Proper use of noncontact infrared thermometry for temperature screening during COVID-19

Abstract Among the myriad of challenges healthcare institutions face in dealing with coronavirus disease 2019 (COVID–19), screening for the detection of febrile persons entering facilities remains problematic, particularly when paired with CDC and WHO spatial distancing guidance. Aggressive source c...

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Autores principales:	Amber S. Hussain, Heather S. Hussain, Nathan Betcher, Robert Behm, Burt Cagir
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0cfd967f115343f4b8c9a2f33e325a69
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spelling	oai:doaj.org-article:0cfd967f115343f4b8c9a2f33e325a692021-12-02T15:56:49ZProper use of noncontact infrared thermometry for temperature screening during COVID-1910.1038/s41598-021-90100-12045-2322https://doaj.org/article/0cfd967f115343f4b8c9a2f33e325a692021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90100-1https://doaj.org/toc/2045-2322Abstract Among the myriad of challenges healthcare institutions face in dealing with coronavirus disease 2019 (COVID–19), screening for the detection of febrile persons entering facilities remains problematic, particularly when paired with CDC and WHO spatial distancing guidance. Aggressive source control measures during the outbreak of COVID-19 has led to re-purposed use of noncontact infrared thermometry (NCIT) for temperature screening. This study was commissioned to establish the efficacy of this technology for temperature screening by healthcare facilities. We conducted a prospective, observational, single-center study in a level II trauma center at the onset of the COVID-19 outbreak to assess (i) method agreement between NCIT and temporal artery reference temperature, (ii) diagnostic accuracy of NCIT in detecting referent temperature $$\ge 100.0\,^{\circ }{\mathrm{F}}$$ ≥ 100.0 ∘ F and ensuing test sensitivity and specificity and (iii) technical limitations of this technology. Of 51 healthy, non-febrile, healthcare workers surveyed, the mean temporal artery temperature was $$98.4\,^{\circ }{\mathrm{F}}$$ 98.4 ∘ F ( $$95\%$$ 95 % confidence interval (CI) = $$[98.2,98.6]\,^{\circ }{\mathrm{F}}$$ [ 98.2 , 98.6 ] ∘ F ). Mean NCIT temperatures measured from $${1}\,{\mathrm{ft}}$$ 1 ft , $${3}\,{\mathrm{ft}}$$ 3 ft , and $${6}\,{\mathrm{ft}}$$ 6 ft distances were $$92.2\,^{\circ }{\mathrm{F}}$$ 92.2 ∘ F $$(95\%\ {\text {CI}}=[91.8\ 92.67]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 91.8 92.67 ] ∘ F ) , $$91.3\,^{\circ }{\mathrm{F}}$$ 91.3 ∘ F $$(95\%\ {\text {CI}}=[90.8\ 91.8]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 90.8 91.8 ] ∘ F ) , and $$89.6\,^{\circ }{\mathrm{F}}$$ 89.6 ∘ F $$(95\%\ {\text {CI}}=[89.2 \ 90.1]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 89.2 90.1 ] ∘ F ) , respectively. From statistical analysis, the only method in sufficient agreement with the reference standard was NCIT at $${1}\,{\mathrm{ft}}$$ 1 ft . This demonstrated that the device offset (mean temperature difference) between these methods was $$-6.15\,^{\circ }{\mathrm{F}}$$ - 6.15 ∘ F ( $$95\%\ {\text {CI}}=[-6.56,-5.74]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 6.56 , - 5.74 ] ∘ F ) with 95% of measurement differences within $$-8.99\,^{\circ }{\mathrm{F}}$$ - 8.99 ∘ F ( $$95\%\ {\text {CI}}=[-9.69,-8.29]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 9.69 , - 8.29 ] ∘ F ) and $$-3.31\,^{\circ }{\mathrm{F}}$$ - 3.31 ∘ F ( $$95\%\ {\text {CI}}= [-4.00,-2.61]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 4.00 , - 2.61 ] ∘ F ). By setting the NCIT screening threshold to $$93.5\,^{\circ }{\mathrm{F}}$$ 93.5 ∘ F at $${1}\,{\mathrm{ft}}$$ 1 ft , we achieve diagnostic accuracy with $$70.9\%$$ 70.9 % test sensitivity and specificity for temperature detection $$\ge 100.0\,^{\circ }{\mathrm{F}}$$ ≥ 100.0 ∘ F by reference standard. In comparison, reducing this screening criterion to the lower limit of the device-specific offset, such as $$91.1\,^{\circ }{\mathrm{F}}$$ 91.1 ∘ F , produces a highly sensitive screening test at $$98.2\%$$ 98.2 % , which may be favorable in high-risk pandemic disease. For future consideration, an infrared device with a higher distance-to-spot size ratio approaching 50:1 would theoretically produce similar results at $${6}\,{\mathrm{ft}}$$ 6 ft , in accordance with CDC and WHO spatial distancing guidelines.Amber S. HussainHeather S. HussainNathan BetcherRobert BehmBurt CagirNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Amber S. Hussain Heather S. Hussain Nathan Betcher Robert Behm Burt Cagir Proper use of noncontact infrared thermometry for temperature screening during COVID-19
