Beeckman D, Van den Bussche K, Alves P, Arnold Long MC, Beele H, Ciprandi G, Coyer F, de Groot T, De Meyer D, Deschepper E, Dunk AM, Fourie A, García-Molina P, Gray M, Iblasi A, Jelnes R, Johansen E, Karadağ A, Leblanc K, Kis Dadara Z, Meaume S, Pokorna A, Romanelli M, Ruppert S, Schoonhoven L, Smet S, Smith C, Steininger A, Stockmayr M, Van Damme N, Voegeli D, Van Hecke A, Verhaeghe S, Woo K, Kottner J, et al.
The British journal of dermatology. Date of publication 2018 Jun 1;volume 178(6):1331-1340.
1. Br J Dermatol. 2018 Jun;178(6):1331-1340. doi: 10.1111/bjd.16327. Epub 2018
Apr 19.
Towards an international language for incontinence-associated dermatitis (IAD):
design and evaluation of psychometric properties of the Ghent Global IAD
Categorization Tool (GLOBIAD) in 30 countries.
Beeckman D(1)(2), Van den Bussche K(1), Alves P(3), Arnold Long MC(4), Beele
H(5), Ciprandi G(6), Coyer F(7), de Groot T(8), De Meyer D(1), Deschepper E(1),
Dunk AM(9), Fourie A(10), García-Molina P(11), Gray M(12), Iblasi A(13), Jelnes
R(14), Johansen E(15), Karadağ A(16), Leblanc K(17), Kis Dadara Z(18), Meaume
S(19), Pokorna A(20), Romanelli M(21), Ruppert S(22), Schoonhoven L(23)(24)(25),
Smet S(26), Smith C(27), Steininger A(28), Stockmayr M(29), Van Damme N(1),
Voegeli D(23), Van Hecke A(1), Verhaeghe S(1), Woo K(30), Kottner J(1)(31).
Author information:
(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.
Comment in
Br J Dermatol. 2018 Jun;178(6):1238-1239. doi: 10.1111/bjd.16651.
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.
© 2018 British Association of Dermatologists.
DOI: 10.1111/bjd.16327
PMID: 29315488 [Indexed for MEDLINE]
