The Matching Assessment using Photographs with Scars (MAPS) App: Reliability testing

Ms Tanja Klotz1, Ms Rochelle Kurmis1

1Royal Adelaide Hospital, Adult Burns Service, Adelaide, Australia


The Matching Assessment using Photographs with Scars (MAPS) scar assessment tool was developed in 2005. MAPS was recommended in a systematic review as a preferred scar assessment tool for enabling accurate relocation for reassessment of scars. It is used across Australia, however, distribution was hampered by the A4 paper manual format.

In addition to the MAPS, the Modified Vancouver Scar Scale (mVSS) and a Patient Reported Outcomes questionnaire was incorporated into a new App to produce a comprehensive scar assessment package: ClinMAPS™Pro. At the time of development no other scar assessment Apps were available, making this the first of its kind.

To ensure the digitised MAPS is a reliable scar assessment, a reliability study was required.

The digitised MAPS module within ClinMAPS™Pro was used for intra- and inter-rater reliability testing. Convenience sampling was utilised to recruit burns patients representing 42 scars, based on pre-determined power calculations. Three therapists, one experienced and two novice, acted as the assessors. Each therapist assessed pre-selected scars with the digitised MAPS. Re-assessment of the same scar sites occurred 3-7 days later.

Inter-rater reliability testing scores showed fair to moderate agreement (combined Fleiss Kappa=0.38-0.49, P<0.0001). Intra-rater reliability scores between initial and repeat measures showed moderate to almost perfect agreement (Cohen’s Kappa=0.43-0.90, P<0.0001).

The digitisation of this scar assessment manual ensures that MAPS within the ClinMAPS™Pro App is now readily available for clinicians and researchers internationally, with electronic or paper reporting options. Results of the reliability testing of the MAPS component confirm its intra- and inter-rater reliability.


Rochelle Kurmis has been the Allied Health Project Manager at the Royal Adelaide Hospital, Adult Burns Service since 2010. Her role incorporates supporting all multi-disciplinary staff in quality management, quality improvement, and research related activities across the continuum of care. She is a current ANZBA member and contributes to the BRANZ steering committee. She also co-chairs the Joanna Briggs Institute Burns Node.


ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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