Reliability Testing of the Matching Assessment using Photographs of Scars (MAPS) App.

The Matching Assessment using Photographs with Scars assessment tool, published in 2005, enables accurate relocation and reassessment of scars. Whilst used in Australia, uptake has been hampered by its paper manual format. With electronic records and increasing use of smart devices in health, here we report the development of the Matching Assessment using Photographs with Scars manual into a mobile application format: ClinMAPSPro. At the time of development, no other digital scar assessment applications were available. For clinical validation, the digitised Matching Assessment using Photographs with Scars module within ClinMAPSPro was used for intra- and inter-rater reliability testing. Convenience sampling was utilised to recruit burns patients representing 44 scars, based on pre-determined power calculations. Three therapists, one experienced and two novice, acted as the assessors. Each therapist assessed pre-selected scars with the digitised Matching Assessment using Photographs with Scars. Re-assessment of the same scar sites occurred 3-7 days later. Inter-rater reliability testing scores of the new electronic assessment application showed fair to moderate agreement (combined Fleiss Kappa = 0.38-0.49, P < 0.0001). Intra-rater reliability scores between initial and repeat measures showed moderate to almost perfect agreement (Cohen's Kappa = 0.43-0.90, P < 0.0001). It was noted that for an experienced rater, intra-rater agreement demonstrated substantial to almost perfect agreement. Intraclass Correlation Coefficients calculated to allow for comparison between other published scar assessment tools demonstrated excellent reliability for all scar assessment parameters for both intra- (=0.76-0.91) and inter- (=0.76-0.98) reliability. Notably, reliability testing results confirm its intra- and inter-rater reliability. Our findings validate this novel concept for digitisation of the previously paper-based scar assessment manual and prove that the Matching Assessment using Photographs with Scars within the ClinMAPSPro application is now readily available for clinicians and researchers internationally. This article is protected by copyright. All rights reserved.