Diagnostic Test Accuracy of New Generation Tympanic Thermometry in Children under Different Cutoffs: A Systematic Review and Meta-analysis

Abstract Purposes: To identify and quantify studies reporting the diagnostic accuracy of the new generation of infrared tympanic thermometer (IRTT) in children and to compare the sensitivity and specificity of IRTT under different cutoffs and give the optimal cutoff. Methods: Articles were derived from a systematic search in PubMed, Web of Science Core Collection, and Embase, and were assessed for internal validity by the Quality Assessment of Diagnostic Accuracy Studies-2　（QUADAS-Ⅱ）. The figure of risk of bias was created by Review Manager 5.3 and data were synthesized by MetaDisc 1.4. Results: Nineteen diagnostic studies, involving 4,639 pediatric patients, were included. The cut-offs varied from 37.0℃ to 38.0℃ among these studies. The cut-off 37.8℃ was with the highest sROC AUC (0.97) and Youden Index (0.83) and was deemed to be the optimal cutoff. Conclusion: The optimal cutoff for infrared tympanic thermometers is 37.8℃. New Generation Tympanic Thermometry is with high diagnostic accuracy in pediatric patients and can be an alternative for fever screening in children.