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Use of standardized, quantitative digital photography in a multicenter Web-based study.

Molnar JA, Lew WK, Rapp DA, Gordon ES, Voignier D, Rushing S, Willner W - Eplasty (2009)

Bottom Line: Digital photography is a simple and cost-effective method for quantifying wound size when used in conjunction with digital planimetry (SigmaScan) and photo enhancement (Adobe Photoshop) programs.The accuracy of the SigmaScan program in calculating predetermined areas was within 4.7% (95% CI, 3.4%-5.9%).Images obtained by individuals denying experience in photography proved reliable and useful for clinical evaluation and quantification of wound area.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA. jmolnar@wfubmc.edu

ABSTRACT

Objective: We developed a Web-based, blinded, prospective, randomized, multicenter trial, using standardized digital photography to clinically evaluate hand burn depth and accurately determine wound area with digital planimetry.

Methods: Photos in each center were taken with identical digital cameras with standardized settings on a custom backdrop developed at Wake Forest University containing a gray, white, black, and centimeter scale. The images were downloaded, transferred via the Web, and stored on servers at the principal investigator's home institution. Color adjustments to each photo were made using Adobe Photoshop 6.0 (Adobe, San Jose, Calif). In an initial pilot study, model hands marked with circles of known areas were used to determine the accuracy of the planimetry technique. Two-dimensional digital planimetry using SigmaScan Pro 5.0 (SPSS Science, Chicago, Ill) was used to calculate wound area from the digital images.

Results: Digital photography is a simple and cost-effective method for quantifying wound size when used in conjunction with digital planimetry (SigmaScan) and photo enhancement (Adobe Photoshop) programs. The accuracy of the SigmaScan program in calculating predetermined areas was within 4.7% (95% CI, 3.4%-5.9%). Dorsal hand burns of the initial 20 patients in a national study involving several centers were evaluated with this technique. Images obtained by individuals denying experience in photography proved reliable and useful for clinical evaluation and quantification of wound area.

Conclusion: Standardized digital photography may be used quantitatively in a Web-based, multicenter trial of burn care. This technique could be modified for other medical studies with visual endpoints.

No MeSH data available.


Related in: MedlinePlus

To determine the accuracy of the SigmaScan planimetry, wound models with                        known areas were created with circles of diameter 4 cm.
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Figure 1: To determine the accuracy of the SigmaScan planimetry, wound models with known areas were created with circles of diameter 4 cm.

Mentions: The techniques outlined were designed for a clinical study to evaluate a new technique of acute burn care.1 Since visual observation remains the “gold standard” to determine the size of the wounds, it was necessary to develop a quantitative and standardized technique of digital photography that would allow objective evaluation by digital planimetry. Before applying this technique clinically, it was necessary to validate the technique in the laboratory with a simulated wound model. Once this validation was completed, we could apply the technique in a prospective multicenter trial. To determine the accuracy of the planimetry technique, standard wound models of known size were created on a volunteer hand. The dorsa of 3 separate hands were marked with 3 circular templates of a predetermined area of 12.566 cm2 each circle. Care was taken to ensure that the final diameter on the hand was 4 cm. A circle shape was used as this is potentially one of the most difficult shapes to outline accurately with the planimetry techniques used. Images were obtained using the same method and custom backdrop described below. The model hand was repositioned and images were captured 4 times for 3 separate hands, for a total of 12 images. The digital planimetry program, SigmaScan Pro 5.0 (SPSS Science, Chicago, Ill), was then used to calculate the areas marked from each image (Fig 1). The sum of the 3 circular areas were calculated and then compared with the actual predetermined areas of 37.698 cm2 (=3 × 12.566 cm2). The data were analyzed using a t test.


Use of standardized, quantitative digital photography in a multicenter Web-based study.

Molnar JA, Lew WK, Rapp DA, Gordon ES, Voignier D, Rushing S, Willner W - Eplasty (2009)

To determine the accuracy of the SigmaScan planimetry, wound models with                        known areas were created with circles of diameter 4 cm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627310&req=5

Figure 1: To determine the accuracy of the SigmaScan planimetry, wound models with known areas were created with circles of diameter 4 cm.
Mentions: The techniques outlined were designed for a clinical study to evaluate a new technique of acute burn care.1 Since visual observation remains the “gold standard” to determine the size of the wounds, it was necessary to develop a quantitative and standardized technique of digital photography that would allow objective evaluation by digital planimetry. Before applying this technique clinically, it was necessary to validate the technique in the laboratory with a simulated wound model. Once this validation was completed, we could apply the technique in a prospective multicenter trial. To determine the accuracy of the planimetry technique, standard wound models of known size were created on a volunteer hand. The dorsa of 3 separate hands were marked with 3 circular templates of a predetermined area of 12.566 cm2 each circle. Care was taken to ensure that the final diameter on the hand was 4 cm. A circle shape was used as this is potentially one of the most difficult shapes to outline accurately with the planimetry techniques used. Images were obtained using the same method and custom backdrop described below. The model hand was repositioned and images were captured 4 times for 3 separate hands, for a total of 12 images. The digital planimetry program, SigmaScan Pro 5.0 (SPSS Science, Chicago, Ill), was then used to calculate the areas marked from each image (Fig 1). The sum of the 3 circular areas were calculated and then compared with the actual predetermined areas of 37.698 cm2 (=3 × 12.566 cm2). The data were analyzed using a t test.

Bottom Line: Digital photography is a simple and cost-effective method for quantifying wound size when used in conjunction with digital planimetry (SigmaScan) and photo enhancement (Adobe Photoshop) programs.The accuracy of the SigmaScan program in calculating predetermined areas was within 4.7% (95% CI, 3.4%-5.9%).Images obtained by individuals denying experience in photography proved reliable and useful for clinical evaluation and quantification of wound area.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA. jmolnar@wfubmc.edu

ABSTRACT

Objective: We developed a Web-based, blinded, prospective, randomized, multicenter trial, using standardized digital photography to clinically evaluate hand burn depth and accurately determine wound area with digital planimetry.

Methods: Photos in each center were taken with identical digital cameras with standardized settings on a custom backdrop developed at Wake Forest University containing a gray, white, black, and centimeter scale. The images were downloaded, transferred via the Web, and stored on servers at the principal investigator's home institution. Color adjustments to each photo were made using Adobe Photoshop 6.0 (Adobe, San Jose, Calif). In an initial pilot study, model hands marked with circles of known areas were used to determine the accuracy of the planimetry technique. Two-dimensional digital planimetry using SigmaScan Pro 5.0 (SPSS Science, Chicago, Ill) was used to calculate wound area from the digital images.

Results: Digital photography is a simple and cost-effective method for quantifying wound size when used in conjunction with digital planimetry (SigmaScan) and photo enhancement (Adobe Photoshop) programs. The accuracy of the SigmaScan program in calculating predetermined areas was within 4.7% (95% CI, 3.4%-5.9%). Dorsal hand burns of the initial 20 patients in a national study involving several centers were evaluated with this technique. Images obtained by individuals denying experience in photography proved reliable and useful for clinical evaluation and quantification of wound area.

Conclusion: Standardized digital photography may be used quantitatively in a Web-based, multicenter trial of burn care. This technique could be modified for other medical studies with visual endpoints.

No MeSH data available.


Related in: MedlinePlus