–79.5) 78.4 (76.9–80.0) 63.3 (61.6–65.1)
Positive predictive value (95% CI) 9.0 (6.9–11.2) 8.8 (6.8–11.3) 5.6 (4.3–7.1)
Negative predictive value (95% CI) 99.8 (99.5–99.9) 99.7 (99.3–99.9) 99.8 (99.4–99.9)

*OptoTherm Thermoscreen (OptoTherm Thermal Imaging Systems and Infrared Cameras Inc., Sewickley, PA, USA), FLIR ThermoVision A20M (FLIR Systems Inc., Boston, MA, USA), and Wahl Fever Alert Imager HIS2000S (Wahl Instruments Inc., Asheville, NC, USA). CI, confidence interval; ITDS, infrared thermal detection system.

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