ISRCTN ISRCTN15413321
DOI https://doi.org/10.1186/ISRCTN15413321
Secondary identifying numbers 33590
Submission date
26/06/2017
Registration date
27/07/2017
Last edited
06/08/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
National guidelines recommend measuring temperature whenever a child is ill using a digital thermometer in the armpit or an ear thermometer. However, armpit thermometers require healthcare professionals to undress the child and hold the thermometer under the arm for at least 30 seconds. Ear thermometers are easier to use, but may be inaccurate due to ear wax or insufficient straightening of the ear canal. A non-contact thermometer is a no touch thermometer, designed to allow to take children’s temperature on the forehead without touching the child and potentially causes less distress to children. This thermometer works by measuring infrared emissions from the body, which only takes a few seconds. The aim of the study is to assess the agreement between two NCIT versus ear and armpit thermometers in children aged 5 years or under.

Who can participate?
Unwell children aged 0-5 years (maximum illness 14 days) presenting to GP practice or out-of-hours service.

What does the study involve?
Participating children have their background details (age, gender, etc) recorded. They then have their body temperature measured using an armpit thermometer, an ear thermometer and twice with two different non-contact infrared thermometers. Parents/guardians and children are asked to rate each thermometer by preference.

What are the possible benefits and risks of participating?
There are no direct benefits of participating. There are no notable risks, however, it does take up a small amount of participant’s time and could be distressing to an unwell child.

Where is the study run from?
The study is run from the University of Oxford and takes place in GP practices and out-of-hours service in Oxfordshire (UK).

When is the study starting and how long is it expected to run for?
December 2016 to August 2018

Who is funding the study?
National Institute for Health Research (UK)

Who is the main contact?
1. Gail Hayward
Gail.hayward@phc.ox.ac.uk
2. George Edwards
george.edwards@phc.ox.ac.uk

Contact information

Ms Gail Hayward
Public

Radcliffe Primary Care
Radcliffe Observatory Quarter
Woodstock Road
Oxford
OX2 6GG
United Kingdom

Phone +44 (0)1865 289357
Email Gail.hayward@phc.ox.ac.uk
Mr George Edwards
Public

Radcliffe Primary Care
Radcliffe Observatory Quarter
Woodstock Road
Oxford
OX2 6GG
United Kingdom

Phone +44 (0)1865 289300
Email george.edwards@phc.ox.ac.uk

Study information

Study designNon-randomised; Observational; Design type: Cross-sectional
Primary study designObservational
Secondary study designCross sectional study
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleMEasuring TemperatuRe In Children: Non-contact infrared thermometers for measuring body temperature in acutely ill children: a method comparison study
Study acronymMETRIC
Study hypothesisThe aim of the study is to assess the agreement between two Non-Contact Infrared Thermometers (Thermofocus and Firhealth) versus electronic axillary and infrared tympanic thermometers in children who present with an acute illness in primary care.
Ethics approval(s)South Central-Berkshire Research Ethics Committee, 17/03/2017, 17/SC/0068
ConditionSpecialty: Primary Care, Primary sub-specialty: Children; UKCRC code/ Disease: Other/ General symptoms and signs
InterventionParents/guardians of children aged five years or under are approached by the research assistant while they are in the GP waiting area for possible recruitment. The research assistant records demographic information (including household composition, parental age and ethnicity) and baseline information (including prior fever medication use, parental impression of fever, fever duration) for each eligible child (after verbal consent from parents/guardians). Subsequently, the research assistant measures body temperature with four different thermometers, in a random order predetermined by the use of a random number generator. Children under four weeks of age do not have the tympanic thermometer measurement. Temperature measurements are performed consecutively in the shortest time frame possible, and no medication or drinks are administered between measurements. Once the four primary measurements are complete, a second measurement is taken with each Non-Contact Infrared Thermometer (NCIT) to evaluate reproducibility. Failures to perform measurements due to lack of cooperation of the child after three attempts, mechanical issues (operational or technological failure) and clinically implausible readings (based on clinician’s assessment) are recorded.

Parents are asked to score the acceptability of each thermometer on a visual analogue scale and rank the thermometers by preference. Children`s reaction to the different measurements are recorded by the Patient Discomfort Scale. Children aged four to five years are asked to score each thermometer using the Wong-Baker Face pain rating scale. Parents and children are blinded to the temperature measurements until they have rated their acceptability to avoid bias.

