Clinical validation of a mHealth App for wound assessment: correlation and reliability study (Preprint)

2020 ◽  
Author(s):  
Ariane DO KHAC ◽  
Claire JOURDAN ◽  
Sylvain FAZILLEAU ◽  
Claire PALAYER ◽  
Isabelle LAFFONT ◽  
...  
Keyword(s):  
Data Storage ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Intraclass Correlation ◽  
Qualitative Evaluation ◽  
Daily Practice ◽  
Minimal Detectable Change ◽  
Free Access ◽  
Wound Assessment ◽  
Cord Injury

BACKGROUND The clinical evaluation of a pressure ulcer is based on a quantitative and qualitative evaluation. In clinical practice, the technique of reference to measure wound surface is the use of acetate tracing, however it is difficult to use in daily practice (availability of the material, data storage issues, time needed to calculate the surface are). Planimetry techniques developed with mobile health (mHealth) apps can overcome these difficulties. OBJECTIVE To evaluate the metrological properties of a free access mHealth app to assess pressure ulcers. METHODS This was a non-interventional validation study (2019_IRB-MTP_06-02). We included patients with spinal cord injury presenting with a pressure ulcer, regardless of its stage or location. We performed wound measurements with a ruler and acetate tracing using a transparent dressing with a wound measurement grid. Wound evaluation via the mHealth app was conducted twice by the main investigator and also with a co-investigator (validity study, intra and inter-rater reproducibility). The Bland-Altman plot and intraclass correlation coefficient (ICC) were used to compute the minimal detectable change expressed as percentage (MDC%). RESULTS Overall, 61 different pressure ulcers were included. Analyses showed that the validity and intra- and inter-rater reliability of the mHealth app vs. acetate tracing (considered the method of reference) were good, with ICC respectively at 0.97 (0.93-0.99), 0.99 (0.98-0.99) and 0.98 (0.96-0.99), and a MDC% between 17 and 35%. CONCLUSIONS This study unveils the good validity and reproducibility of the imitoMeasure app. It could be a proper alternative to standard wound assessment methods. Further studies are needed, especially on larger and more diverse wounds. CLINICALTRIAL ClinicalTrials.gov NCT04402398

scholarly journals mHealth App for Pressure Ulcer Wound Assessment in Patients With Spinal Cord Injury: Clinical Validation Study

10.2196/26443 ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e26443
Author(s):  
Ariane Do Khac ◽  
Claire Jourdan ◽  
Sylvain Fazilleau ◽  
Claire Palayer ◽  
Isabelle Laffont ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pressure Ulcer ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Intraclass Correlation Coefficients ◽  
Wound Assessment ◽  
Cord Injury

Background Clinical evaluation of a pressure ulcer is based on quantitative and qualitative evaluation. In clinical practice, acetate tracing is the standard technique used to measure wound surface area; however, it is difficult to use in daily practice (because of material availability, data storage issues, and time needed to calculate the surface area). Planimetry techniques developed with mobile health (mHealth) apps can be used to overcome these difficulties. Objective The goal of this study was to evaluate the metrological properties of a free-access mHealth app, called imitoMeasure, to assess pressure ulcers. Methods This was a noninterventional, validation study. We included patients with spinal cord injury presenting with a pressure ulcer, regardless of its stage or location. We performed wound measurements with a ruler, and we performed acetate tracing using a transparent dressing with a wound measurement grid. Wound evaluation via the mHealth app was conducted twice by the main investigator and also by a coinvestigator to determine validity, intrarater reproducibility, and interrater reproducibility. Bland-Altman plots and intraclass correlation coefficients were used to compute the minimal detectable change percentage. Results Overall, 61 different pressure ulcers were included. The validity, intrarater reproducibility, and interrater reproducibility of the mHealth app vs acetate tracing (considered the method of reference) were good, with intraclass correlation coefficients of 0.97 (95% CI 0.93-0.99), 0.99 (95% CI 0.98-0.99), and 0.98 (95% CI 0.96-0.99), respectively, and minimal detectable change percentages between 17% and 35%. Conclusions The imitoMeasure app had good validity and reproducibility. It could be an alternative to standard wound assessment methods. Further studies on larger and more diverse wounds are needed. Trial Registration ClinicalTrials.gov NCT04402398; http://clinicaltrials.gov/ct2/show/NCT04402398

scholarly journals “What pressure ulcers mean to me?” Representations of pressure ulcer in persons with spinal cord injury: A qualitative study

2020 ◽  
Vol 29 (4) ◽  
pp. 324-330
Author(s):  
Mathieu GOURLAN ◽  
Alessandra PELLECHIA ◽  
Sandrine ROBINEAU ◽  
Bernard FOULON ◽  
Dominique GAULT ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Qualitative Study ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Cord Injury

scholarly journals Reliability and validity of transfer assessment instrument version 3.0 in individuals with acute spinal cord injury in early rehabilitation phase

