Pilot study of an automated method to determine Melasma Area and Severity Index

Summary Background Objective outcome measures for melasma severity are essential for the evaluation of severity as well as results of treatment. The modified Melasma Area and Severity Index (mMASI) score is a validated tool for assessing melasma severity but is often subject to inter‐observer variab...

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Veröffentlicht in:British journal of dermatology (1951) 2015-06, Vol.172 (6), p.1535-1540
Hauptverfasser: Tay, E.Y., Gan, E.Y., Tan, V.W.D., Lin, Z., Liang, Y., Lin, F., Wee, S., Thng, T.G.
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container_end_page 1540
container_issue 6
container_start_page 1535
container_title British journal of dermatology (1951)
container_volume 172
creator Tay, E.Y.
Gan, E.Y.
Tan, V.W.D.
Lin, Z.
Liang, Y.
Lin, F.
Wee, S.
Thng, T.G.
description Summary Background Objective outcome measures for melasma severity are essential for the evaluation of severity as well as results of treatment. The modified Melasma Area and Severity Index (mMASI) score is a validated tool for assessing melasma severity but is often subject to inter‐observer variability. Objectives To develop and validate a novel image analysis software designed to automatically calculate the area and degree of hyperpigmentation in melasma from computer image analysis of whole‐face digital photographs, thereby deriving an automated mMASI score (aMASI). Methods The algorithm was developed in collaboration between dermatologists and image analysis experts. Firstly, using an adaptive threshold method, the algorithm identifies, segments and calculates the areas involved. It then calculates the darkness. Finally, the derived area and darkness are then used to calculate mMASI. The scores derived from the algorithm are validated prospectively. Twenty‐nine patients with melasma using depigmenting agents were recruited for validation. Three dermatologists scored mMASI at baseline and post‐treatment using standardized photographs. These scores were compared with aMASI scores derived from computer analysis. Results aMASI scores correlated well with clinical mMASI pre‐treatment (r = 0·735, P 
doi_str_mv 10.1111/bjd.13699
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The modified Melasma Area and Severity Index (mMASI) score is a validated tool for assessing melasma severity but is often subject to inter‐observer variability. Objectives To develop and validate a novel image analysis software designed to automatically calculate the area and degree of hyperpigmentation in melasma from computer image analysis of whole‐face digital photographs, thereby deriving an automated mMASI score (aMASI). Methods The algorithm was developed in collaboration between dermatologists and image analysis experts. Firstly, using an adaptive threshold method, the algorithm identifies, segments and calculates the areas involved. It then calculates the darkness. Finally, the derived area and darkness are then used to calculate mMASI. The scores derived from the algorithm are validated prospectively. Twenty‐nine patients with melasma using depigmenting agents were recruited for validation. Three dermatologists scored mMASI at baseline and post‐treatment using standardized photographs. These scores were compared with aMASI scores derived from computer analysis. Results aMASI scores correlated well with clinical mMASI pre‐treatment (r = 0·735, P &lt; 0·001) and post‐treatment (r = 0·608, P &lt; 0·001). aMASI was reliable in detecting changes with treatment. These changes in aMASI scores correlated well with changes in clinician‐assessed mMASI (r = 0·622, P &lt; 0·001). Conclusions This study proposes a novel approach in melasma scoring using digital image analysis. It holds promise as a tool that would enable clinicians worldwide to standardize melasma severity scoring and outcome measures in an easy and reproducible manner, enabling different treatment options to be compared accurately. What's already known about this topic? The Melasma Area and Severity Index (MASI) and modified MASI (mMASI) are the only two validated scores for assessing melasma severity. They are essential to the evaluation of treatment response in trials and in the clinical setting. However, MASI and mMASI scoring is subject to much inter‐observer variability and training is necessary to ensure consistent scoring. What does this study add? A novel image analysis software has been developed to derive automated a MASI scores. Automated mMASI scores correlate well with clinician‐scored mMASI scores.</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1111/bjd.13699</identifier><identifier>PMID: 25641313</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Algorithms ; Automation ; Computer applications ; Dermatology ; Facial Dermatoses - pathology ; Female ; Humans ; Hyperpigmentation ; Image processing ; Image Processing, Computer-Assisted - methods ; Male ; Melanosis - pathology ; Middle Aged ; Pilot Projects ; Software</subject><ispartof>British journal of dermatology (1951), 2015-06, Vol.172 (6), p.1535-1540</ispartof><rights>2015 British Association of Dermatologists</rights><rights>2015 British Association of Dermatologists.