Clinician Inter-rater Reliability Using a Medical Wound Imaging System

The ability to determine the effectiveness of alternative treatments in the management of wounds is central to wound research and ultimately to the development of sound evidence on which to base clinical decision making. Measurement precision is therefore a critical factor in research which aims to determine the effects of treatment on healing rates, especially when the research is being conducted across sites and measurements are being made by different individuals. Additionally, as with any digital planimetric system, the quality of the measurement is dependent on the skill of the operator, therefore it is considered essential to measure the inter-rater reliability of the measuring system used. This paper describes how the inter-rater reliability of the Alfred/Medseed Wound Imaging System, now known as the Advanced Medical Wound Imaging System (AMWIS) was established. Four clinicians involved in the trial were asked to independently trace (measure) the same 20 wound images using AMWIS. The data collected for each image included the total area and the various tissue characteristics for the wound. The results showed that there was high inter-rater reliability for the measures of total area, granulation and slough. Additional feedback suggested that better definitions and guidelines to assist in the differentiation and recording of tissue characteristics would be of value to the users.