Assessing the reliability and validity of the revised WCCNR stomatitis staging system for cancer therapy-induced stomatitis.

Abstract

Before developing interventions for stomatitis, nurses require a simple, valid and reliable approach to staging severity. The eight-item WCCNR(R) was previously validated for chemotherapy-induced stomatitis. In this study, the validity and reliability of the WCCNR(R), a shorter three-item tool for staging stomatitis caused by chemotherapy, radiotherapy, or both, was assessed. Pairs of data collectors evaluated 207 patients from 10 Canadian cancer centres. The WCCNR(R) correlated well with the MacDibbs Mouth Assessment (r = 0.44, p = 0.0002 to r = 0.54, p < 0.0001), a standardized tool for staging radiotherapy-induced stomatitis. Agreement between data collectors at five sites was acceptable (kappa = 0.75); three additional sites were close to this target. Findings indicate that the WCCNR is a valid and reasonably reliable tool for staging stomatitis due to cancer therapy.