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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

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
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
Background Incontinence-associated dermatitis (IAD) is a specific type of irritant contact dermatitis with different levels of severity. 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 and psychometrically evaluate the Ghent Global IAD Categorisation Tool (GLOBIAD).
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 reflecting different severity levels in a sample of 823 health professionals in 30 countries. Measures for diagnostic accuracy (sensitivity and specificity), agreement, inter-rater reliability (multi-rater Fleiss kappa), and intra-rater reliability (Cohen’s Kappa) were assessed.

Results The GLOBIAD consists of two categories according to the presence of persistent redness (Cat.1) and skin loss (Cat.2), both subdivided based on the presence of clinical signs of infection. The agreement for differentiating between Cat.1 and Cat.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 Cat.1 and Cat.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 Cat.1 and Cat.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 forward towards a better systematic assessment of IAD in clinical practice and research worldwide. Further validation is however needed.
0007-0963
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Alves, P.
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Beeckman, D., Van den Bussche, K., Alves, P., Arnold Long, M.C., Beele, H., Ciprandi, G., Coyer, F., de Groot, T., De Meyer, D., Deschepper, E., Dunk, A.M., 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. and Kottner, 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. British Journal of Dermatology. (doi:10.1111/bjd.16327).

Record type: Article

Abstract

Background Incontinence-associated dermatitis (IAD) is a specific type of irritant contact dermatitis with different levels of severity. 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 and psychometrically evaluate the Ghent Global IAD Categorisation Tool (GLOBIAD).
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 reflecting different severity levels in a sample of 823 health professionals in 30 countries. Measures for diagnostic accuracy (sensitivity and specificity), agreement, inter-rater reliability (multi-rater Fleiss kappa), and intra-rater reliability (Cohen’s Kappa) were assessed.

Results The GLOBIAD consists of two categories according to the presence of persistent redness (Cat.1) and skin loss (Cat.2), both subdivided based on the presence of clinical signs of infection. The agreement for differentiating between Cat.1 and Cat.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 Cat.1 and Cat.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 Cat.1 and Cat.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 forward towards a better systematic assessment of IAD in clinical practice and research worldwide. Further validation is however needed.

Text
Towards an international language for Incontinence-Associated Dermatitis (IAD): design and evaluation of psychometric properties of the Ghent Global IAD Categorisation Tool (GLOBIAD) in 30 countries - Accepted Manuscript
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Accepted/In Press date: 1 January 2018
e-pub ahead of print date: 8 January 2018

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Local EPrints ID: 416977
URI: https://eprints.soton.ac.uk/id/eprint/416977
ISSN: 0007-0963
PURE UUID: 0fe93282-9f8f-4995-a090-795f89b24b47
ORCID for L. Schoonhoven: ORCID iD orcid.org/0000-0002-7129-3766
ORCID for D. Voegeli: ORCID iD orcid.org/0000-0003-3457-7177

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Date deposited: 16 Jan 2018 17:30
Last modified: 02 Apr 2019 04:01

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Contributors

Author: D. Beeckman
Author: K. Van den Bussche
Author: P. Alves
Author: M.C. Arnold Long
Author: H. Beele
Author: G. Ciprandi
Author: F. Coyer
Author: T. de Groot
Author: D. De Meyer
Author: E. Deschepper
Author: A.M. Dunk
Author: A. Fourie
Author: P. García-Molina
Author: M. Gray
Author: A. Iblasi
Author: R. Jelnes
Author: E. Johansen
Author: A. Karadağ
Author: K. Leblanc
Author: Z. Kis Dadara
Author: S. Meaume
Author: A. Pokorna
Author: M. Romanelli
Author: S. Ruppert
Author: L. Schoonhoven ORCID iD
Author: S. Smet
Author: C. Smith
Author: A. Steininger
Author: M. Stockmayr
Author: N. Van Damme
Author: D. Voegeli ORCID iD
Author: A. Van Hecke
Author: S. Verhaeghe
Author: K. Woo
Author: J. Kottner

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