Comparison of wound surface area measurements obtained using clinically validated artificial intelligence-based technology versus manual methods and the effect of measurement method on debridement code reimbursement cost.

IF 1.4 4区医学 Q3 DERMATOLOGY

Wounds : a compendium of clinical research and practice Pub Date : 2023-10-01

Misael C Alonso, Heba Tallah Mohammed, Robert D Fraser, Jose L Ramirez Garcia Luna, David Mannion

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引用次数: 0

Abstract

Background: Evidence shows that ongoing accurate wound assessments using valid and reliable measurement methods is essential to effective wound monitoring and better wound care management. Relying on subjective interpretation in measuring wound dimensions and assuming a rectilinear shape of all wounds renders an inconsistent and inaccurate wound area measurement.

Objective: The authors investigated the discrepancy in wound area measurements using a DWMS versus TPR methods and compared debridement codes submitted for reimbursement by assessment method.

Methods: The width and length of 177 wounds in 56 patients were measured at an outpatient clinic in the United States using the TPR method (width × length formula) and a DWMS (traced wound dimensions). The maximal allowable payment for debridement was calculated for both methods using the reported CPT codes based on each 20-cm2 estimated surface area.

Results: The average wound surface area was significantly higher with the TPR method than with the DWMS (20.20 and 12.81, respectively; P = .025). For patients with dark skin tones, ill-defined wound edges, irregular wound shapes, unhealthy tissues, and the presence of necrotic tissues, the use of the DWMS resulted in significantly lower mean differences in wound area measurements of 14.4 cm2 (P < .008), 8.2 cm2 (P = .040), 6.8 cm2 (P = .045), 13.1 cm2 (P = .036), and 7.6 cm2 (P = .043), respectively, compared with the TPR method. Use of the DWMS for wound surface area measurement resulted in a 10.6% lower reimbursement amount for debridement, with 82 fewer submitted codes, compared with the TPR method.

Conclusions: Compared with the DWMS, TPR measurements overestimated wound area more than 36.6%. This overestimation was associated with dark skin tones and wounds with irregular edges, irregular shapes, and necrotic tissue.

本刊更多论文

采用临床验证的基于人工智能的技术与手工方法获得的创面面积测量值的比较以及测量方法对清创代码报销成本的影响。

背景:证据表明，使用有效和可靠的测量方法进行持续准确的伤口评估对于有效的伤口监测和更好的伤口护理管理至关重要。在测量伤口尺寸时，依靠主观解释，假设所有伤口都是直线形状，会导致伤口面积测量不一致和不准确。目的:探讨采用DWMS和TPR方法测量创面面积的差异，并比较通过评估方法提交报销的清创代码。方法:采用TPR法(宽度×长度公式)和DWMS法(追踪创面尺寸)测量56例美国门诊177例创面的宽度和长度。根据每20平方厘米的估计表面面积，使用报告的CPT代码计算两种方法的最大允许清创费用。结果:TPR法的平均创面面积显著高于DWMS法(分别为20.20和12.81);P = .025)。对于肤色深、创面边缘不清晰、创面形状不规则、组织不健康、存在坏死组织的患者，与TPR法相比，使用DWMS的创面面积测量的平均差异显著降低，分别为14.4 cm2 (P < 0.008)、8.2 cm2 (P = 0.040)、6.8 cm2 (P = 0.045)、13.1 cm2 (P = 0.036)和7.6 cm2 (P = 0.043)。与TPR方法相比，使用DWMS进行创面面积测量导致清创报销金额降低10.6%，提交的代码减少82个。结论:与DWMS相比，TPR测量高估创面面积超过36.6%。这种高估与肤色深、伤口边缘不规则、形状不规则和组织坏死有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Wounds : a compendium of clinical research and practice 医学-皮肤病学

CiteScore

1.50

自引率

11.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Wounds is the most widely read, peer-reviewed journal focusing on wound care and wound research. The information disseminated to our readers includes valuable research and commentaries on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies. Our multidisciplinary readership consists of dermatologists, general surgeons, plastic surgeons, vascular surgeons, internal medicine/family practitioners, podiatrists, gerontologists, researchers in industry or academia (PhDs), orthopedic surgeons, infectious disease physicians, nurse practitioners, and physician assistants. These practitioners must be well equipped to deal with a myriad of chronic wound conditions affecting their patients including vascular disease, diabetes, obesity, dermatological disorders, and more. Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest in research and practice in this ever-growing field of medicine.