D Beeckman1,2, K Van den Bussche1, P Alves3, M C Arnold Long4, H Beele5, G Ciprandi6, F Coyer7, T de Groot8, D De Meyer1, E Deschepper1, A M Dunk9, A Fourie10, P García-Molina11, M Gray12, A Iblasi13, R Jelnes14, E Johansen15, A Karadağ16, K Leblanc17, Z Kis Dadara18, S Meaume19, A Pokorna20, M Romanelli21, S Ruppert22, L Schoonhoven23,24,25, S Smet26, C Smith27, A Steininger28, M Stockmayr29, N Van Damme1, D Voegeli23, A Van Hecke1, S Verhaeghe1, K Woo30, J Kottner1,31. 1. University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium. 2. School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland. 3. Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Catholic University of Portugal, Oporto, Portugal. 4. Department of Nursing, Roper Hospital, Charleston, SC, U.S.A. 5. Department of Dermatology, Ghent University Hospital, Ghent, Belgium. 6. Department of Pediatric Surgery, Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy. 7. Intensive Care Services, Royal Brisbane and Women's Hospital and School of Nursing, Queensland University of Technology, Brisbane, Australia. 8. Wond Expertise Centrum, Lange Land Ziekenhuis, Zoetermeer, the Netherlands. 9. Tissue Viability Unit, Canberra Hospital, ACT Health, Canberra, Australia. 10. Scientific Affairs & Education Manager, 3M (Critical and Chronic Care Solutions), Johannesburg, South Africa. 11. Department of Nursing, University of Valencia, Valencia, Spain. 12. Department of Urology, University of Virginia, Charlottesville, VA, U.S.A. 13. Wound Care, King Saud Medical City (KSMC), Riyadh, Saudi Arabia. 14. Wound Clinic, Sygehus Sonderjylland, Sonderborg, Denmark. 15. University College of Southeast Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, Drammen, Norway. 16. School of Nursing, Koc University, Istanbul, Turkey. 17. School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Canada. 18. Development of Care, Barmherzige Brüder Austria, Vienna, Austria. 19. Geriatric and Wound Healing Department, APHP, Hôpital Rothschild, Paris, France. 20. Department of Nursing, Masaryk University, Faculty of Medicine, Brno, Czech Republic. 21. Department of Dermatology, University of Pisa, Pisa, Italy. 22. Department of Medicine II, Vienna General Hospital, Vienna, Austria. 23. Faculty of Health Sciences, University of Southampton, Southampton, U.K. 24. National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC Wessex), University of Southampton, Southampton, U.K. 25. Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands. 26. Wound Care Center, Ghent University Hospital, Ghent, Belgium. 27. Wound Ostomy Clinic, Marion General Hospital, Marion, IN, U.S.A. 28. Private Universität für Medizinische Informatik und Technik (UMIT) und Pflegeakademie der Barmherzigen Brüder Wien Pflegewissenschaft und Gerontologie, Vienna, Austria. 29. Department of Surgery, Vienna General Hospital, Vienna, Austria. 30. Department of Nursing, Queen's University, Kingston, Canada. 31. Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universtitätsmedizin Berlin, Berlin, Germany.
Abstract
BACKGROUND: Incontinence-associated dermatitis (IAD) is a specific type of irritant contact dermatitis with different severity levels. An internationally accepted instrument to assess the severity of IAD in adults, with established diagnostic accuracy, agreement and reliability, is needed to support clinical practice and research. OBJECTIVES: To design the Ghent Global IAD Categorization Tool (GLOBIAD) and evaluate its psychometric properties. METHODS: The design was based on expert consultation using a three-round Delphi procedure with 34 experts from 13 countries. The instrument was tested using IAD photographs, which reflected different severity levels, in a sample of 823 healthcare professionals from 30 countries. Measures for diagnostic accuracy (sensitivity and specificity), agreement, interrater reliability (multirater Fleiss kappa) and intrarater reliability (Cohen's kappa) were assessed. RESULTS: The GLOBIAD consists of two categories based on the presence of persistent redness (category 1) and skin loss (category 2), both of which are subdivided based on the presence of clinical signs of infection. The agreement for differentiating between category 1 and category 2 was 0·86 [95% confidence interval (CI) 0·86-0·87], with a sensitivity of 90% and a specificity of 84%. The overall agreement was 0·55 (95% CI 0·55-0·56). The Fleiss kappa for differentiating between category 1 and category 2 was 0·65 (95% CI 0·65-0·65). The overall Fleiss kappa was 0·41 (95% CI 0·41-0·41). The Cohen's kappa for differentiating between category 1 and category 2 was 0·76 (95% CI 0·75-0·77). The overall Cohen's kappa was 0·61 (95% CI 0·59-0·62). CONCLUSIONS: The development of the GLOBIAD is a major step towards a better systematic assessment of IAD in clinical practice and research worldwide. However, further validation is needed.
BACKGROUND:Incontinence-associated dermatitis (IAD) is a specific type of irritant contact dermatitis with different severity levels. An internationally accepted instrument to assess the severity of IAD in adults, with established diagnostic accuracy, agreement and reliability, is needed to support clinical practice and research. OBJECTIVES: To design the Ghent Global IAD Categorization Tool (GLOBIAD) and evaluate its psychometric properties. METHODS: The design was based on expert consultation using a three-round Delphi procedure with 34 experts from 13 countries. The instrument was tested using IAD photographs, which reflected different severity levels, in a sample of 823 healthcare professionals from 30 countries. Measures for diagnostic accuracy (sensitivity and specificity), agreement, interrater reliability (multirater Fleiss kappa) and intrarater reliability (Cohen's kappa) were assessed. RESULTS: The GLOBIAD consists of two categories based on the presence of persistent redness (category 1) and skin loss (category 2), both of which are subdivided based on the presence of clinical signs of infection. The agreement for differentiating between category 1 and category 2 was 0·86 [95% confidence interval (CI) 0·86-0·87], with a sensitivity of 90% and a specificity of 84%. The overall agreement was 0·55 (95% CI 0·55-0·56). The Fleiss kappa for differentiating between category 1 and category 2 was 0·65 (95% CI 0·65-0·65). The overall Fleiss kappa was 0·41 (95% CI 0·41-0·41). The Cohen's kappa for differentiating between category 1 and category 2 was 0·76 (95% CI 0·75-0·77). The overall Cohen's kappa was 0·61 (95% CI 0·59-0·62). CONCLUSIONS: The development of the GLOBIAD is a major step towards a better systematic assessment of IAD in clinical practice and research worldwide. However, further validation is needed.
Authors: Charlotte Anrys; Hanne Van Tiggelen; Sofie Verhaeghe; Ann Van Hecke; Dimitri Beeckman Journal: Int Wound J Date: 2018-11-09 Impact factor: 3.315
Authors: H Van Tiggelen; K LeBlanc; K Campbell; K Woo; S Baranoski; Y Y Chang; A M Dunk; M Gloeckner; H Hevia; S Holloway; P Idensohn; A Karadağ; E Koren; J Kottner; D Langemo; K Ousey; A Pokorná; M Romanelli; V L C G Santos; S Smet; G Tariq; K Van den Bussche; A Van Hecke; S Verhaeghe; H Vuagnat; A Williams; D Beeckman Journal: Br J Dermatol Date: 2019-11-28 Impact factor: 9.302
Authors: Monira El Genedy-Kalyoncu; Alexandra Fastner; Bettina Völzer; Kathrin Raeder; Konrad Neumann; Nils Axel Lahmann; Jan Kottner Journal: BMJ Open Date: 2022-09-29 Impact factor: 3.006