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Glob Health Action. 2017 Jun;10(sup3):1328168. doi: 10.1080/16549716.2017.1328168.

A smartphone-based consultation system for acute burns - methodological challenges related to follow-up of the system.

Author information

a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.
b Stellenbosch Institute for Advanced Study (STIAS) , Wallenberg Research Centre at Stellenbosch University , Stellenbosch , South Africa.
c Division of Emergency Medicine, Faculty of Medicine and Health Sciences , Stellenbosch University , Bellville , South Africa.
d Institute of Social and Health Sciences , University of South Africa , Pretoria , South Africa.



A smartphone-based consultation system for acute burns is currently being implemented in the Western Cape, South Africa. Even though studies indicate that similar systems for burns tend to support valid diagnosis and influence patient management, the evidence is still sparse. There is a need for more in-depth evaluations, not least in resource-constrained settings where mHealth projects are increasing.


This article describes the consultation system and assessments in relation to its implementation with a special focus on methodological challenges.


A number of evaluations and assessments have been conducted, are ongoing or planned for in relation to the implementation of the teleconsultation system. Initial assessments showed that size and depth of burns could be assessed at least as well using photographs as at bedside and that the image quality of handheld devices can be used as well as computers. Studies on system usability are currently being done with a mixed-methods approach. A historical cohort design will be applied to assess the potential health impact of the system. Patients with burn injuries where the doctor at point of care has used the app to receive diagnostic support from a burns expert will be considered as exposed and patients with burn injuries where the app has not been used will be considered as non-exposed.


Smartphone-based consultation systems have the potential to strengthen the assessment of burn injury in many settings. However, ethically and methodologically sound evaluations are needed to find the best systems and solutions. This article identifies challenges and suggests potential assessments in relation to the implementation of such a system.


Acute burns; burn outcome measures; image-based diagnostic; mHealth; mHealth for Improved Access and Equity in Health Care

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