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 ( p o ) and reliability [Cohen's Kappa (ĸ) and intra‐class correlation coefficients (ICC)] were analysed. The p o 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.