title: Lack of precision of burn surface area calculation by UK Armed Forces medical personnel.
abstract: OBJECTIVE
  Accurate determination of the severity of burn is essential for the care of thermally injured patients. We aimed to examine the accuracy and precision of TBSA calculation performed by specialist military burn care providers and non-specialist but experienced military clinicians.
  
  
  METHODS
  Using a single case example with photographic montages and a modified Lund and Browder chart, the two cohorts of clinicians were each given 10min to map and calculate the case example TBSA involvement. The accuracy and precision of results from the two cohorts were compared to a set standard %TBSA.
  
  
  RESULTS
  The set standard %TBSA involvement was 64.5%. Mean %TBSA mapped by non-specialists (52.53±10.03%) differed significantly from the set standard (p<0.0001). No difference was observed when comparing results from the burn care providers (65.68±10.29%; p=0.622). However, when comparing precision of calculation of TBSA burned, there was no evidence of a difference in heterogeneity of results between the two cohorts (F test, p=0.639; Levene's test, p=0.448).
  
  
  CONCLUSIONS
  These results indicate that experienced military burn care providers overall more accurately assess %TBSA burned than relatively inexperienced clinicians. However, results demonstrate a lack of precision in both groups.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Derriford Hospital, Plymouth, UK.
authors.forename: Niall A J
authors.initials: NA
authors.lastname: Martin
authors.affiliation: United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Lundy
authors.affiliation: Department of Plastic and Reconstructive Surgery, Derriford Hospital, Plymouth, UK; Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK. Electronic address: roryrickard@nhs.net.
authors.forename: Rory F
authors.initials: RF
authors.lastname: Rickard
mesh_terms: D002056:Burns / Q000175:diagnosis*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005104:Expert Testimony / Q000592:standards*; D006801:Humans; D008887:Military Medicine / Q000592:standards*; D008889:Military Personnel; D012720:Severity of Illness Index; D006113:United Kingdom
keywords: Accuracy; Burn wound mapping; Military burns; Precision