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Cited by 48Infrared Thermography in MedicineThermography and Photoacoustic TechniquesThermal Regulation in Medicine

Infrared Thermography for Measuring Elevated Body Temperature: Clinical Accuracy, Calibration, and Evaluation

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Wang, Quanzeng, Zhou, Yangling, Ghassemi, Pejman, McBride, David, Casamento, Jon P., Pfefer, T. Joshua·2021·Sensors
DOI 10.3390/s22010215PMC PMC8749858
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Abstract

Infrared thermographs (IRTs) implemented according to standardized best practices have shown strong potential for detecting elevated body temperatures (EBT), which may be useful in clinical settings and during infectious disease epidemics. However, optimal IRT calibration methods have not been established and the clinical performance of these devices relative to the more common non-contact infrared thermometers (NCITs) remains unclear. In addition to confirming the findings of our preliminary analysis of clinical study results, the primary intent of this study was to compare methods for IRT calibration and identify best practices for assessing the performance of IRTs intended to detect EBT. A key secondary aim was to compare IRT clinical accuracy to that of NCITs. We performed a clinical thermographic imaging study of more than 1000 subjects, acquiring temperature data from several facial locations that, along with reference oral temperatures, were used to calibrate two IRT systems based on seven different regression methods. Oral temperatures imputed from facial data were used to evaluate IRT clinical accuracy based on metrics such as clinical bias (Δcb), repeatability, root-mean-square difference, and sensitivity/specificity. We proposed several calibration approaches designed to account for the non-uniform data density across the temperature range and a constant offset approach tended to show better ability to detect EBT. As in our prior study, inner canthi or full-face maximum temperatures provided the highest clinical accuracy. With an optimal calibration approach, these methods achieved a Δcb between ±0.03 °C with standard deviation (σΔcb) less than 0.3 °C, and sensitivity/specificity between 84% and 94%. Results of forehead-center measurements with NCITs or IRTs indicated reduced performance. An analysis of the complete clinical data set confirms the essential findings of our preliminary evaluation, with minor differences. Our findings provide novel insights into methods and metrics for the clinical accuracy assessment of IRTs. Furthermore, our results indicate that calibration approaches providing the highest clinical accuracy in the 37–38.5 °C range may be most effective for measuring EBT. While device performance depends on many factors, IRTs can provide superior performance to NCITs.

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  • Indirect core body temperature evaluation can achieve a high accuracy of ±0.03 °C.

    “From these data, the internal core body temperature is evaluated with a high accuracy of ±0.03 °C [129,140,146,147,148,149].”

    From The Current State of Optical Sensors in Medical Wearables (2022) · cites this paper as [148]

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Research works printed but not linked: 2

  1. [8]Widmaier E.P. Raff H. Strang K.T. Regulation of Organic Metabolism and Energy Balance-Section B: Regulation of Total-Body Energy Balance and Temperature Vander’s Human Physiology McGraw-Hill New York, NY, USA 2008 583 596
  2. [49]Del Bene V.E. Temperature Clinical Methods: The History, Physical, and Laboratory Examinations Walker H.K. Hall W.D.H. Hurst J.W. Butterworth Publishers, a Division of Reed Publishing Boston, MA, USA 1990 990 993 21250045

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Authors
Wang, Q., Zhou, Y., Ghassemi, P., McBride, D., Casamento, J. P., & Pfefer, T. J.
Affiliations
  • United States Food and Drug Administration (US)
  • Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD 20993, USA
  • University of Maryland, College Park (US)
Corresponding author
Wang, Quanzeng
ORCID
Venue
Sensors
Publisher
MDPI AG
Published
2021-12-29
Volume
22
Issue
1
Pages
215
ISSN
1424-8220 (ISSN-L)
DOI
10.3390/s22010215
PMC
PMC8749858
OpenAlex
W4200395617
Cited by
48
References
56
Citations by year
2026: 8 · 2025: 10 · 2024: 11 · 2023: 7 · 2022: 12
FWCI
3.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Sensors (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Maryland Shared Open Access Repository (USMAI Consortium) (submittedVersion, cc-by)
  • Digital Repository at the University of Maryland (University of Maryland College Park) (cc-by)
Funders
United States Food and Drug Administration (16ECDRH407)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Infrared Thermography in Medicine
  • Physical Sciences › Engineering › Mechanics of Materials › Thermography and Photoacoustic Techniques
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Thermal Regulation in Medicine
Keywords
infrared thermography, elevated body temperature, fever detection, non-contact infrared thermometer, clinical accuracy, forehead temperature, sensitivity and specificity, infectious disease surveillance
MeSH terms
Body Temperature, Calibration, Fever, Humans, Infrared Rays, Thermography, Thermometers

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