How reliably can ultrasound help determine muscle and adipose tissue thickness in clinical settings? An assessment of intra- and inter-examiner reliability in the USVALID study

Reliability and feasibility of skeletal muscle ultrasound in the acute burn setting

“…Many previous studies have examined the reliability of QMLT and RF-CSA measurements in the critically-ill population, primarily using the no-compression technique, producing high inter-rater reliability coefficients (ICC >0.9) and small interrater differences (<0.1 cm) comparable to this study [37,[41][42][43]46,59,[70][71][72]. However, to the best of our knowledge, no study has to date examined ultrasound as a tool to measure muscle parameters in the burn population.…”

“…Small shifts in transducer position might therefore result in different thickness measurements, although this issue is inherent to all protocols using body landmarks [59].…”

“…One such limitation was the fact that skin markings were not erased between raters, as most measurements had to take place during a very limited time window (during dressing changes) and we were unable to erase skin markings during the same session. While this choice might have overestimated reliability by eliminating potential variability associated with landmarking [59], it is the authors' experience from pilot testing that most of the observed procedural variability did not originate from landmarking, but rather from the ultrasound performance (applied tissue compression and tilt of the transducer) [60]. Nevertheless, in selected burn patients with intact thigh surface, the use of permanent skin markings, as is common in non-burned patient populations, might in fact be desirable for examining longitudinal changes [41].…”