Verbal consent is sought for further contact regarding a qualitative telephone interview study to explore parent’s views and preferences regarding the different thermometers used. A subset of parents who consent to further contact are approached for an interview based on a purposive sampling procedure.

Verbal informed consent is also obtained from parents to keep their contact email or telephone number securely. This would be in order that future contact could be made to obtain written informed consent to access details of their child’s medical notes regarding re-attendance, secondary care referrals and admissions in the 30 days after the initial contact.

There is only one study visit, which is at the GP practice or out-of-hours service where the children are recruited and all interventions are performed.
Intervention typeOther
Primary outcome measureAgreement between the Thermofocus NCIT and electronic axillary thermometer is assessed using the limits of agreement at study visit
Secondary outcome measures1. Agreement between the Thermofoucs NCIT and Infrared tympanic thermometer (and therefore between tympanic and axillary) is assessed using the limits of agreement at study visit
2. Agreement between the Thermofocus NCIT and Firhealth NCIT is assessed using the limits of agreement at study visit
3. The ability of NCITs to detect fever (≥38°C) is assessed using accuracy of diagnosing fever at study visit
4. The failure rates of all thermometers is assessed using proportion of failed measurements at study visit
5. The acceptability of the four thermometry methods is assessed using acceptability to parents and children if applicable at study visit
6. The reproducibility of measurements made with the two NCITs is assessed using intra-observer variability at study visit

Tertiary outcome:
Association between temperature readings and medication use at the index consultation with incidence of repeat consultations in in-hours and out-of-hours general practice, secondary referrals and hospital admission in the 30 days following initial recruitment is assessed by reviewing children’s medical notes.
Overall study start date01/12/2016
Overall study end date31/08/2018

Eligibility

Participant type(s)Patient
Age groupChild
Lower age limit0 Years
Upper age limit5 Years
SexBoth
Target number of participants533
Total final enrolment401
Participant inclusion criteria1. Parent or guardian is willing and able to give informed consent for participation in the study.
2. Male or Female, aged 0 to 5 years
3. Presenting to a GP practice or out-of-hours service with an acute illness of a maximum of 14
days duration

Inclusion criteria for qualitative interviews:
1. Recruited to main study
2. Able to conduct a telephone interview in English
Participant exclusion criteria1. Acute trauma
2. Clinically unstable warranting immediate care
3. Prior inclusion in the study
4. Unable to understand trial material in English
Recruitment start date19/04/2017
Recruitment end date31/08/2018

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Nuffield Department of Primary Care Health Sciences
University of Oxford
Primary Care Health Sciences
Radcliffe Primary Care Building
Radcliffe Observatory Quarter
Woodstock Road
Oxford
OX2 6GG
United Kingdom

Sponsor information

University of Oxford
University/education

Clinical Trials and Research Governance
Oxford
OX1 3BD
England
United Kingdom

ROR logo "ROR" https://ror.org/052gg0110

Funders

Funder type

Government

National Institute for Health Research
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom

Results and Publications

Intention to publish date01/09/2019
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal.
IPD sharing planOnce all publications are complete the datasets generated during and/or analysed during the current study will be available upon request from Gail Hayward (Gail.hayward@phc.ox.ac.uk) and George Edwards (george.edwards@phc.ox.ac.uk).

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 26/03/2020 31/03/2020 Yes No
Protocol file version 2 10/03/2017 10/08/2022 No No
HRA research summary 28/06/2023 No No
Results article 01/10/2020 06/08/2024 Yes No

Additional files

33840 Protocol V2 10March2017.pdf

Editorial Notes

06/08/2024: Publication reference added.
10/08/2022: Uploaded protocol (not peer-reviewed) as an additional file.
31/03/2020: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.
24/05/2019: The following changes were made to the trial record:
1. The recruitment end date was changed from 31/01/2018 to 31/08/2018.
2. The overall trial end date was changed from 31/05/2018 to 31/08/2018.
3. The intention to publish was changed from 31/05/2019 to 01/09/2019.
22/05/2019: Contact details updated.
21/05/2019: Internal review.
11/08/2017: Internal review.