Open Access
High-Fidelity Digital Burn Assessment: A Clinical Validation of the Digital Tool against Manual Lund and Browder Chart Gold Standard for Total Body Surface Area Estimation
1
Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Malaysia
2
Deparment of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Malaysia
3
Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Malaysia
4
Azman Hashim International Business School, Universiti Teknologi Malaysia, Malaysia
Abstract
Precise total body surface area estimation is paramount for effective burn care. This study aimed to validate the E-Burn app, a digital tool, by comparing its total body surface area estimations against the established Lund and Browder chart, the clinical gold standard. A prospective, cross-sectional study was conducted on 101 burn cases. Total body surface area was independently estimated in parallel using both the E-Burn app and the Lund and Browder chart. Data were analysed using Wilcoxon signed rank tests, Intraclass Correlation Coefficients, and Bland-Altman plots to assess systematic difference, absolute agreement, and bias. The E-Burn app demonstrated excellent agreement with the Lund and Browder chart, achieving an outstanding Intraclass Correlation Coefficients of 0.997. Although a statistically significant median difference was identified (p < 0.001), Bland-Altman analysis quantified this as a clinically minor mean bias of -0.35%. Crucially, the 95% limits of agreement were impressively narrow (+1.32% to -2.02%), indicating minimal random variation and high consistency. The E-Burn app is a precise and highly reliable tool for TBSA estimation, with its minor bias being clinically inconsequential. While this single-centre study warrants future multi-centre validation, these findings robustly support the app’s integration into clinical practice to enhance efficiency and consistency, critically supporting the development of future innovative digital burn tools in Malaysia.
Keywords
Burn,Digital Tool,Total Body Surface Area,Diagnosis Accuracy,Malaysia
How to Cite
Suondoh, M. S., Sukur, S. M., Mat Zain, M. A., & Basiruddin, R. (2025). High-Fidelity Digital Burn Assessment: A Clinical Validation of the Digital Tool against Manual Lund and Browder Chart Gold Standard for Total Body Surface Area Estimation. International Journal of Digital Health & Patient Care, 2(2), 79–85. https://doi.org/10.5281/zenodo.18048397
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