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Re:Time to redefine normal body temperature? by kqr on Thursday December 29, 2022 @02:04AM (#34170277)
The whole enterprise of trying to find "a normal" temperature seems silly to me, increasingly after getting two kids with fevers every now and then.

We use both high-quality ear canal and anal thermometers, and while we have enough statistical grounds to unbias their results compared to each other, there remains significant variance. I.e. if we use an anal or ear canal thermometer makes temperature vary ±0.4 °C.

Then how sloppily you take the measurement with the same thermometer can result in a ±0.2 °C difference for the butt, and ±0.6 °C for the ear canal.

Of course, the time of day we take the temperature can give us a ±0.5 °C difference, and the activity level of the person something like a ±1 °C difference (we don't have as much data on these last ones, naturally.)

And all this is before you bring in the fever! So all of this we consider normal.

Basically, in our experience, anything below 38.4 °C could just as well be caused by any of a number of non-fever conditions at something like a 90 % confidence level, so unless there's a strong prior of fever, a "non-normal" temperature reading on its own is a fairly weak signal.

...which brings me to my final point: the prior ought to strongly affect what counts as normal temperature, but all of this discussion ignores it.

There's also the question whether you prefer false positives or false negatives when it comes to fever detection. My impression is that the medical community prefers false negatives, i.e. pretending that people with a low fever are perfectly normal -- but a lot of private persons I talk to have the opposite preference: they would prefer to think of someone as sick even though they are healthy.

Like any good medical test, you pick a threshold based on what probability you want for false positives and negatives, and you weigh the prior into this judgment. Just investigating what an average resting temperature with a particular measurement method seems to me silly.

Re:Time to redefine normal body temperature? by mise_en_place on Thursday December 29, 2022 @02:37AM (#34170435)
Anecdotal, but my family has a history of autoimmune disease (including multiple myeloma in my father’s case). My temp is always slightly higher than what is considered normal. It could be due to how my immune system tends to be overactive, many doctors have claimed it is caused by having “connective tissue disease”. Never had any adverse health problems from it.
Re:Time to redefine normal body temperature? by Broken_Hippo on Thursday December 29, 2022 @05:25AM (#34171247)
Just to push back at the anecdote, another anecdote: I personally have an autoimmune disease (MS, in particular, with overactive immune system) and my body temperature has run low for most of my life.
Re:Time to redefine normal body temperature? by saurik on Thursday December 29, 2022 @02:33AM (#34170412)
> if we use an anal or ear canal thermometer makes temperature vary ±0.4 °C.

This part is just known, though: the usual "close enough" standard for core temperature is an anal temperature and everything else you have to adjust. (Everything else you say I agree with, though.)

Re:Time to redefine normal body temperature? by kqr on Thursday December 29, 2022 @02:45AM (#34170463)
I know that's common wisdom, but I also have started to doubt it -- when variation is so large, does it really matter whether you measure in the ear or the butt?

(For what it's worth, my local hospitals use ear canal temperatures for diagnostic purposes.)

Re:Time to redefine normal body temperature? by oefrha on Thursday December 29, 2022 @02:52AM (#34170498)
Of course it does matter, look up systematic error and random error.
Re:Time to redefine normal body temperature? by kqr on Thursday December 29, 2022 @03:42AM (#34170745)
Before being very dismissive, please consider the alternative that I do know about the things you mention, and that there are other ways of looking at the situation.

1. If the ear temperature are consistently wrong (systematic error) it is very easy to debias them and they become equivalent (modulo random error) to anal temperatures.

2. Perhaps cephalic temperature is a better diagnostic tool than gut temperature to evaluate the effects of fever? After all, the brain is a more sensitive organ than the butt.

Re:Time to redefine normal body temperature? by sokoloff on Thursday December 29, 2022 @06:13AM (#34171519)
> the brain is a more sensitive organ than the butt

The more time I spend on the internet, the less certain of this I become.

Re:Time to redefine normal body temperature? by aleken on Thursday December 29, 2022 @02:57AM (#34170519)
I applaud your accuracy when measuring your kids' temperature. My approach when figuring out if my kids are sick is if their temperature is "high" and their general appearance and conditition is out of the ordinary. The exact decimal of the temperature doesn't matter too much by itself.
Re:Time to redefine normal body temperature? by kqr on Thursday December 29, 2022 @03:45AM (#34170768)
We didn't always care to this accuracy. We just used the anal temperature and went on with our day. Then we got the ear canal thermometer for convenience and discovered that the result was not what we expected, so I got curious and started keeping detailed records...

