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

J 2018

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., K. VAN DEN BUSSCHE, P. ALVES, Arnold M.C. LONG, H. BEELE et. al.

Basic information

Original name

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

Authors

BEECKMAN, D. (56 Belgium, guarantor), K. VAN DEN BUSSCHE (56 Belgium), P. ALVES (620 Portugal), Arnold M.C. LONG (840 United States of America), H. BEELE (56 Belgium), G. CIPRANDI (380 Italy), F. COYER (36 Australia), T. de GROOT (528 Netherlands), D. DE MEYER (56 Belgium), E. DESCHEPPER (56 Belgium), A.M. DUNK (36 Australia), A. FOURIE (710 South Africa), P. GARCIA-MOLINA (724 Spain), M. GRAY (840 United States of America), A. IBLASI (682 Saudi Arabia), R. JELNES (208 Denmark), E. JOHANSEN (578 Norway), A. KARADAG (792 Turkey), K. LEBLANC (124 Canada), Z.K. DADARA (40 Austria), S. MEAUME (250 France), Andrea POKORNÁ (203 Czech Republic, belonging to the institution), M. ROMANELLI (380 Italy), S. RUPPERT (40 Austria), L. SCHOONHOVEN (826 United Kingdom of Great Britain and Northern Ireland), S. SMET (840 United States of America), C. SMITH (40 Austria), A. STEININGER (40 Austria), M. STOCKMAYR (40 Austria), N. VAN DAMME (56 Belgium), D. VOEGELI (826 United Kingdom of Great Britain and Northern Ireland), A. VAN HECKE (56 Belgium), S. VERHAEGHE (56 Belgium), K. WOO (124 Canada) and J. KOTTNER (56 Belgium)

Edition

British Journal of Dermatology, Hoboken, Wiley-Blackwell, 2018, 0007-0963

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30216 Dermatology and venereal diseases

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 6.714

RIV identification code

RIV/00216224:14110/18:00103951

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1111/bjd.16327

UT WoS

000435078600118

Keywords in English

Incontinence-associated dermatitis

Abstract

V originále

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. What's already known about this topic? Incontinence-associated dermatitis (IAD) is an irritant contact dermatitis in adults with incontinence. Ten IAD severity categorization instruments have been developed, some of which have been found to be time-consuming and (linguistically) complex when used in clinical practice. A universal IAD classification system is needed to guide practice, inform educational platforms and support research. What does this study add? The Ghent Global IAD Categorization Tool is based on input from international experts and was psychometrically tested by 823 healthcare professionals from 30 countries. The accuracy of differentiating between a diagnosis of erythema vs. skin loss was high when IAD was classified based on images. The identification of clinical signs of infection can be prone to error.

Citovat

BEECKMAN, D., K. VAN DEN BUSSCHE, P. ALVES, Arnold M.C. LONG, H. BEELE, G. CIPRANDI, F. COYER, T. de GROOT, D. DE MEYER, E. DESCHEPPER, A.M. DUNK, A. FOURIE, P. GARCIA-MOLINA, M. GRAY, A. IBLASI, R. JELNES, E. JOHANSEN, A. KARADAG, K. LEBLANC, Z.K. DADARA, S. MEAUME, Andrea POKORNÁ, M. ROMANELLI, S. RUPPERT, L. SCHOONHOVEN, S. SMET, C. SMITH, A. STEININGER, M. STOCKMAYR, N. VAN DAMME, D. VOEGELI, A. VAN HECKE, S. VERHAEGHE, K. WOO and J. KOTTNER. 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. British Journal of Dermatology. Hoboken: Wiley-Blackwell, 2018, vol. 178, No 6, p. 1331-1340. ISSN 0007-0963. Available from: https://dx.doi.org/10.1111/bjd.16327.

@article{1446157,
   author = {Beeckman, D. and Van den Bussche, K. and Alves, P. and Long, Arnold M.C. and Beele, H. and Ciprandi, G. and Coyer, F. and Groot, T. de and De Meyer, D. and Deschepper, E. and Dunk, A.M. and Fourie, A. and GarciaandMolina, P. and Gray, M. and Iblasi, A. and Jelnes, R. and Johansen, E. and Karadag, A. and Leblanc, K. and Dadara, Z.K. and Meaume, S. and Pokorná, Andrea and Romanelli, M. and Ruppert, S. and Schoonhoven, L. and Smet, S. and Smith, C. and Steininger, A. and Stockmayr, M. and Van Damme, N. and Voegeli, D. and Van Hecke, A. and Verhaeghe, S. and Woo, K. and Kottner, J.},
   article_location = {Hoboken},
   article_number = {6},
   doi = {http://dx.doi.org/10.1111/bjd.16327},
   keywords = {Incontinence-associated dermatitis},
   language = {eng},
   issn = {0007-0963},
   journal = {British Journal of Dermatology},
   title = {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},
   volume = {178},
   year = {2018}
}

TY  - JOUR
ID  - 1446157
AU  - Beeckman, D. - Van den Bussche, K. - Alves, P. - Long, Arnold M.C. - Beele, H. - Ciprandi, G. - Coyer, F. - Groot, T. de - De Meyer, D. - Deschepper, E. - Dunk, A.M. - Fourie, A. - Garcia-Molina, P. - Gray, M. - Iblasi, A. - Jelnes, R. - Johansen, E. - Karadag, A. - Leblanc, K. - Dadara, Z.K. - Meaume, S. - Pokorná, Andrea - 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.
PY  - 2018
TI  - 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
JF  - British Journal of Dermatology
VL  - 178
IS  - 6
SP  - 1331-1340
EP  - 1331-1340
PB  - Wiley-Blackwell
SN  - 00070963
KW  - Incontinence-associated dermatitis
N2  - 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. What's already known about this topic? Incontinence-associated dermatitis (IAD) is an irritant contact dermatitis in adults with incontinence. Ten IAD severity categorization instruments have been developed, some of which have been found to be time-consuming and (linguistically) complex when used in clinical practice. A universal IAD classification system is needed to guide practice, inform educational platforms and support research. What does this study add? The Ghent Global IAD Categorization Tool is based on input from international experts and was psychometrically tested by 823 healthcare professionals from 30 countries. The accuracy of differentiating between a diagnosis of erythema vs. skin loss was high when IAD was classified based on images. The identification of clinical signs of infection can be prone to error.
ER  -

BEECKMAN, D., K. VAN DEN BUSSCHE, P. ALVES, Arnold M.C. LONG, H. BEELE, G. CIPRANDI, F. COYER, T. de GROOT, D. DE MEYER, E. DESCHEPPER, A.M. DUNK, A. FOURIE, P. GARCIA-MOLINA, M. GRAY, A. IBLASI, R. JELNES, E. JOHANSEN, A. KARADAG, K. LEBLANC, Z.K. DADARA, S. MEAUME, Andrea POKORNÁ, M. ROMANELLI, S. RUPPERT, L. SCHOONHOVEN, S. SMET, C. SMITH, A. STEININGER, M. STOCKMAYR, N. VAN DAMME, D. VOEGELI, A. VAN HECKE, S. VERHAEGHE, K. WOO and J. KOTTNER. 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. \textit{British Journal of Dermatology}. Hoboken: Wiley-Blackwell, 2018, vol.~178, No~6, p.~1331-1340. ISSN~0007-0963. Available from: https://dx.doi.org/10.1111/bjd.16327.

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