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

D Beeckman, K Van den Bussche, P Alves, M C Arnold Long, H Beele, G Ciprandi, F Coyer, T de Groot, D De Meyer, E Deschepper, A M Dunk, A Fourie, P García-Molina, M Gray, A Iblasi, R Jelnes, E Johansen, A Karadağ, K Leblanc, Z Kis Dadara & 15 others S Meaume, A Pokorna, 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, J Kottner

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1331-1340
Number of pages10
JournalBritish Journal of Dermatology
Volume178
Issue number6
DOIs
Publication statusPublished - Jun 2018
Externally publishedYes

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Dermatitis
Psychometrics
Language
Confidence Intervals
Irritant Dermatitis
Contact Dermatitis
Research
Referral and Consultation
Delivery of Health Care
Sensitivity and Specificity
Skin
Infection

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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. / 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; Kottner, J.

In: British Journal of Dermatology, Vol. 178, No. 6, 06.2018, p. 1331-1340.

Research output: Contribution to journalArticle

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 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, vol. 178, no. 6, pp. 1331-1340. https://doi.org/10.1111/bjd.16327
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 ; Kottner, J. / 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. In: British Journal of Dermatology. 2018 ; Vol. 178, No. 6. pp. 1331-1340.
@article{f027fb3908474b3eb3e4fe52ca41a7a3,
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",
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.",
author = "D Beeckman and {Van den Bussche}, K and P Alves and {Arnold Long}, {M C} and H Beele and G Ciprandi and F Coyer and {de Groot}, T and {De Meyer}, D and E Deschepper and Dunk, {A M} and A Fourie and P Garc{\'i}a-Molina and M Gray and A Iblasi and R Jelnes and E Johansen and A Karadağ and K Leblanc and {Kis Dadara}, Z and S Meaume and A Pokorna and M Romanelli and S Ruppert and L Schoonhoven and S Smet and C Smith and A Steininger and M Stockmayr and {Van Damme}, N and D Voegeli and {Van Hecke}, A and S Verhaeghe and K Woo and J Kottner",
note = "{\circledC} 2018 British Association of Dermatologists.",
year = "2018",
month = "6",
doi = "10.1111/bjd.16327",
language = "English",
volume = "178",
pages = "1331--1340",
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TY - JOUR

T1 - Towards an international language for incontinence-associated dermatitis (IAD)

T2 - design and evaluation of psychometric properties of the Ghent Global IAD Categorization Tool (GLOBIAD) in 30 countries

AU - Beeckman, D

AU - Van den Bussche, K

AU - Alves, P

AU - Arnold Long, M C

AU - Beele, H

AU - Ciprandi, G

AU - Coyer, F

AU - de Groot, T

AU - De Meyer, D

AU - Deschepper, E

AU - Dunk, A M

AU - Fourie, A

AU - García-Molina, P

AU - Gray, M

AU - Iblasi, A

AU - Jelnes, R

AU - Johansen, E

AU - Karadağ, A

AU - Leblanc, K

AU - Kis Dadara, Z

AU - Meaume, S

AU - Pokorna, A

AU - Romanelli, M

AU - Ruppert, S

AU - Schoonhoven, L

AU - Smet, S

AU - Smith, C

AU - Steininger, A

AU - Stockmayr, M

AU - Van Damme, N

AU - Voegeli, D

AU - Van Hecke, A

AU - Verhaeghe, S

AU - Woo, K

AU - Kottner, J

N1 - © 2018 British Association of Dermatologists.

PY - 2018/6

Y1 - 2018/6

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.

AB - 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.

U2 - 10.1111/bjd.16327

DO - 10.1111/bjd.16327

M3 - Article

VL - 178

SP - 1331

EP - 1340

JO - British Journal of Dermatology

JF - British Journal of Dermatology

SN - 0007-0963

IS - 6

ER -