[Diagnosis and classification of pressure ulcers and other skin lesions: interrater reliability and agreement].

Accurate and precise diagnosis and classification of pressure ulcers is important in clinical practice and research. In the planning phase of a cohort study 14 data collectors were trained according to the classification of the European Pressure Ulcer Advisory Panel (EPUAP). Interrater reliability and agreement was measured using 20 images of the pressure ulcer classification CD (PUCLAS). Across all categories values varied between 0.36 (95 percent CI 0.32 to 0.40) and 0.54 (95 percent CI 0.49 to 0.58). Highest values of interrater reliability and agreement were measured for the categories "Pressure ulcer grade 4", "Pressure ulcer grade 2", and "Blanchable erythema". Low values were measured for the categories "Other lesion" and "Incontinence lesion". Interpretation and transferability of these results into practice is limited due to low prevalence of some categories, artificial assessment conditions and due to small sample sizes. More efforts must be made to further improve interrater reliability and agreement.