Ultrasound is a reproducible and valid tool for measuring scar height in children with burn scars: a cross-sectional study of the psychometric properties and utility of the ultrasound and 3D camera

Simons, M., Kee, E. G., Kimble, R. and Tyack, Z. (2017) Ultrasound is a reproducible and valid tool for measuring scar height in children with burn scars: a cross-sectional study of the psychometric properties and utility of the ultrasound and 3D camera. Burns, 43 5: 993-1001. doi:10.1016/j.burns.2017.01.034


Author Simons, M.
Kee, E. G.
Kimble, R.
Tyack, Z.
Title Ultrasound is a reproducible and valid tool for measuring scar height in children with burn scars: a cross-sectional study of the psychometric properties and utility of the ultrasound and 3D camera
Journal name Burns   Check publisher's open access policy
ISSN 1879-1409
0305-4179
Publication date 2017-02-21
Sub-type Article (original research)
DOI 10.1016/j.burns.2017.01.034
Open Access Status Not yet assessed
Volume 43
Issue 5
Start page 993
End page 1001
Total pages 9
Place of publication Kidlington, Oxford, United Kingdom
Publisher Pergamon Press
Language eng
Abstract The aim of this study was to investigate the reproducibility and validity of measuring scar height in children using ultrasound and 3D camera.

Using a cross-sectional design, children with discrete burn scars were included. Reproducibility was tested using Intraclass Correlation Coefficient (ICC) for reliability, and percentage agreement within 1mm between test and re-test, standard error of measurement (SEM), smallest detectable change (SDC) and Bland Altman limits of agreement for agreement. Concurrent validity was tested using Spearman's rho for support of pre-specified hypotheses.

Forty-nine participants (55 scars) were included. For ultrasound, test-retest and inter-rater reproducibility of scar thickness was acceptable for scarred skin (ICC=0.95, SDC=0.06cm and ICC=0.82, SDC=0.14cm). The ultrasound picked up changes of <1mm. Inter-rater reproducibility of maximal scar height using the 3D camera was acceptable (ICC=0.73, SDC=0.55cm). Construct validity of the ultrasound was supported with a strong correlation between the measure of scar thickness and observer ratings of thickness using the POSAS (ρ=0.61). Construct validity of the 3D camera was also supported with a moderate correlation (ρ=0.37) with the same measure using maximal scar height.

The ultrasound is capable of detecting smaller changes or differences in scar thickness than the 3D camera, in children with burn scars. However agreement as part of reproducibility was lower than expected between raters for the ultrasound. Improving the accuracy of scar relocation may go some way to address agreement.
Formatted abstract
Objective: The aim of this study was to investigate the reproducibility and validity of measuring scar height in children using ultrasound and 3D camera.

Method: Using a cross-sectional design, children with discrete burn scars were included. Reproducibility was tested using Intraclass Correlation Coefficient (ICC) for reliability, and percentage agreement within 1. mm between test and re-test, standard error of measurement (SEM), smallest detectable change (SDC) and Bland Altman limits of agreement for agreement. Concurrent validity was tested using Spearman's rho for support of pre-specified hypotheses.

Results: Forty-nine participants (55 scars) were included. For ultrasound, test-retest and inter-rater reproducibility of scar thickness was acceptable for scarred skin (ICC = 0.95, SDC = 0.06. cm and ICC = 0.82, SDC = 0.14. cm). The ultrasound picked up changes of <1. mm. Inter-rater reproducibility of maximal scar height using the 3D camera was acceptable (ICC = 0.73, SDC = 0.55. cm). Construct validity of the ultrasound was supported with a strong correlation between the measure of scar thickness and observer ratings of thickness using the POSAS (ρ = 0.61). Construct validity of the 3D camera was also supported with a moderate correlation (ρ = 0.37) with the same measure using maximal scar height.

Conclusions: The ultrasound is capable of detecting smaller changes or differences in scar thickness than the 3D camera, in children with burn scars. However agreement as part of reproducibility was lower than expected between raters for the ultrasound. Improving the accuracy of scar relocation may go some way to address agreement.
Keyword Burn scar thickness
Cicatrix
Outcome measure
Pediatric
Ultrasound
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Admin only - CHRC
Child Health Research Centre Publications
 
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