</rights><rights>Copyright © 2015 British Association of Dermatologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4619-3715268378c0e190b82fcba82da9dc727ee5177c24f95c022306c39e99f047a73</citedby><cites>FETCH-LOGICAL-c4619-3715268378c0e190b82fcba82da9dc727ee5177c24f95c022306c39e99f047a73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjd.13699$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjd.13699$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25641313$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tay, E.Y.</creatorcontrib><creatorcontrib>Gan, E.Y.</creatorcontrib><creatorcontrib>Tan, V.W.D.</creatorcontrib><creatorcontrib>Lin, Z.</creatorcontrib><creatorcontrib>Liang, Y.</creatorcontrib><creatorcontrib>Lin, F.</creatorcontrib><creatorcontrib>Wee, S.</creatorcontrib><creatorcontrib>Thng, T.G.</creatorcontrib><title>Pilot study of an automated method to determine Melasma Area and Severity Index</title><title>British journal of dermatology (1951)</title><addtitle>Br J Dermatol</addtitle><description>Summary Background Objective outcome measures for melasma severity are essential for the evaluation of severity as well as results of treatment. The modified Melasma Area and Severity Index (mMASI) score is a validated tool for assessing melasma severity but is often subject to inter‐observer variability. Objectives To develop and validate a novel image analysis software designed to automatically calculate the area and degree of hyperpigmentation in melasma from computer image analysis of whole‐face digital photographs, thereby deriving an automated mMASI score (aMASI). Methods The algorithm was developed in collaboration between dermatologists and image analysis experts. Firstly, using an adaptive threshold method, the algorithm identifies, segments and calculates the areas involved. It then calculates the darkness. Finally, the derived area and darkness are then used to calculate mMASI. The scores derived from the algorithm are validated prospectively. Twenty‐nine patients with melasma using depigmenting agents were recruited for validation. Three dermatologists scored mMASI at baseline and post‐treatment using standardized photographs. These scores were compared with aMASI scores derived from computer analysis. Results aMASI scores correlated well with clinical mMASI pre‐treatment (r = 0·735, P &lt; 0·001) and post‐treatment (r = 0·608, P &lt; 0·001). aMASI was reliable in detecting changes with treatment. These changes in aMASI scores correlated well with changes in clinician‐assessed mMASI (r = 0·622, P &lt; 0·001). Conclusions This study proposes a novel approach in melasma scoring using digital image analysis. It holds promise as a tool that would enable clinicians worldwide to standardize melasma severity scoring and outcome measures in an easy and reproducible manner, enabling different treatment options to be compared accurately. What's already known about this topic? The Melasma Area and Severity Index (MASI) and modified MASI (mMASI) are the only two validated scores for assessing melasma severity. They are essential to the evaluation of treatment response in trials and in the clinical setting. However, MASI and mMASI scoring is subject to much inter‐observer variability and training is necessary to ensure consistent scoring. What does this study add? A novel image analysis software has been developed to derive automated a MASI scores. Automated mMASI scores correlate well with clinician‐scored mMASI scores.</description><subject>Algorithms</subject><subject>Automation</subject><subject>Computer applications</subject><subject>Dermatology</subject><subject>Facial Dermatoses - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperpigmentation</subject><subject>Image processing</subject><subject>Image Processing, Computer-Assisted - methods</subject><subject>Male</subject><subject>Melanosis - pathology</subject><subject>Middle Aged</subject><subject>Pilot Projects</subject><subject>Software</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10EFvFCEUB3BiNHZbPfgFDIkXe5j2ATMwHOtW15pqTao18UJYeBNnnRkqMNr99qLb9mAil3f5vT_wJ-QZgyNWzvF644-YkFo_IIsym4ozIR6SBQCoCrQUe2Q_pQ0AE9DAY7LHG1kzwcSCXHzsh5BpyrPf0tBRO1E75zDajJ6OmL8FT3OgHjPGsZ-QvsfBptHSk4i2aE8v8SfGPm_p2eTx5gl51Nkh4dPbeUA-v3n9afm2Or9YnS1PzitXS6YroVjDZStU6wCZhnXLO7e2LfdWe6e4QmyYUo7XnW4ccC5AOqFR6w5qZZU4IC93udcx_JgxZTP2yeEw2AnDnAyTrQRV_l8X-uIfuglznMrrDC9Xc8EbgKIOd8rFkFLEzlzHfrRxaxiYPy2b0rL523Kxz28T5_WI_l7e1VrA8Q786gfc_j_JvHp3ehdZ7Tb6lPHmfsPG70YqoRrz5cPKfL1cXrWnVysjxW9FOZLS</recordid><startdate>201506</startdate><enddate>201506</enddate><creator>Tay, E.Y.</creator><creator>Gan, E.Y.</creator><creator>Tan, V.W.D.</creator><creator>Lin, Z.</creator><creator>Liang, Y.</creator><creator>Lin, F.