Investigating the intra- and inter-rater reliability of a panel of subjective and objective burn scar measurement tools

Lee, Kwang Chear; Bamford, Amy; Gardiner, Fay; Agovino, Annarita; Horst, Britt ter; Bishop, Jonathan; Sitch, Alice; Grover, Liam M.; Logan, Ann; Moiemen, Naiem

doi:10.1016/j.burns.2019.02.002

Cited by 51 publications

(66 citation statements)

References 28 publications

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“…Model parameters obtained for healthy skin and scar tissue are in line with the values reported for the different dermal layers in previous analyses of skin suction [23,24,26]. This is in agreement with the fact that the experimental data correspond to previously reported ranges for both Cutometer and Nimble [21,28].…”

Section: Discussionsupporting

confidence: 91%

On the Reliability of Suction Measurements for Skin Characterization

Mueller

Elrod

Distler

et al. 2020

Journal of Biomechanical Engineering

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In-vivo skin characterization methods were shown to be useful in detection of microstructural alterations of the dermis due to skin diseases. Specifically the diagnostic potential of skin suction has been widely explored, yet measurement uncertainties prevented so far its application in clinical assessment. In the present work, we analyse specific factors influencing the reliability of suction measurements. We recently proposed a novel suction device, called Nimble, addressing the limitations of existing instruments, and applied it in clinical trials quantifying mechanical differences between healthy skin and scars. Measurements were performed with the commercial device Cutometer and with the new device. A set of new suction measurements was carried out on scar tissue and healthy skin and FE-based inverse analysis was applied to determine corresponding parameters of a hyperelastic-viscoelastic material model. FE simulations were used to rationalize differences between suction protocols and to analyse specific factors influencing the measurement procedure. Tissue stiffness obtained from Cutometer measurements was significantly higher compared to the one from Nimble measurements, which was shown to be associated with the higher deformation levels in the Cutometer and the non-linear mechanical response of skin. The effect of the contact force exerted on skin during suction measurements was quantified, along with an analysis of the effectiveness of a corresponding correction procedure. Parametric studies demonstrated the inherently higher sensitivity of displacement- over load-controlled suction measurements, thus rationalizing the superior ability of the Nimble to distinguish between tissues.

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Section: Discussionsupporting

confidence: 91%

On the Reliability of Suction Measurements for Skin Characterization

Mueller

Elrod

Distler

et al. 2020

Journal of Biomechanical Engineering

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“…Hence, only one neuroradiologist subsequently performed all morphometric measurements on PACS images by using click‐and‐drag electronic calipers in the built‐in image measurement tools of the PACS system. This analysis was quantitative, objective, and unambiguous, thus not requiring measurement of intraobserver reliability that would be necessary for more subjective interpretations (Lee et al, 2019). Moreover, since there were no subjective, qualitative, or semi‐qualitative recordings made in this study, that is, the measurements did not contain any ambiguity in the characteristics of interest in the rating target, it was also not necessary for more than one person to perform the measurements (Lee et al, 2019; Viera & Garrett, 2005).…”

Section: Methodsmentioning

confidence: 99%

“…Hence, only one neuroradiologist subsequently performed all morphometric measurements on PACS images by using click-and-drag electronic calipers in the built-in image measurement tools of the PACS system. This analysis was quantitative, objective, and unambiguous, thus not requiring measurement of intraobserver reliability that would be necessary for more subjective interpretations (Lee et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

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Imaging anatomy of the vertebral canal for trans‐sacral hiatus puncture of the lumbar cistern

2020

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A standard lumbar puncture may be impossible for many anatomic or technical reasons. Previous accounts of caudal epidural anesthesia and other procedures via the sacral hiatus prompted us to test if image‐guided percutaneous trans‐sacral hiatus access to the lumbosacral subarachnoid cistern would be anatomically feasible. To study vertebral canal morphometry and curvature, we analyzed midsagittal computed tomography‐myelogram images of 40 normal subjects and digitally measured sacral curvatures between S1 to S5 and S2 to S4 using two methods whereby a lower angle signifies a straighter sacrum. We measured midsagittal vertebral canal area, hiatus width, dural sac termination levels, and distance from sacral hiatus to the dural sac tip (needle distance). Subjects were F:M = 25:15, with a mean age of 44.9 years. The two S1–S5 full sacral curvature mean angles were 57.3° and 60.4°. Almost all sacral hiatuses were at S4, and dural sac terminations were at S1–S2. The mean S2–S4 sacral curvature was 25.1°, and the mean needle distance was 57.7 mm. Using two‐way analysis of variance, there were significant sex differences for needle distances (p = .001), and full and limited sacral curvatures (p = .02, and p = .046, respectively). There were no significant linear regression correlations between age and sacral curvature, needle distance, canal area, or hiatus width. Therefore, despite a frequently prominent full sacral curvature, the combination of S1–S2 dural sac termination plus a relatively straight trajectory of the lower vertebral canal between S2 and S4 support the theoretical feasibility of percutaneous trans‐sacral hiatus and vertebral canal access to the lumbosacral cistern using a standard spinal needle.

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“…A relatively high gain (mode four gain profile 13, using the DermaScan C) was used for image capture to measure thickness in post-burn scars, which produce hypoechoic images. 56 However, when assessing change in tissue over time, or differences between populations, many factors may affect repeated scanning, with accurate repositioning and the gain settings being key factors. Previous studies utilising HFU vary, with the gain setting being adjusted if thickness measures are being assessed 42,43,53 or standardised if echogenicity is assessed.…”

Section: Ta B L E 4 Primary Lymphoedema (Plo)mentioning

confidence: 99%

Dermal thickness and echogenicity using DermaScan C high frequency ultrasound: Methodology and reliability testing in people with and without primary lymphoedema

Phillips

Reynolds

Gordon

2020

Skin Research and Technology

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Ultrasound has been used to measure in vivo skin thickness and fluid content since the 1980s. 1-4 In particular, the superficial focus of high frequency ultrasound (HFU) (15-22 MHz) results in an image of 1-2 mm depth where the dermis and epidermis are clearly demarcated and accessible for measurement. The distance from the entrance echo (on the surface of the epidermis) to the dermal subcutaneous tissue interface measures total skin thickness. This has been used for optimal site selection of dermal injections in diabetes 5 and vaccines in children and adults, 6 and enabled skin and subcutaneous tissue assessment following prednisolone treatment. 7 The validity of HFU to measure skin thickness was demonstrated in early investigations using a 15 MHz ultrasound and A-mode images by charting

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Investigating the intra- and inter-rater reliability of a panel of subjective and objective burn scar measurement tools

Cited by 51 publications

References 28 publications

On the Reliability of Suction Measurements for Skin Characterization

On the Reliability of Suction Measurements for Skin Characterization

Imaging anatomy of the vertebral canal for trans‐sacral hiatus puncture of the lumbar cistern

Dermal thickness and echogenicity using DermaScan C high frequency ultrasound: Methodology and reliability testing in people with and without primary lymphoedema

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