Quantitative Measurement of Hypertrophic Scar: Interrater Reliability and Concurrent Validity

Abstract

Research into the pathophysiology and treatment of hypertrophic scar (HSc) remains limited by the heterogeneity of scar and the imprecision with which its severity is measured. The objective of this study was to test the interrater reliability and concurrent validity of the Cutometer measurement of elasticity, the Mexameter measurement of erythema and pigmentation, and total thickness measure of the DermaScan C relative to the modified Vancouver Scar Scale (mVSS) in patient-matched normal skin, normal scar, and HSc. Three independent investigators evaluated 128 sites (severe HSc, moderate or mild HSc, donor site, and normal skin) on 32 burn survivors using all of the above measurement tools. The intraclass correlation coefficient, which was used to measure interrater reliability, reflects the inherent amount of error in the measure and is considered acceptable when it is >0.75. Interrater reliability of the totals of the height, pliability, and vascularity subscales of the mVSS fell below the acceptable limit ( congruent with0.50). The individual subscales of the mVSS fell well below the acceptable level (< or =0.3). The Cutometer reading of elasticity provided acceptable reliability (>0.89) for each study site with the exception of severe scar. Mexameter and DermaScan C reliability measurements were acceptable for all sites (>0.82). Concurrent validity correlations with the mVSS were significant except for the comparison of the mVSS pliability subscale and the Cutometer maximum deformation measure comparison in severe scar. In conclusion, the Mexameter and DermaScan C measurements of scar color and thickness of all sites, as well as the Cutometer measurement of elasticity in all but the most severe scars shows high interrater reliability. Their significant concurrent validity with the mVSS confirms that these tools are measuring the same traits as the mVSS, and in a more objective way.

Sympathetic influence on biomechanical skin properties after spinal cord injury

“…All the parameters measured by Cutometer are related to the composition and structure of the skin that exhibits high inter-and intra-rater reliability. [9][10] The parameters consist of the following biomechanical skin properties: distensibility, elasticity and viscoelasticity. And they can be divided into absolute and relative parameters.…”

Managing Scars: Measurements to Improve Scar Management

“…Already many different devices are available such as DermaScan (Cortex Technology) and studies on validation as well as in clinical scenarios were performed. They have demonstrated to be reliable and accurate [ 33,34 ] . Lau et al [ 35 ] used an ultra sound palpation system (TUPS -tissue ultrasound palpation system) which is portable.…”

Measurement of change in the mechanical properties of burned skin to therapist intervention with a vacuum device

“…reported as low as 0.07-0.50 [2,3]. Therefore, it would be beneficial for burn care providers to have access to reliable and valid instruments that provide high quality data regarding change in burn scars due to interventions.…”