{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:31:51Z","timestamp":1789774311497,"version":"4.0.1"},"reference-count":26,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","award":["NIHR300952"],"award-info":[{"award-number":["NIHR300952"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Oxford NIHR Biomedical Research Centre and the NIHR Health Protection Research Unit on Antimicrobial Resistance and Healthcare Associated Infection in partnership with the UK Health Security Agency","award":["NIHR200915"],"award-info":[{"award-number":["NIHR200915"]}]},{"name":"NIHR Healthtech Research Centre in Community Healthcare"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,4]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Skin temperature assessment is essential for the diagnosis of cellulitis and monitoring treatment response, but is currently subjective and can contribute to overdiagnosis. We aimed to characterise skin temperature changes over time in cellulitis and compare two objective measurement approaches, a thermal imaging camera (TIC) and a non-contact infrared thermometer (NCIT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A device comparison study nested within a prospective cohort. We measured limb temperatures daily for 4\u2009days using a TIC and two NCITs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two acute hospitals in the UK\u2019s National Health Service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>202 adults (age \u226518 years) diagnosed with lower limb cellulitis who attended hospital for antibiotic treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>We used linear mixed-effects models to quantify changes in temperature over time and intraclass correlation coefficients (ICC) to assess reliability. We compared temperature measurements between devices using Lin\u2019s concordance coefficients and Bland-Altman plots with estimated 95% limits of agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>202 patients were included: 95% white ethnicity. Baseline limb temperature differences varied between 2.4\u00b0C and 3.4\u00b0C, depending on the device. All devices showed significant reductions in affected limb temperature per day, with the largest decrease recorded by the TIC (\u22120.34\u00b0C per day, 95%\u2009CI \u22120.48\u00b0C to \u22120.19\u00b0C, p&lt;0.001). Only the TIC and NCIT-1 showed significant reductions in limb temperature difference per day. All devices had excellent reliability (ICCs \u22650.98). However, the magnitude of daily temperature change estimates was small relative to the repeatability coefficients of each device. The NCIT-2 consistently recorded the smallest differences in limb temperatures and demonstrated evidence of proportional bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Daily temperature changes may be too small for reliable monitoring at the individual patient level, but cumulative changes from day 0 to day 3 may be sufficient for clinical interpretation, despite limitations in the precision of device measurements. NCITs\u2019 measurement capabilities differ widely, so these devices cannot be used interchangeably. Due to this and the potential benefits of advanced thermal image analysis, TICs should be prioritised for further study in cellulitis. Future research should confirm our findings in different skin tones and explore the clinical utility of thermal imaging in enabling earlier diagnosis or detecting signs of therapeutic failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-100667","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T10:05:26Z","timestamp":1752833126000},"page":"e100667","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Comparing thermal imaging and non-contact infrared thermometers for monitoring skin temperature in a prospective cohort with lower limb cellulitis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7462-8330","authenticated-orcid":false,"given":"Elizabeth L A","family":"Cross","sequence":"first","affiliation":[{"name":"Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK"},{"name":"Department of Infection, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6811-1124","authenticated-orcid":false,"given":"Martin John","family":"Llewelyn","sequence":"additional","affiliation":[{"name":"Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK"},{"name":"Department of Infection, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-8509","authenticated-orcid":false,"given":"(Ann) Sarah","family":"Walker","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine, University of Oxford, Oxford, UK"},{"name":"NIHR Oxford Biomedical Research Centre, Oxford, UK"},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0852-627X","authenticated-orcid":false,"given":"Gail","family":"Hayward","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK"},{"name":"Healthtech Research Centre in Community Healthcare, National Institute for Health and Care Research, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"2025101812495145000_15.7.e100667.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.8825"},{"key":"2025101812495145000_15.7.e100667.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.03.023"},{"key":"2025101812495145000_15.7.e100667.3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu444"},{"key":"2025101812495145000_15.7.e100667.4","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13283"},{"key":"2025101812495145000_15.7.e100667.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10275.x"},{"key":"2025101812495145000_15.7.e100667.6","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.12977"},{"key":"2025101812495145000_15.7.e100667.7","doi-asserted-by":"publisher","DOI":"10.1097\/mej.0000000000000245"},{"key":"2025101812495145000_15.7.e100667.8","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12632"},{"key":"2025101812495145000_15.7.e100667.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-016-2067-0","article-title":"Appropriateness 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