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Director of Research and Evaluation, Victoria General Hospital, Winnipeg, Manitoba
To the Editor:
I am writing in response to an article recently published in Anesthesia & Analgesia (1). In this article temporal artery skin temperature, measured with the new and noninvasive infrared scanner SensorTouch, is compared to temperatures monitored at the pulmonary artery site in adults and bladder site in children.
It is with considerable disappointment that I note a journal of the caliber of Anesthesia & Analgesia reporting on instrument testing when the accuracy (in vitro testing) of the reference instruments, in this case pulmonary artery and bladder catheters, is not reported. Although these instruments cannot be tested before insertion, they can be tested following removal from patients. Unfortunately the only reference made to the accuracy of these catheters to which the SensorTouch was compared is in a brief statement in the Methods section where the investigators report "The accuracy of these devices is 
0.2°C." Although the original research question posed in this study is important to clinical practice, I question if there is any point in reading the information past the above noted statement. Unless one knows the error of the reference instruments and makes the necessary corrections to the data for this inaccuracy, it is impossible to deduce the true accuracy of the test instrument.
The science of temperature measurement has moved past the stage where sole reliance is placed upon the manufacturer’s reported accuracy. Researchers and journal reviewers need to routinely question results of studies where this information is not provided by the investigators if improved techniques are to be developed and new technology is to be fairly evaluated.
Reference
University of Louisville, Louisville, KY
In Response:
Fallis’ focus on the accuracy of thermocouples is misguided. Thermocouples and thermistors themselves are accurate and precise, as are mercury thermometers, infrared skin sensors, and liquid crystal strips. The issue is the site at which these devices are used and the relation between that site and the thermal core; this relationship is thus the focus of all our thermometry studies (1–3)
Infrared and pulmonary artery temperatures differed by 1.3 ± 0.6°C, and 89% of the adult temperatures differed by more than 0.5°C. Not a single SensorTouch value in the adults exceeded 37.4°C, although 59% of the core measurements exceeded this value. The SensorTouch thermometer thus had a sensitivity of 0% for detecting fever in the adults. This is not the result of pulmonary artery thermistor miscalibration!
Instead, inaccuracy resulted from an inconsistent relationship between forehead skin temperature and core temperature. Our conclusion that the SensorTouch thermometer is inaccurate under the conditions of our study is obvious from the reported results.
References
This article has been cited by other articles:
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  L. Lawson, E. J. Bridges, I. Ballou, R. Eraker, S. Greco, J. Shively, and V. Sochulak Accuracy and Precision of Noninvasive Temperature Measurement in Adult Intensive Care Patients Am. J. Crit. Care., September 1, 2007; 16(5): 485 - 496. [Abstract] [Full Text] [PDF]
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