Aim: The American Academy of Pediatrics and the European Centre for Pediatric and Adolescent Medicine guideline define fever as a temperature >38.0°C for all ages and recommend use of rectal thermometers in children <3 years. Based on new literature, this definition of fever using a fixed threshold of 38.0°C needs to be re-examined.
Design: A multi-site diagnostic accuracy study was conducted to compare an "age-based" threshold model with a "fixed" threshold over 38.0°C on a total of 894 patients of which 373 were ill.
Methods: The "age-based" and "fixed" threshold fever determinations were then compared to a clinical categorization ("well" or "ill") conducted by a clinician through a comprehensive examination.
Results: The sensitivity and accuracy for the age-based thresholds were found to be superior to the fixed thresholds in all ages and current ear thermometers were found equivalent to rectal thermometers in infants <6 months.
Keywords: adult; age-based; body temperature; children; fever; infant; newborn; paediatrics; parents; sensitivity; specificity; thermometer.
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