Journal of the Formosan Medical Association
Volume 107, Issue 12 , Pages 937-944, December 2008

Mass Screening of Suspected Febrile Patients with Remote-sensing Infrared Thermography: Alarm Temperature and Optimal Distance

  • Ming-Fu Chiang

      Affiliations

    • Department of Neurosurgery, Mackay Memorial Hospital, Mackay Medicine, Management and Nursing College, Taipei Medical University, Taiwan
    • ,
  • Po-Wei Lin

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Municipal Wan Fang Hospital, Taipei Medical University, Taiwan
    • ,
  • Li-Fong Lin

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Municipal Wan Fang Hospital, Taipei Medical University, Taiwan
    • ,
  • Hung-Yi Chiou

      Affiliations

    • School of Public Health, Taipei Medical University, Taiwan
    • Corresponding Author InformationHung-Yi Chiou and Wen-Ta Chiu contributed equally to this work
    • ,
  • Ching-Wen Chien

      Affiliations

    • Institute of Hospital and Health Care Administration, National Yang-Ming University, Taiwan
    • ,
  • Shu-Fen Chu

      Affiliations

    • Institute of Injury Prevention and Control, Taipei Medical University, Taiwan
    • ,
  • Wen-Ta Chiu

      Affiliations

    • Department of Neurosurgery, Municipal Wan Fang Hospital, and Institute of Injury Prevention and Control, Taipei Medical University, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Wen-Ta Chiu, Department of Neurosurgery, Municipal Wan Fang Hospital, Institute of Injury Prevention and Control, Taipei Medical University, 250 Wu-Hsin Street, Taipei 110, Taiwan
    • Corresponding Author InformationHung-Yi Chiou and Wen-Ta Chiu contributed equally to this work

Received 3 January 2008; received in revised form 3 May 2008; accepted 23 June 2008.

Background/Purpose

Detection of fever has become an essential step in identifying patients who may have severe acute respiratory syndrome (SARS) or avian influenza. This study evaluated infrared thermography (IRT) and compared the influence of different imagers, ambient temperature discrepancy, and the distance between the subject and imager.

Methods

IRT-digital infrared thermal imaging (IRT-DITI), thermoguard, and ear drum IRT were used for visitors to Municipal Wang Fang Hospital, Taipei, Taiwan. The McNemar and c2 test, standard Pearson correlation, ANOVA, intraclass correlation coefficient (ICC), and receiver operating characteristic curve (ROC) analysis were used to calculate the alarm temperature for each imager.

Results

A total of 1032 subjects were recruited. Different distances and ambient temperature discrepancy had a significant influence on thermoguard, and lateral and frontal view DITI. By ICC analysis, a significant difference was found at 10 m distance between ear drum IRT and thermoguard (r = 0.45), lateral view DITI (r = 0.37), and frontal view DITI (r = 0.44). With ROC analysis, the optimal preset cut-off temperatures for the different imagers were: 36.05°C for thermoguard (area under the curve [AUC], 0.716), 36.25°C for lateral view DITI (AUC, 0.801), and 36.25°C for frontal view DITI (AUC, 0.812).

Conclusion

The temperature readings obtained by IRT may be used as a proxy for core temperature. An effective IRT system with a strict operating protocol can be rapidly implemented at the entrance of a hospital during SARS or avian influenza epidemics.

Key Words:  avian influenza , infrared thermography , intraclass correlation coefficient , receiver operating characteristic curve , severe acute respiratory syndrome

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PII: S0929-6646(09)60017-6

doi:10.1016/S0929-6646(09)60017-6

Journal of the Formosan Medical Association
Volume 107, Issue 12 , Pages 937-944, December 2008

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