Cost-effectiveness of Laser Doppler Imaging in Burn Care

Quality of life is measured with the EuroQol-5D in patient ≥ 5 years old (Bouillon et al., 2002) or the ItQol-47 in patients <5 years old (Raat et al., 2007):

1. Baseline measurement within one month post burn
2. Second measurement within 3 months post burn

Scar quality is measured after 3 months:

1. Scar elasticity with the Cutometer® Skin Elasticity Meter 575 (Draaijers et al., 2004)
2. Vascularity and pigmentation with the Dermaspectometer (Draaijers et al., 2004)
3. Self-reported scar quality: Patients Observer Scar Assessment Scale (van der Wal et al., 2011)

Effect of the introduction of the LDI will be assessed by comparing diagnostic decisions of burn clinicians, before and after the use of LDI.

Possible diagnostic decisions are (Monstrey et al., 2011):

• Superficial dermal burn, will heal (within 14 days)
• Intermediate burn (possible will heal, or needs grafting)
• Deep dermal or subdermal (full thickness) burn, needs grafting (will not heal within 21 days)

The possible therapeutic decisions are:

• Surgery
• Postponement of decision
• No surgery

Costs from a societal perspective are calculated (following the Dutch guidelines from Oostenbrink et al., 2004):

1. Costs during hospital stay
2. Outpatient costs
3. Non-hospital and non-medical costs

In case of differences in patient outcome (wound healing time and scar quality) between both diagnostic strategies, cost-effectiveness will be calculated by dividing the difference in average costs by the difference in average time of wound healing or scar quality.

In case of difference in quality of life between both diagnostic strategies, cost-utility will be calculated by dividing the difference in average costs by the difference in Quality Adjusted Life Years (QALY's).