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Frequency and Consequences of Routine Temperature Measurement at Well-Child Visits

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eMediNexus    08 December 2022

The present study determined the (1) frequency and visit characteristics of routine temperature measurement and (2) rates of interventions by temperature measurement practice and the probability of incidental fever detection.

 

It analyzed well-child visits between 2014–2019, and performed multivariable regression to characterize visits associated with routine temperature measurement, and conducted generalized estimating equations regression to determine adjusted rates of interventions (antibiotic prescription and diagnostic testing) and vaccine deferral by temperature measurement and fever status, clustered by clinic and patient. It used a dual independent chart review to characterize fever (≥100.4°F) as probable, possible, or unlikely to be incidentally detected.

 

The study observed-

 

  • Temperature measurement at 155 527 of 274 351 (58.9%) well-child visits.
  • Of 24 clinics, 16 measured temperature at >90% of visits ("routine measurement clinics") and eight at <20% of visits ("occasional measurement clinics").
  • Common antibiotic prescription, whereas uncommong diagnostic testing advise at routine measurement clinics after adjusting for age, ethnicity, race, and insurance.
  • Fever detection in 0.2% of routine measurement clinic visits, among which 17.4% were probable incidental fever.
  • Frequent Antibiotic prescription and diagnostic testing at visits with probable incidental fever than without fever, and defferal of vaccines at 50% of such visits.

 

This study shows that temperature measurement is common in >50% of well-child visits and is a clinic-driven practice. Its impact on subsequent interventions and vaccine deferral necessitates investigating this practice′s harm–benefit profile.

 

Dang R. et al. Frequency and Consequences of Routine Temperature Measurement at Well-Child Visits. Pediatrics. 2022; 149 (1): e2021053412. https://doi.org/10.1542/peds.2021-053412

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