Lymphoedema measurement methods in cancer survivors: accuracy, health economics and practice implications

BACKGROUND: Lymphoedema assessment is central to diagnosis and management, but the optimal method remains uncertain. Tape measurement is widely used, although newer technologies may improve efficiency and patient experience. AIMS: To compare five assessment methods for diagnostic accuracy, time-efficiency, cost and acceptability. Analyses included reliability (Cronbach's alpha, Pearson's correlation), diagnostic accuracy and a health economic evaluation. FINDINGS: Tape measurement at a 7.5% threshold achieved the highest accuracy (sensitivity 94%, specificity 95%). The Perometer was fastest and most favoured by participants, but was costly. Bio-impedance methods had moderate diagnostic value, particularly for early detection. CONCLUSION: The tape measure remains the most practical standard tool, while the Perometer offers efficiency and patient appeal where resources permit.