Body surface assessment with 3D laser-based anthropometry: reliability, validation, and improvement of empirical surface formulae

Abstract

PurposeBody surface area is a physiological quantity relevant for many medical applications. In clinical practice, it is determined by empirical formulae. 3D laser-based anthropometry provides an easy and effective way to measure body surface area but is not ubiquitously available. We used data from laser-based anthropometry from a population-based study to assess validity of published and commonly used empirical formulae.MethodsWe performed a large population-based study on adults collecting classical anthropometric measurements and 3D body surface assessments (N = 1435). We determined reliability of the 3D body surface assessment and validity of 18 different empirical formulae proposed in the literature. The performance of these formulae is studied in subsets of sex and BMI. Finally, improvements of parameter settings of formulae and adjustments for sex and BMI were considered.Results3D body surface measurements show excellent intra- and inter-rater reliability of 0.998 (overall concordance correlation coefficient, OCCC was used as measure of agreement). Empirical formulae of Fujimoto and Watanabe, Shuter and Aslani and Sendroy and Cecchini performed best with excellent concordance with OCCC > 0.949 even in subgroups of sex and BMI. Re-parametrization of formulae and adjustment for sex and BMI slightly improved results.ConclusionIn adults, 3D laser-based body surface assessment is a reliable alternative to estimation by empirical formulae. However, there are empirical formulae showing excellent results even in subgroups of sex and BMI with only little room for improvement.Electronic supplementary materialThe online version of this article (doi:10.1007/s00421-016-3525-5) contains supplementary material, which is available to authorized users.

High‐Resolution Three‐Dimensional Photonic Scan‐Derived Equations Improve Body Surface Area Prediction in Diverse Populations

“…Most empirically derived equations overestimated BSA, similar to previous reports . Compared with BSA 3DPS , BSA overestimation ranged from 0.4% to 6.7% (mean 3.9%) in males and from 0.1% to 8.6% (mean 3.0%) in females.…”

“…Of the six equations evaluated, only Tikuisis, a 3DPS-based equation (27), produced estimates that were not significantly different from BSA 3DPS in both males and females. Our population differed from that of Tikuisis with a wider age (18-83 vs. 18-64 years) and BMI Most empirically derived equations overestimated BSA, similar to previous reports (27)(28)(29)(30). Compared with BSA 3DPS , BSA overestimation ranged from 0.4% to 6.7% (mean 3.9%) in males and from 0.1% to 8.6% (mean 3.0%) in females.…”

“…All equations are presented, allowing readers to make their own determination about statistical significance versus practical importance. In the Kuehnapfel et al study , from among 18 equations that included DuBois and DuBois and three newly developed 3DPS‐based equations, the 3DPS‐based sex‐ and BMI‐adjusted equation produced the smallest bias. Differences in BSA estimates by sex could be explained by differences in anatomy.…”

“…The precision of the estimated BSA decreased with increasing BMI such that the bias (difference between equation‐estimated BSA and BSA 3DPS ) increased as BMI increased, suggesting the need for BMI‐specific BSA equations in some instances. Kuehnapfel et al evaluated BSA 3DPS against 18 empirically derived equations and found that empirical formulas overestimated BSA for participants with obesity and underestimated BSA in lean participants. Both the Daniell et al and Kuehnapfel et al studies involved homogeneous samples of Caucasian origin only, thus limiting their generalizability.…”

“…Kuehnapfel et al evaluated BSA 3DPS against 18 empirically derived equations and found that empirical formulas overestimated BSA for participants with obesity and underestimated BSA in lean participants. Both the Daniell et al and Kuehnapfel et al studies involved homogeneous samples of Caucasian origin only, thus limiting their generalizability. Our data showed no interaction between BSA 3DPS and BMI (Figure B).…”