Intercambiabilità e accuratezza diagnostica dei termometri digitali e a infrarossi in ambito pediatrico: un'alternativa al termometro a mercurio in vetro

Body temperature (BT) measurement is considered part of the initial health assessment in children in hospitals, since it can lead to a correct diagnosis and an appropriate therapeutic approach. Therefore, it is crucial that the device used to measure BT should be valid and reliable. Although the glass mercury thermometer (GMT) has historically been considered the ‘gold standard’, a current global trend to replace it with modern alternative devices can be observed, due to the alarm raised by the Minamata Convention (MC) on mercury hazards. Considering that, in Albania, the axillary glass mercury (AXLMER) thermometer is still available, we compared it to the alternative thermometers. This allowed us to significantly contribute to the international debate on the validity and reliability of the modern clinical devices and fill the gaps in evidence-based practice. The availability of high-quality research to confirm the validity and reliability of alternative devices is needed to reduce the risk of misdiagnosis, unnecessary treatments and omission of nursing care in the paediatric population. In fact, alternative devices have been introduced in clinical practice due to their convenience and acceptability to patients, especially in the paediatric setting. This study aimed at documenting the interchangeability and accuracy of modern alternative devices such as the digital axillary (AXLDGT), infrared tympanic (TYMIR), and non-contact infrared forehead (FHDIR) thermometers compared to the AXLMER. A comparative observational study was conducted in a fifty-bed paediatric ward of a general hospital in Albania from September 2018 to January 2019. The study included all the 356 hospitalized children aged up to 14 years. Twice a day, morning and afternoon, the body temperature of each child was measured, making a total of 711 measurements. We hypothesized that all alternative devices were 6 interchangeable with the AXLMER thermometer and diagnostically accurate in detecting fever in the paediatric setting. BT values detected with alternative devices showed a significant moderate (p<0.001) to strong bivariate correlation (p<0.01) with the ‘gold standard’ (AXLMER). Our results showed that the AXLDGT thermometer is the best alternative to the AXLMER in paediatric clinical settings. AXLDGT also showed a better performance in detecting fever than the ‘gold standard’. In accordance with the not significant clinical differences, TYMIR and FHDIR should be used taking in consideration the clinical picture of the paediatric patient. Our hypothesis is fully confirmed in relation to the AXLDGT.