</creator><creator>Wee, S.</creator><creator>Thng, T.G.</creator><general>Blackwell Publishing Ltd</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201506</creationdate><title>Pilot study of an automated method to determine Melasma Area and Severity Index</title><author>Tay, E.Y. ; Gan, E.Y. ; Tan, V.W.D. ; Lin, Z. ; Liang, Y. ; Lin, F. ; Wee, S. ; Thng, T.G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4619-3715268378c0e190b82fcba82da9dc727ee5177c24f95c022306c39e99f047a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Algorithms</topic><topic>Automation</topic><topic>Computer applications</topic><topic>Dermatology</topic><topic>Facial Dermatoses - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperpigmentation</topic><topic>Image processing</topic><topic>Image Processing, Computer-Assisted - methods</topic><topic>Male</topic><topic>Melanosis - pathology</topic><topic>Middle Aged</topic><topic>Pilot Projects</topic><topic>Software</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tay, E.Y.</creatorcontrib><creatorcontrib>Gan, E.Y.</creatorcontrib><creatorcontrib>Tan, V.W.D.</creatorcontrib><creatorcontrib>Lin, Z.</creatorcontrib><creatorcontrib>Liang, Y.</creatorcontrib><creatorcontrib>Lin, F.</creatorcontrib><creatorcontrib>Wee, S.</creatorcontrib><creatorcontrib>Thng, T.G.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tay, E.Y.</au><au>Gan, E.Y.</au><au>Tan, V.W.D.</au><au>Lin, Z.</au><au>Liang, Y.</au><au>Lin, F.</au><au>Wee, S.</au><au>Thng, T.G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pilot study of an automated method to determine Melasma Area and Severity Index</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2015-06</date><risdate>2015</risdate><volume>172</volume><issue>6</issue><spage>1535</spage><epage>1540</epage><pages>1535-1540</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><abstract>Summary Background Objective outcome measures for melasma severity are essential for the evaluation of severity as well as results of treatment. The modified Melasma Area and Severity Index (mMASI) score is a validated tool for assessing melasma severity but is often subject to inter‐observer variability. Objectives To develop and validate a novel image analysis software designed to automatically calculate the area and degree of hyperpigmentation in melasma from computer image analysis of whole‐face digital photographs, thereby deriving an automated mMASI score (aMASI). Methods The algorithm was developed in collaboration between dermatologists and image analysis experts. Firstly, using an adaptive threshold method, the algorithm identifies, segments and calculates the areas involved. It then calculates the darkness. Finally, the derived area and darkness are then used to calculate mMASI. The scores derived from the algorithm are validated prospectively. Twenty‐nine patients with melasma using depigmenting agents were recruited for validation. Three dermatologists scored mMASI at baseline and post‐treatment using standardized photographs. These scores were compared with aMASI scores derived from computer analysis. Results aMASI scores correlated well with clinical mMASI pre‐treatment (r = 0·735, P &lt; 0·001) and post‐treatment (r = 0·608, P &lt; 0·001). aMASI was reliable in detecting changes with treatment. These changes in aMASI scores correlated well with changes in clinician‐assessed mMASI (r = 0·622, P &lt; 0·001). Conclusions This study proposes a novel approach in melasma scoring using digital image analysis. It holds promise as a tool that would enable clinicians worldwide to standardize melasma severity scoring and outcome measures in an easy and reproducible manner, enabling different treatment options to be compared accurately. What's already known about this topic? The Melasma Area and Severity Index (MASI) and modified MASI (mMASI) are the only two validated scores for assessing melasma severity. They are essential to the evaluation of treatment response in trials and in the clinical setting. However, MASI and mMASI scoring is subject to much inter‐observer variability and training is necessary to ensure consistent scoring. What does this study add? A novel image analysis software has been developed to derive automated a MASI scores. Automated mMASI scores correlate well with clinician‐scored mMASI scores.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25641313</pmid><doi>10.1111/bjd.13699</doi><tpages>6</tpages></addata></record>
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source MEDLINE; Oxford Academic Journals (OUP); Wiley Online Library All Journals
subjects Algorithms
Automation
Computer applications
Dermatology
Facial Dermatoses - pathology
Female
Humans
Hyperpigmentation
Image processing
Image Processing, Computer-Assisted - methods
Male
Melanosis - pathology
Middle Aged
Pilot Projects
Software
title Pilot study of an automated method to determine Melasma Area and Severity Index
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