Fevers Are Rarer in the Morning—Could We Be Missing Infectious Disease Cases by Screening for Fever Then?

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Abstract

We retrospectively studied US emergency department visits ( n =295,406), including nationally representative results. Patients were less likely to have detectable fevers during mornings, with especially large morning-evening differences during influenza outbreaks (national RR=0.56, 95%CI=0.47-0.66). This suggests morning screenings could miss otherwise-detectable cases. Twice-daily screenings could be a simple solution. However, similar COVID-19 research is needed.

Article Summary Line

Fevers were about half as common in the morning as in the evening during influenza outbreaks, suggesting that mornings may be a bad time to perform once-daily fever screenings for infectious diseases, and that twice-daily screenings could be preferable.

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  1. SciScore for 10.1101/2020.05.23.20093484: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethics declarations: The institutional review board of Beth Israel Deaconess Medical Center approved the Boston study with a waver of informed consent.
    Consent: Ethics declarations: The institutional review board of Beth Israel Deaconess Medical Center approved the Boston study with a waver of informed consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.