title: The use of real-time digital video in the assessment of post-operative outcomes of breast reconstruction.
abstract: BACKGROUND
  Outcome measures of breast reconstruction have used panel assessment of photographs. This provides limited information to the assessor as these images are static.. The aim of this study was to assess whether the use of digital video was a valid assessment tool and to compare its use against photography.
  
  
  METHODS
  35 patients post-reconstruction underwent photography, digital video capture and completed Breast Cancer Treatment Outcomes Scale (BCTOS) questionnaires. The photographs/video clips were randomised and shown to a 21 member panel. Opinions on aesthetic aspects of the reconstruction were assessed using the BCTOS and Harris scale. Panel inter-rater agreement and patient-panel correlation was assessed using Kendall's Coefficient of Concordance and Spearman's rank correlation tests respectively.
  
  
  RESULTS
  There was a "moderate" degree of inter-rater agreement amongst panel members in all categories. Greater agreement occurred using video footage to assess overall cosmesis (0.548 vs 0.507) and shape (0.505 vs 0.486). Video showed a greater degree of correlation with patient self-assessment scores in comparison to photography (0.311 vs 0.281).
  
  
  CONCLUSIONS
  Video footage coupled with panel assessment is a valid method of assessing post-operative outcomes of breast reconstruction and appears superior to still photographs in terms of inter-rater agreement and correlation with patient self-assessment.
authors.affiliation: Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK. Electronic address: adam.gilmour@nhs.net.
authors.forename: A
authors.initials: A
authors.lastname: Gilmour
authors.affiliation: Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK.
authors.forename: I R
authors.initials: IR
authors.lastname: Mackay
authors.affiliation: Department of Mathematics & Statistics, University of Strathclyde, Glasgow G1 1XQ, UK.
authors.forename: D
authors.initials: D
authors.lastname: Young
authors.affiliation: Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Hill
authors.affiliation: Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK.
authors.forename: L
authors.initials: L
authors.lastname: Brown
authors.affiliation: Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Malyon
mesh_terms: D003199:Computer Systems; D005260:Female; D006801:Humans; D016462:Mammaplasty; D017060:Patient Satisfaction; D010781:Photography; D015203:Reproducibility of Results; D013524:Surgical Flaps; D016896:Treatment Outcome; D014741:Video Recording
keywords: Breast reconstruction; Digital video; Standardised photographs; Subjective assessment