3D技术用于瘢痕表面积测量的有效性和可靠性的临床计量学评估
A clinimetric assessment of the validity and reliability of 3D technology for scar surface area measurement.
作者信息
Doomen M C H A, Rijpma D, Pijpe A, Meij-de Vries A, Niessen F B, Karaoglu S, de Vet H C W, Gevers T, van Zuijlen P P M
机构信息
Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Association of Dutch Burn Centers, Beverwijk 1941 AJ, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Plastic Reconstructive and Hand Surgery, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Movement Sciences, Tissue Function and Regeneration, Amsterdam, the Netherlands.
Burn Center, Red Cross Hospital, Beverwijk, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Plastic Reconstructive and Hand Surgery, De Boelelaan 1117, Amsterdam, Netherlands; Amsterdam Movement Sciences, Tissue Function and Regeneration, Amsterdam, the Netherlands.
出版信息
Burns. 2023 May;49(3):583-594. doi: 10.1016/j.burns.2022.12.008. Epub 2022 Dec 23.
INTRODUCTION
The quality of scars has become an important outcome of burn care. Objective scar assessment through scar surface area measurement enables quantification of scar formation and evaluation of treatment efficacy. 3D technology has proven valid and reliable but often remains cumbersome, expensive, and time-consuming. 3D technology with depth sensors on mobile devices has become available and might surpass these limitations. This study provides a clinimetric assessment of the validity and reliability of a 3D system with a depth sensor for scar surface area measurement.
METHODS
A technology involving a depth sensor mounted on a mobile device was used. Images and analyses were made with a custom-made software application. A standardized one-keyframe image capturing procedure was followed. To assess validity, stickers with predefined dimensions (8.01 cm - 77.70 cm) were imaged in a single observer setting on various body parts of healthy volunteers. To assess reliability, hypertrophic scars, keloids, and normotrophic scars were imaged and rated by two observers independently. Data are expressed as mean (+/-SD), Coefficient of Variation (CV), Intraclass Correlation Coefficients (ICC), and Limits of Agreements (LoA).
RESULTS
Eighty stickers placed on 20 healthy volunteers showed validity with CV between 0.62%- 1.67% for observer A and 0.75%- 1.19% for observer B. For the reliability study, 69 scars on 36 patients were included. Mean scar surface area ranged from 0.83 cm to 155.59 cm. Mean scar surface area measurement was 13.83 cm (SD 23.06) for observer A and 13.59 cm (SD 23.31) for observer B. Adjusted interobserver CV for trained observers is estimated as 5.59%, with corresponding LoA = 0 ± 0.15 x mean surface area. Interobserver ICCs were 0.99-1.00.
CONCLUSION
This 3D technology with a depth sensor for measuring scar surface area provides valid and reliable data and thereby surpasses expensive and time-consuming 3D cameras.
引言
瘢痕质量已成为烧伤护理的一项重要成果。通过瘢痕表面积测量进行客观瘢痕评估能够对瘢痕形成进行量化，并评估治疗效果。3D技术已被证明有效且可靠，但通常仍然繁琐、昂贵且耗时。配备深度传感器的移动设备3D技术已经出现，可能会突破这些限制。本研究对一种带有深度传感器的3D系统在测量瘢痕表面积方面的有效性和可靠性进行了临床测量评估。
方法
采用一种涉及安装在移动设备上的深度传感器的技术。使用定制的软件应用程序进行图像采集和分析。遵循标准化的一键式图像捕捉程序。为评估有效性，在单一观察者设置下，对健康志愿者身体各部位带有预定义尺寸（8.01厘米 - 77.70厘米）的贴纸进行成像。为评估可靠性，由两名观察者独立对增生性瘢痕、瘢痕疙瘩和正常瘢痕进行成像和评级。数据以平均值（±标准差）、变异系数（CV）、组内相关系数（ICC）和一致性界限（LoA）表示。
结果
贴在20名健康志愿者身上的80张贴纸显示出有效性，观察者A的CV在0.62% - 1.67%之间，观察者B的CV在0.75% - 1.19%之间。在可靠性研究中，纳入了36例患者身上的69个瘢痕。瘢痕平均表面积在0.83平方厘米至155.59平方厘米之间。观察者A测得的瘢痕平均表面积为13.83平方厘米（标准差23.06），观察者B测得的为13.59平方厘米（标准差23.31）。经调整后，训练有素的观察者之间的CV估计为5.59%，相应的LoA = 0 ± 0.15×平均表面积。观察者之间的ICC为0.99 - 1.00。
结论
这种带有深度传感器用于测量瘢痕表面积的3D技术提供了有效且可靠的数据，从而超越了昂贵且耗时的3D相机。
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