Easy Volumeter in Detection of Breast Cancer-Related Lymphedema: A Validity Study

Onur Engin, MD,1 Elif Akalın, MD,2 Efe Sarıbay, MS,3 Ceren Aslan, MD,2 Ebru S xahin, MD,2 and Serap Alper, MD2. Lymphatic Research Biology, February 2019

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Easy Volumeter in Detection of Breast Cancer-Related Lymphedema: A Validity Study

Onur Engin, MD,1 Elif Akalın, MD,2 Efe Sarıbay, MS,3 Ceren Aslan, MD,2 Ebru S xahin, MD,2 and Serap Alper, MD2. Lymphatic Research Biology, February 2019

Aim and Hypothesis: The standard volumeter is heavy and fragile, and using the same volumeter for different patients can result in hygiene problems. These disadvantages point to the need for the development of a new model of volumeter. The new volumeter put forward in this study is lighter, smaller, sturdier, and easier to clean, while also having its own scale. In this study, the validity of this newly designed volumeter is investigated.

Materials and Methods: In the first step, the volume of standard cylinders was measured thrice using a standard volumeter and an easy-measurement volumeter, after which a total of 30 arm volumes of 15 volunteers were measured. In the final stage, the arms of 28 patients with breast cancer-related lymphedema were measured once with both volumeters and the mean results were compared.

Results: There was a high degree of consistency between the measured volumes of cylinders of known volume when measured with a standard volumeter and the ‘‘Easy volumeter.’’ The measured mean volumes with the two volumeters were assessed with paired sample t-test, resulting in a significance (p-value) of 0.927, indicating no difference between the measurements of the two volumeters. The variance of measurement of the devices was assessed with a Levene’s test, and the significance (p-value) was obtained as 0.981. Based on this result, the null hypothesis cannot be rejected, meaning that there is no difference in the variances of measurements of the two volumeters. Likewise, a paired sample t-test was used to evaluate the differences between the mean measurements of the healthy volunteer’s group, and no difference was detected between the mean arm volumes measured with each volumeter (significance=0.105). The measurements between the two volumeters were also consistent in the lymphedema patient group (involved arm significance=0.842 and normal arm significance=0.075).

Conclusion: Our study revealed the validity of the newly designed ‘‘Easy Volumeter’’ for the measurement of arm volumes, indicating its appropriateness for use in daily practice

Main findings

  • This research evaluates a new volumeter.
  • The design combines two different components—a displacement volumeter for standard measurement and an additional measuring cylinder—in a single volumeter. This feature provides ease of use and reduces the space occupied by the instrument. The weight of the volumeter developed in this study is less than half that of a standard volumeter (6.8kg vs. 3.3 kg), and it is also more durable, being produced from nonbreakable materials. This easy-measurement volumeter can be easily emptied and cleaned through a tilting platform, which the authors believe is one of the most important components of its design.
  • Arm-hand circumference measurements were obtained using a measuring tape at four different points, including the metacarpal circumference, the wrist, and 10cm below and 10cm above the lateral epicondyle. Arm-hand volume measurements were recorded using a standard volumeter and an easy-measurement volumeter, the validity of which was being investigated. The weight of the displaced water was measured by inserting the subject’s arm into the volumeter up to the axilla. For both cups, the procedures were performed once in the patient group and repeated thrice in the control group. In addition, cylindrical objects with known volumes (12 different volumes, varying between 250 and 3000mL) were measured using both volumeters to evaluate displacement. All measurements were then statistically evaluated to investigate validity.
  • It was found to be as reliable as the standard volumeter.