title: Validation of a new imaging device for telemedical ulcer monitoring.
abstract: OBJECTIVE
  To clarify whether a new portable imaging device (PID) providing 3D images for telemedical use constitutes a more correct expression of the clinical situation compared to standard telemedical equipment in this case iPhone 4s.
  
  
  METHODS
  We investigated intra- and interindividual variability between the new portable camera and the iPhone images vs. clinical assessment as the 'gold standard'. The study included 36 foot ulcers. Four specialists rated the ulcers and filled out a questionnaire, which formed the basis of the evaluation.
  
  
  RESULTS
  We found fair to very good intra-rater agreement for the new PID and iPhone, respectively. The gold standard was evaluated by assessing the ulcer twice by two different specialists. Kappa values were moderate to very good with respect to inter-rater agreement except for two variables. The agreement between standard and new equipment compared to the gold standard showed highest agreement with the new PID.
  
  
  CONCLUSIONS
  The new PID is more in accordance with the clinical assessment compared to standard images. It opens for the possibility of using more advanced techniques in a telemedical approach to ulcer treatment and care, including volume measurements.
authors: Department of Medical Endocrinology, Odense University Hospital, Denmark, Odense, Denmark.
authors: B S B
authors: http://orcid.org/0000-0002-7357-0755
authors: BS
authors: Rasmussen
authors: Department of Orthopedic Surgery, Odense University Hospital, Denmark, Odense, Denmark.
authors: J
authors: J
authors: Froekjaer
authors: Department of Medical Endocrinology, Odense University Hospital, Denmark, Odense, Denmark.
authors: L B
authors: LB
authors: Joergensen
authors: Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark.
authors: U
authors: U
authors: Halekoh
authors: Department of Medical Endocrinology, Odense University Hospital, Denmark, Odense, Denmark.
authors: K B
authors: KB
authors: Yderstraede
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046169:Dermoscopy / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D015588:Observer Variation; D010781:Photography / Q000295:instrumentation*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012648:Self Care / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D012883:Skin Ulcer / Q000473:pathology*; D017216:Telemedicine / Q000295:instrumentation*; D055815:Young Adult
keywords: development; gold standard; image; photo; telemedicine; ulcer care