description	Abstract Among the myriad of challenges healthcare institutions face in dealing with coronavirus disease 2019 (COVID–19), screening for the detection of febrile persons entering facilities remains problematic, particularly when paired with CDC and WHO spatial distancing guidance. Aggressive source control measures during the outbreak of COVID-19 has led to re-purposed use of noncontact infrared thermometry (NCIT) for temperature screening. This study was commissioned to establish the efficacy of this technology for temperature screening by healthcare facilities. We conducted a prospective, observational, single-center study in a level II trauma center at the onset of the COVID-19 outbreak to assess (i) method agreement between NCIT and temporal artery reference temperature, (ii) diagnostic accuracy of NCIT in detecting referent temperature $$\ge 100.0\,^{\circ }{\mathrm{F}}$$ ≥ 100.0 ∘ F and ensuing test sensitivity and specificity and (iii) technical limitations of this technology. Of 51 healthy, non-febrile, healthcare workers surveyed, the mean temporal artery temperature was $$98.4\,^{\circ }{\mathrm{F}}$$ 98.4 ∘ F ( $$95\%$$ 95 % confidence interval (CI) = $$[98.2,98.6]\,^{\circ }{\mathrm{F}}$$ [ 98.2 , 98.6 ] ∘ F ). Mean NCIT temperatures measured from $${1}\,{\mathrm{ft}}$$ 1 ft , $${3}\,{\mathrm{ft}}$$ 3 ft , and $${6}\,{\mathrm{ft}}$$ 6 ft distances were $$92.2\,^{\circ }{\mathrm{F}}$$ 92.2 ∘ F $$(95\%\ {\text {CI}}=[91.8\ 92.67]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 91.8 92.67 ] ∘ F ) , $$91.3\,^{\circ }{\mathrm{F}}$$ 91.3 ∘ F $$(95\%\ {\text {CI}}=[90.8\ 91.8]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 90.8 91.8 ] ∘ F ) , and $$89.6\,^{\circ }{\mathrm{F}}$$ 89.6 ∘ F $$(95\%\ {\text {CI}}=[89.2 \ 90.1]\,^{\circ }{\mathrm{F}})$$ ( 95 % CI = [ 89.2 90.1 ] ∘ F ) , respectively. From statistical analysis, the only method in sufficient agreement with the reference standard was NCIT at $${1}\,{\mathrm{ft}}$$ 1 ft . This demonstrated that the device offset (mean temperature difference) between these methods was $$-6.15\,^{\circ }{\mathrm{F}}$$ - 6.15 ∘ F ( $$95\%\ {\text {CI}}=[-6.56,-5.74]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 6.56 , - 5.74 ] ∘ F ) with 95% of measurement differences within $$-8.99\,^{\circ }{\mathrm{F}}$$ - 8.99 ∘ F ( $$95\%\ {\text {CI}}=[-9.69,-8.29]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 9.69 , - 8.29 ] ∘ F ) and $$-3.31\,^{\circ }{\mathrm{F}}$$ - 3.31 ∘ F ( $$95\%\ {\text {CI}}= [-4.00,-2.61]\,^{\circ }{\mathrm{F}}$$ 95 % CI = [ - 4.00 , - 2.61 ] ∘ F ). By setting the NCIT screening threshold to $$93.5\,^{\circ }{\mathrm{F}}$$ 93.5 ∘ F at $${1}\,{\mathrm{ft}}$$ 1 ft , we achieve diagnostic accuracy with $$70.9\%$$ 70.9 % test sensitivity and specificity for temperature detection $$\ge 100.0\,^{\circ }{\mathrm{F}}$$ ≥ 100.0 ∘ F by reference standard. In comparison, reducing this screening criterion to the lower limit of the device-specific offset, such as $$91.1\,^{\circ }{\mathrm{F}}$$ 91.1 ∘ F , produces a highly sensitive screening test at $$98.2\%$$ 98.2 % , which may be favorable in high-risk pandemic disease. For future consideration, an infrared device with a higher distance-to-spot size ratio approaching 50:1 would theoretically produce similar results at $${6}\,{\mathrm{ft}}$$ 6 ft , in accordance with CDC and WHO spatial distancing guidelines.
format	article
author	Amber S. Hussain Heather S. Hussain Nathan Betcher Robert Behm Burt Cagir
author_facet	Amber S. Hussain Heather S. Hussain Nathan Betcher Robert Behm Burt Cagir
author_sort	Amber S. Hussain
title	Proper use of noncontact infrared thermometry for temperature screening during COVID-19
title_short	Proper use of noncontact infrared thermometry for temperature screening during COVID-19
title_full	Proper use of noncontact infrared thermometry for temperature screening during COVID-19
title_fullStr	Proper use of noncontact infrared thermometry for temperature screening during COVID-19
title_full_unstemmed	Proper use of noncontact infrared thermometry for temperature screening during COVID-19
title_sort	proper use of noncontact infrared thermometry for temperature screening during covid-19
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0cfd967f115343f4b8c9a2f33e325a69
work_keys_str_mv	AT ambershussain properuseofnoncontactinfraredthermometryfortemperaturescreeningduringcovid19 AT heathershussain properuseofnoncontactinfraredthermometryfortemperaturescreeningduringcovid19 AT nathanbetcher properuseofnoncontactinfraredthermometryfortemperaturescreeningduringcovid19 AT robertbehm properuseofnoncontactinfraredthermometryfortemperaturescreeningduringcovid19 AT burtcagir properuseofnoncontactinfraredthermometryfortemperaturescreeningduringcovid19
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Proper use of noncontact infrared thermometry for temperature screening during COVID-19

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