title: BurnCase 3D software validation study: Burn size measurement accuracy and inter-rater reliability.
abstract: OBJECTIVE
  The aim of this study was to compare the accuracy of burn size estimation using the computer-assisted software BurnCase 3D (RISC Software GmbH, Hagenberg, Austria) with that using a 2D scan, considered to be the actual burn size.
  
  
  METHODS
  Thirty artificial burn areas were pre planned and prepared on three mannequins (one child, one female, and one male). Five trained physicians (raters) were asked to assess the size of all wound areas using BurnCase 3D software. The results were then compared with the real wound areas, as determined by 2D planimetry imaging. To examine inter-rater reliability, we performed an intraclass correlation analysis with a 95% confidence interval.
  
  
  RESULTS
  The mean wound area estimations of the five raters using BurnCase 3D were in total 20.7±0.9% for the child, 27.2±1.5% for the female and 16.5±0.1% for the male mannequin. Our analysis showed relative overestimations of 0.4%, 2.8% and 1.5% for the child, female and male mannequins respectively, compared to the 2D scan. The intraclass correlation between the single raters for mean percentage of the artificial burn areas was 98.6%. There was also a high intraclass correlation between the single raters and the 2D Scan visible.
  
  
  CONCLUSIONS
  BurnCase 3D is a valid and reliable tool for the determination of total body surface area burned in standard models. Further clinical studies including different pediatric and overweight adult mannequins are warranted.
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Daryousch
authors.initials: D
authors.lastname: Parvizi
authors.affiliation: Research Unit for Medical-Informatics, RISC Software GmbH, Johannes Kepler University Linz, Linz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Giretzlehner
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children Galveston, Galveston, TX, USA. Electronic address: wurzer_paul@gmx.at.
authors.forename: Paul
authors.initials: P
authors.lastname: Wurzer
authors.affiliation: Mediwound Ltd., Yavne, Israel.
authors.forename: Limor Dinur
authors.initials: LD
authors.lastname: Klein
authors.affiliation: Department of Plastic and Reconstructive Surgery, Soroka University Medical Center, Beer-Sheba, Israel; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheba, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Shoham
authors.affiliation: Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children Galveston, Galveston, TX, USA.
authors.forename: Fredrick J
authors.initials: FJ
authors.lastname: Bohanon
authors.affiliation: Trauma Hospital Linz of AUVA, Linz, Austria.
authors.forename: Herbert L
authors.initials: HL
authors.lastname: Haller
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Tuca
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children Galveston, Galveston, TX, USA.
authors.forename: Ludwik K
authors.initials: LK
authors.lastname: Branski
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: David B
authors.initials: DB
authors.lastname: Lumenta
authors.affiliation: Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children Galveston, Galveston, TX, USA.
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.affiliation: Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Lars-P
authors.initials: LP
authors.lastname: Kamolz
mesh_terms: D000328:Adult; D001830:Body Surface Area; D002056:Burns / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002648:Child; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008348:Manikins; D015588:Observer Variation; D010865:Pilot Projects; D015203:Reproducibility of Results; D012984:Software
keywords: Burn size estimation; BurnCase 3D; Burns; Software; Total body surface area