2018 ◽  
Vol 38 (02) ◽  
pp. 115-123
Author(s):  
Preeti Baghel ◽  
Shefali Walia ◽  
Majumi M Noohu
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Care Center ◽  
Tertiary Care ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Early Rehabilitation ◽  
Assessment Instrument ◽  
Minimal Detectable Change ◽  
Cord Injury

Background: Transfers are very important in functional activities of subjects with spinal cord injury (SCI). The transfer assessment instrument (TAI) was the first tool to standardize the assessment of transfer technique. Objective: The purpose of this study was to establish the reliability and validity of TAI 3.0 in people with SCI in early rehabilitation phase. Methods: Thirty subjects with acute traumatic SCI were recruited from a tertiary care center for SCI management. Four raters assessed the quality of transfer using TAI 3.0 and a fifth rater used global assessment of transfer scale (VAS). TAI 3.0’s intraclass correlation coefficient (ICC) for intrarater and interrater reliability, standard error of measurement (SEM), minimal detectable change (MDC), limits of agreement and concurrent validity was determined. Results: The intrarater ICC was 0.93 to 0.98 and interrater ICC was 0.99, indicating high levels of reliability. The SEMs among the raters for TAI 3.0 total was from 0.23 to 0.28. The MDC among the raters TAI 3.0 total was from 0.54 to 0.86. Correlation for different raters between the TAI 3.0 and VAS ranged between 0.88 and 0.90. Conclusion: TAI 3.0 is a reliable and valid tool to assess the transfer skill in individuals with SCI in early rehabilitation phase.

Systematic review of behavioral and educational interventions to prevent pressure ulcers in adults with spinal cord injury

2016 ◽  
Vol 31 (7) ◽  
pp. 871-880 ◽  
Author(s):  
Alison M Cogan ◽  
Jeanine Blanchard ◽  
Susan L Garber ◽  
Cheryl LP Vigen ◽  
Mike Carlson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Educational Interventions ◽  
Included Study ◽  
Community Dwelling ◽  
Inclusion Criteria ◽  
Skin Breakdown ◽  
Cord Injury

Objective: To investigate the efficacy of behavioral or educational interventions in preventing pressure ulcers in community-dwelling adults with spinal cord injury (SCI). Data sources: Cochrane, Clinical Trials, PubMed, and Web of Science were searched in June 2016. The search combined related terms for pressure ulcers, spinal cord injury, and behavioral intervention. Each database was searched from its inception with no restrictions on year of publication. Review methods: Inclusion criteria required that articles were (a) published in a peer-reviewed journal in English, (b) evaluated a behavioral or educational intervention for pressure ulcer prevention, (c) included community-dwelling adult participants aged 18 years and older with SCI, (d) measured pressure ulcer occurrence, recurrence, or skin breakdown as an outcome, and (e) had a minimum of 10 participants. All study designs were considered. Two reviewers independently screened titles and abstracts. Extracted information included study design, sample size, description of the intervention and control condition, pressure ulcer outcome measures, and corresponding results. Results: The search strategy yielded 444 unique articles of which five met inclusion criteria. Three were randomized trials and two were quasi-experimental designs. A total of 513 participants were represented. The method of pressure ulcer or skin breakdown measurement varied widely among studies. Results on pressure ulcer outcomes were null in all studies. Considerable methodological problems with recruitment, intervention fidelity, and participant adherence were reported. Conclusions: At present, there is no positive evidence to support the efficacy of behavioral or educational interventions in preventing pressure ulcer occurrence in adults with SCI.

scholarly journals The global burden of pressure ulcers among patients with spinal cord injury: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Wondimeneh Shibabaw Shiferaw ◽  
Tadesse Yirga ◽  
Henok Mulugeta ◽  
Yared Asmare Aynalem
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Meta Analysis ◽  
Test Statistic ◽  
Social Burden ◽  
Cord Injury ◽  
Summary Effect

AbstractBackgroundPressure ulcer, one of the common challenging public health problems affecting patient with spinal cord injury, is the formation of lesion and ulceration on the skin specially in the bony prominence areas. It has a significant impact to the patient and health care system. Moreover, it has psychological, physical, social burden and decrease the quality of life (QoL) of patients. Despite its serious complications, limited evidence is available on the global magnitude of pressure ulcers among patient with spinal cord injury. Hence, the objective of this systematic review and meta-analysis was to estimate the global magnitude of pressure ulcers among patient with spinal cord injury.MethodsPubMed, Scopus, Google Scholar, Africa journal online, PsycINFO and web-science were systematically searched online to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline was followed. The random-effects model was fitted to estimate the summary effect. To investigate heterogeneity across the included studies, I2 test was employed. Publication bias was examined using funnel plot and Egger’s regression test statistic. All statistical analysis was done using STATA version 14 software for windows.ResultsTwenty-four studies which comprises of 600,078 participants were included in this meta-analysis. The global pooled magnitude of pressure ulcer among patients with spinal cord injury was 32.36% (95% CI (28.21, 36.51%)). Based on the subgroup analysis, the highest magnitude of pressure ulcer was observed in Africa 41.19% (95% CI: 31.70, 52.18).ConclusionThis systematic review and meta-analysis revealed that about one in three patients with spinal cord injury had pressure ulcers. This implies that the overall global magnitude of pressure ulcer is relatively high. Therefore, policymakers (FMoH) and other concerned bodies need give special attention to reduce the magnitude of pressure ulcers in patient with spinal cord injury.

