title: Body surface assessment with 3D laser-based anthropometry: reliability, validation, and improvement of empirical surface formulae.
abstract: OBJECTIVE
  Body surface area is a physiological quantity relevant for many medical applications. In clinical practice, it is determined by empirical formulae. 3D laser-based anthropometry provides an easy and effective way to measure body surface area but is not ubiquitously available. We used data from laser-based anthropometry from a population-based study to assess validity of published and commonly used empirical formulae.
  
  
  METHODS
  We performed a large population-based study on adults collecting classical anthropometric measurements and 3D body surface assessments (N = 1435). We determined reliability of the 3D body surface assessment and validity of 18 different empirical formulae proposed in the literature. The performance of these formulae is studied in subsets of sex and BMI. Finally, improvements of parameter settings of formulae and adjustments for sex and BMI were considered.
  
  
  RESULTS
  3D body surface measurements show excellent intra- and inter-rater reliability of 0.998 (overall concordance correlation coefficient, OCCC was used as measure of agreement). Empirical formulae of Fujimoto and Watanabe, Shuter and Aslani and Sendroy and Cecchini performed best with excellent concordance with OCCC > 0.949 even in subgroups of sex and BMI. Re-parametrization of formulae and adjustment for sex and BMI slightly improved results.
  
  
  CONCLUSIONS
  In adults, 3D laser-based body surface assessment is a reliable alternative to estimation by empirical formulae. However, there are empirical formulae showing excellent results even in subgroups of sex and BMI with only little room for improvement.
authors.affiliation: Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany. andreas.kuehnapfel@imise.uni-leipzig.de.|Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany. andreas.kuehnapfel@imise.uni-leipzig.de.
authors.forename: Andreas
authors.identifier: http://orcid.org/0000-0003-3668-0784
authors.initials: A
authors.lastname: Kuehnapfel
authors.affiliation: Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany.|Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ahnert
authors.affiliation: Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany.|Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Loeffler
authors.affiliation: Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany.|Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Scholz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods; D001830:Body Surface Area; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007834:Lasers; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012737:Sex Factors
keywords: 3D body scanner; Anthropometry; Body surface area; Reliability; Validity