OBOS, the One Burn One Standard Initiative

The recent development of software for supporting burn treatment has induced a rethinking of current medical documentation processes of burns. In past, the lack of comparability, scientific evaluation possibilities and – as a consequence – missing medical evidence in this field of medicine showed an increasing urgency to deal with this topic. Advanced electronic possibilities to improve the quality of burn treatment have been developed and shown in recent publications. Two generally different ways were taken for electronically estimation of burn size by creating two dimensional systems like SAGE II[1], Wound Flow[2] or Mersey burns and three dimensional systems , like EPRI Burn Vision 3D[1], BurnCase 3D[3,4], BAI[5], Rapid Burn Assessor[6] or others. Systems are mainly based on Lund Browder Charts or Rule of Nines, others on 3D surface calculations. All methods are based on model libraries, in some applications adaptable to specific parameters of the patient, but till now never meeting perfect adaptation. While two dimensional systems mostly perpetuate the errors of Lund Browder calculations[7–10], which are mainly based on the 2 dimensionality of the models, the lack of presenting the lateral body parts and inadequate models the shortcomings of 3D models are caused by inadequate model selection or representation of a patient’s body shape in these models. Each of these methods has a different degree of inter- observer reliability[9,10] and gives different results even when you don’t take into account inter-rater reliability. So to stay comparable an international standard has to be created. During the 2013 meeting of the American Burns Association (ABA) the Organization for Delivery of Burn Care (ODBC) has decided to form a task force to establish an international standard for documentation of burns. This international intention was started by a kick-off meeting of people working in data documentation. Later on, a presentation was given on the need for an international data collection standard in burn care in the plenary session. Another session discussed practical aspects of defining such standards. The way how to develop this effort to an open, international level has been chosen: Modern internet based media should guarantee open access to interested parties after registration. It has been decided to create a wiki to be able to discuss the issues in a structured manner. In a first step, the support of national and international burn societies will be attempted to form a common intention and to reach consensus on the outmost level. The task force “One Burn One Standard” (OBOS) has been formed and provides the organizational structure of the online platform and of the project. The second step should be a definition of work packages and a prioritization of the separate projects. The aim is to define the medical and technical standards on an international level. Everybody is invited to this initiative.