But in the end, I want to get to the point where you are, using a rough rule of thumb. I'm just taking the evidence-based route there!

Re:Time to redefine normal body temperature? by kqr on Thursday December 29, 2022 @07:36AM (#34172007)
Hah! I just now realised the English word is "rectal" not "anal" but it seems my comment influenced plenty of other people to use the wrong word too!
Re:Time to redefine normal body temperature? by fnordpiglet on Thursday December 29, 2022 @08:48AM (#34172540)
Only an anal person would care. You’re good.
Re:Time to redefine normal body temperature? by bombcar on Thursday December 29, 2022 @09:06AM (#34172681)
The name matters much less than making sure you don’t get the various thermometers confused.
Re:Time to redefine normal body temperature? by WelcomeShorty on Friday December 30, 2022 @09:41AM (#34185422)
I learned that from the move Madagascar :)

https://www.youtube.com/watch?v=rQ8m2UqIgrE

Re:Time to redefine normal body temperature? by simplotek on Thursday December 29, 2022 @01:59PM (#34176401)
> The exact decimal of the temperature doesn't matter too much by itself.

Indeed, this pseudo-accuracy seems pointless.

The only relevant conclusions that taking the temperature can deliver is whether, a) there is no fever, b) there is a mild fever not requiring major concern, c) there is a major fever and extra care needs to be taken. No one in their right mind would classify these differences based on sub-degree differences in temperature.

Re:Time to redefine normal body temperature? by hnuser123456 on Thursday December 29, 2022 @02:06PM (#34176491)
No, but it would be cool in the nerdy sense to have a dataset of average temperatures in various conditions, or at least e.g. people are within 98-99f about 60% of the time, within 97.5-99.5 about 90% of the time, within 97-101 about 97% of the time etc, as measured by X device/method at Y time of day after "average" activity level etc.

Instead of just giving temperature, a thermometer could say "there is a 70% chance that your immune system is more active than usual" etc

Of course, small additional data points like "i'm exhausted and coughing more than usual" increase the confidence of the result by orders of magnitude over just temperature...

Re:Time to redefine normal body temperature? by pmontra on Thursday December 29, 2022 @03:48AM (#34170781)
Anecdotally, after measuring my armpit temperature a number of times in recent years due to checks for covid, I'm close to 36 C or even lower than that. In all my adult life I could deal with anything lower than 38 C without drugs. I would stay warm, rest, sleep on it and be good the next day. I start worrying if it gets past 38.
Re:Time to redefine normal body temperature? by IanOzsvald on Thursday December 29, 2022 @05:28AM (#34171270)
With our infant using a digital thermometer in the ear, we routinely observe that the left ear is hotter than the right. We take 3 measurements in each ear, we see a similar variance as you mention per ear. Have you observed a similar difference? As adults with the same device we don't see a difference in our own ears.
Re:Time to redefine normal body temperature? by kqr on Thursday December 29, 2022 @05:37AM (#34171324)
Sometimes the ears differ, and we use the warmer of the temperatures as our final measurement, as per the instruction booklet of the thermometer. I have not stopped to consider whether this is a consistent chirality bias or just noise!
Re:Time to redefine normal body temperature? by yellow_lead on Thursday December 29, 2022 @05:43AM (#34171354)
Maybe it depends on if your child is left brained or right brained (just kidding)
Re:Time to redefine normal body temperature? by bombcar on Thursday December 29, 2022 @09:07AM (#34172690)
I wonder if taking a temperature after laying in your side sleeping would noticeably change based on which ear you were sleeping on.
Re:Time to redefine normal body temperature? by m463 on Thursday December 29, 2022 @01:58PM (#34176391)
These kinds of things make me wonder about body asymmetries - like which side the heart is on, and left/right handedness.
Re:Time to redefine normal body temperature? by Timshel on Thursday December 29, 2022 @06:57AM (#34171771)
Anyway "Fever Is Your Friend" :). Cf from yesterday : https://www.reddit.com/r/medicine/comments/zwz7t1/dont_worry...
Re:Time to redefine normal body temperature? by e4325f on Thursday December 29, 2022 @01:29PM (#34176024)
I wouldn't have thought a fever is of sufficient concern that it would warrant sticking a thermometer up your childs arse.
Re:Time to redefine normal body temperature? by Eisenstein on Thursday December 29, 2022 @01:38PM (#34176126)
Why? It is easier than getting a toddler to hold it under their tongue and is very accurate.