Expert comments

Comments on this technology were invited from clinical experts working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.

All 4 experts who provided comments were familiar with or had used this technology before.

Level of innovation

Three expert commentators thought the technology is a minor variation on an existing laser doppler imaging (LDI) procedure. One expert suggested that LDI has been used as the gold standard for burn depth assessment since NICE published guidance on LDI2‑BI. Another expert noted that healthcare professionals may vary in defining the standard care of burn assessment. For example, some consider clinical assessment as standard care but others would consider LDI as standard care. Two experts indicated that the moorLDLS‑BI would be an add‑on intervention that complements clinical assessment but would not replace real‑time assessment. The experts noted that similar technology such as thermal imaging could be clinically applicable for burn depth assessment.

Potential patient impact

Short scan time and the potential to avoid unnecessary surgery are the benefits identified by all experts. One expert thought that moorLDLS‑BI is more appropriate for children who find it difficult to keep still. They noted that if a child could not keep still for long enough for an LDI scan, the depth assessment might not be accurate based on clinical assessment alone, and subsequently may lead to unnecessary surgery and scarring. All experts agreed that people with major burns or burns of indeterminate depth are most likely to benefit from using moorLDLS‑BI, which could help decision making about their treatment.

Potential system impact

The main benefits for the healthcare system identified by 3 experts were the potential to reduce the number of unnecessary surgical procedures such as skin graft operations and reducing the need for unnecessary dressing care. The experts thought a potential reduction in costs that are associated with hospital stay, follow‑up dressings, and treatment for scarring because of avoidance of unnecessary surgical procedures would outweigh the capital costs for the equipment or costs of providing the service.

General comments

The experts thought moorLDLS‑BI could be used as an add‑on intervention with clinical evaluation for burn depth assessment. None of the experts were aware of any safety issues. All experts agreed that training is needed to use the technology safely and to interpret the results. One expert acknowledged that in some burn services, the technology has not been used regularly. The reasons for infrequent use were unclear. Two experts thought more evidence is needed to show the benefits of moorLDLS‑BI compared with clinical assessment. Another expert also suggested further research is needed to evaluate cost effectiveness and the long‑term outcomes for people who use LDI.