The ghent global IAD monitoring tool (GLOBIAD-M) to monitor the healing of incontinence-associated dermatitis (IAD): Design and reliability study

Abstract

The aim of this study was to design and evaluate the reliability of the Ghent Global incontinence-associated dermatitis (IAD) Monitoring Tool (GLOBIAD-M). The tool was designed based on the internationally validated Ghent Global IAD Categorisation Tool (GLOBIAD). After designing and validation by experts, one trained researcher carried out 36 observations of 9 patients affected with IAD. Photographs of the IAD lesions were independently assessed by a second trained researcher. Measures for inter-rater agreement (po) and reliability [Cohen’s Kappa (ĸ) and intra-class correlation coefficients (ICC)] were analysed. The po ranged between 0.86 for the item ‘maceration’ and 0.97 for the item ‘clinical signs of infection’. The ĸ for the item ‘GLOBIAD classification’ was 0.61 [95% confidence interval (CI) 0.28-0.95] and 0.72 (95% CI 0.50-0.95) for ‘maceration’. The lowest ĸ was found for the item ‘oedema’ (0.27; 95% CI −0.24-0.79). The ICC of the item ‘redness’ was 0.83 (95% CI 0.69-0.91) and 0.87 (95% CI 0.76-0.93) for ‘skin loss’. The inter-rater agreement and reliability of the GLOBIAD-M appears to be good for the assessment of photographs by experts. This tool could support clinical decision-making for IAD treatment. Further validation with clinicians is, however, needed.