title: Reliability of scar assessments performed with an integrated skin testing device - the DermaLab Combo(®).
abstract: BACKGROUND
  The DermaLab Combo(®) is a device with potential to make objective measurements of key scar components - pigmentation, vascularity, pliability and thickness. This study assessed the inter-rater and test-retest reliability of these measurements.
  
  
  METHODS
  Three raters performed scar assessments on thirty patients with burn scars using the DermaLab Combo(®). Measurements of pigmentation, vascularity, pliability and thickness were made and intra-class correlation coefficients (ICC) were derived for inter-rater and test-retest reliability.
  
  
  RESULTS
  Inter-rater reliability was found to be "excellent" in the 'best' and 'worst' areas of the index scar and normal skin for pigmentation (ICC: 0.94-0.98) and thickness (ICC: 0.86-0.96). Test-retest reliability was also "excellent" for pigmentation (ICC: 0.87-0.89) and thickness (ICC: 0.92-0.97) in all areas. Vascularity showed "good" to "excellent" inter-rater reliability (ICC: 0.66-0.84) in all areas however test-retest reliability was "low" (ICC: 0.29-0.42). Test-retest reliability was "excellent" for pliability (ICC: 0.76-0.91). Technical limitations were encountered making measurements in some scars for thickness, and in particular, pliability.
  
  
  CONCLUSIONS
  The DermaLab Combo(®) measured pigmentation, thickness and pliability with "excellent" reliability. If future studies provide protocols to improve test-retest reliability of vascularity measurements and obtain pliability measurements more successfully, the DermaLab Combo(®) will be valuable device for scar assessment.
authors.affiliation: Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia. Electronic address: Uliya.Gankande@uwa.edu.au.
authors.forename: T U
authors.initials: TU
authors.lastname: Gankande
authors.affiliation: Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Duke
authors.affiliation: Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia; Department of Dermatology, Bispebjerg University Hospital, Denmark.
authors.forename: P L
authors.initials: PL
authors.lastname: Danielsen
authors.affiliation: Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia; Burn Outcomes Centre, Royal Perth Hospital, Australia.
authors.forename: H M
authors.initials: HM
authors.lastname: DeJong
authors.affiliation: Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia; Burn Outcomes Centre, Royal Perth Hospital, Australia.
authors.forename: F M
authors.initials: FM
authors.lastname: Wood
authors.affiliation: Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia.
authors.forename: H J
authors.initials: HJ
authors.lastname: Wallace
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000150:complications*; D002921:Cicatrix / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004548:Elasticity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012867:Skin / Q000098:blood supply / Q000503:physiopathology*; D012880:Skin Pigmentation; D055815:Young Adult
keywords: Burns; Inter-rater reliability; Objective scar measurements; Scar assessment; Test–retest reliability