scholarly journals Assessment of pressure ulcers in physically handicapped patients

2020 ◽  
Author(s):  
J. Neugebauer ◽  
V. Tóthová
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Practice ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Care Quality ◽  
Cord Injury ◽  
Norton Scale ◽  
Physically Handicapped ◽  
Assessment Scales

AbstractPurposeAssessment of pressure ulcers is an indicator of nursing care quality. In physically handicapped patients, the risk is elevated, due to the neuropathy and incontinence that frequently accompany paresis and paralysis. We conducted a systematic review of 4 assessment scales to assess their use and usefulness for these patients.Materials/methodsWe searched 5 databases for articles published between 2016 and 2018 that included terms related to the risk of pressure ulcers in physically handicapped patients, including the names of 4 assessment scales (Norton, Braden, Waterlow and Spinal Cord Injury Pressure Ulcer Scale). One hundred and three sources were returned, from which we selected 10. We also selected an earlier source, for a total of 11.ResultsThe Braden and Waterlow scales are popular in clinical practice. The Norton scale is used for scientific comparisons and in clinical practice only sporadically. Expert opinion suggests that acceptance of the Spinal Cord Injury Pressure Ulcer Scale could reduce the incidence of pressure ulcers in physically handicapped patients.ConclusionsIntroduction of a scale designed for handicapped patients, combined with better preventive measures, could result in the bedsore reduction of pressure ulcers. Research testing the effectiveness of the Spinal Cord Injury Pressure Ulcer Scale in the Czech population is needed to validate its use in clinical practice.

scholarly journals An Overview on Pressure Ulcers: Prevention and Management

2021 ◽  
pp. 17-23
Author(s):  
Nasib Kasem Al Shibli ◽  
Bader Menwer N. Albilasi ◽  
Talal Tuwayjir Y. Alruwaili ◽  
Dalal Ali D. Alazmi ◽  
Yazeed Mayah D. Alazmi ◽  
...  
Keyword(s):  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Wound Care ◽  
Major Complication ◽  
The Elderly ◽  
Developed Countries ◽  
Wound Dressings ◽  
Tissue Ischemia ◽  
Cord Injury ◽  
Support Surfaces

Pressure ulcers are significant and painful side effects that might indicate a lack of care. The formation of a pressure ulcer is a major complication of reduced mobility. And since over 65-year-olds are the fastest-growing sector of the population in many developed countries, it imposes the risk of increasing disease incidences. There are also higher rates of obesity, diabetes, and cardiovascular disease, which also increase the risk. There are many causes that can contribute to the formation of pressure ulcers; tissue ischemia is the most prevalent route to ulceration. Pressure ulcer prevention generally begins with an examination to determine who is most vulnerable to pressure ulcers, such as the elderly, the immobile, or individuals with a spinal cord injury. Wound dressings, debridement, physical therapy, antibiotics, and antimicrobials are all possible therapeutic options for pressure ulcers. Interventions such as mobilization, positioning, and repositioning, as well as support surfaces, are utilized in conjunction with other wound care methods. In this review we’ll be looking at prevention and management of pressure ulcers.

scholarly journals Reliability of three-dimensional kinematic gait data in adults with spinal cord injury

2017 ◽  
Vol 4 ◽  
pp. 205566831772999 ◽  
Author(s):  
Pia Wedege ◽  
Kathrin Steffen ◽  
Vegard Strøm ◽  
Arve Isak Opheim
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Cord Injury ◽  
Hip Rotation ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Objectives Three-dimensional gait analysis has been recommended as part of standardized gait assessment in people with spinal cord injury. The aim was to investigate inter- and intra-session reliabilities of gait kinematics in people with spinal cord injury. Methods Fifteen adults with spinal cord injury performed two test sessions on separate days. Six infrared cameras, 16 reflective markers and the Plug-in gait model were used. For each subject, five gait trials from both sessions were included. The Gait Profile Score and the Gait Variable Score were used as kinematic outcome measures. Reliability was assessed with intraclass correlation coefficient, standard error of measurement, minimal detectable change, and Bland–Altman plots. Results Inter-session intraclass correlation coefficient for all variables was >0.82 and standard error of measurement <1.8°, except for hip rotation. Intra-session reliability was found to be high (≥0.78) and slightly better than that for inter-session. Minimal detectable change for all variables was <4.7°, except for hip rotation. Conclusions The high inter- and intra-session reliabilities indicate small intrinsic variation of gait. Thus, three-dimensional gait analysis seems to be a reliable tool to evaluate kinematic gait in adults with spinal cord injury, but caution is warranted especially for hip rotation evaluation.

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