Interrater and intrarater reliability of the Semmes Weinstein aesthesiometer to assess touch pressure threshold in burn scars.

Burn scars are frequently accompanied with sensory deficits often remaining present months or even years after injury. Clinimetric properties of assessment tools remain understudied within burn literature. Tactile sense of touch can be examined with the touch pressure threshold (TPT) method using the Semmes Weinstein monofilament test (SWMT). There is in recent research no consensus on the exact measurement procedure when using the SWMT. The aim of this paper was to determine the interrater and intrarater reliability of TPT within burn scars and healthy controls using the 'ascending descending' measurement procedure. We used the newly developed guidelines for reporting reliability and agreement studies (GRRAS) as a basis to report this reliability study. In total 36 individuals were tested; a healthy control group and a scar group. The interrater reliability was excellent in the scar group (ICC=0.908/SEM=0.21) and fair to good in the control group (ICC=0.731/SEM=0.12). In the scar group intrarater ICC value was excellent (ICC=0.822/SEM=0.33). Within the control group also an excellent intrarater reliability (ICC=0.807/SEM=0.27) was found. In conclusion this study shows that the SWMT with the 'ascending descending' measurement procedure is a feasible and reliable objective measure to evaluate TPT in (older) upper extremities burn scars as well as in healthy skin.

The effect of social factors on diagnosis and treatment of breast cancer.

This study was made to evaluate the influence of the socio-economic status of a particular population in Northern Antwerp on the epidemiology and treatment of breast cancer. Data concerning patient characteristics, breast cancer pathology, treatment and socio-economical factors were compared with regional, national and worldwide literature. The patients in this series were generally older (61% more than 65 years) and tumour stage was more advanced (only 23% T1 tumours). Treatment therefore was more aggressive. The patients in our population had a lower level of education and lower income, and from a social point of view were more disadvantaged: 21% belonged to the social category of widow(er)s and orphans, while 3% had no social security. Thirty percent of patients in this series declared that late hospitalization depended on their social or financial situation. Preventive care and medical services should therefore be directed to socially and financially disabled classes of patients.