ArticleThe British journal of dermatology2020
Standardizing the classification of skin tears: validity and reliability testing of the International Skin Tear Advisory Panel Classification System in 44 countries.
Article in The British journal of dermatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04625426 (Evaluate the Efficacy of Two Advanced Skin Treatment Regimens in Treating Incontinence-associated Dermatitis), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluate the Efficacy of Two Advanced Skin Treatment Regimens in Treating Incontinence-associated Dermatitis: Cluster Randomization Study
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors for skin tears in the older adults: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Validation and Clinimetric Properties of Persian Version of the ISTAP Classification System.International wound journal · 2026Article
- Skin tears in older adults people receiving home care.BMC geriatrics · 2025Article
- Educational Interventions to Improve Knowledge Among Nurses in the Prevention of Skin Tears in Hospitalised Adults and Older Adults: A Scoping Review.International wound journal · 2025Article
- Skin tears in older patients in intensive care units: A multicentre point prevalence study.Nursing in critical care · 2025Observational
- Knowledge status of skin tear prevention and its demographic and occupational influencing factors: A National cross-sectional survey among nurses.Journal of advanced nursing · 2025Article
- Development and Preliminary Validation of a Central Venous Access Device-Associated Skin Impairment Classification Tool Using Modified Delphi and Clinimetric Methods.Journal of advanced nursing · 2025Article
- Risk factors of skin tear in older persons: a protocol for systematic review and meta-analysis.BMJ open · 2024Article
- Article
- Skin tear prevalence in an Australian acute care hospital: A 10-year analysis.International wound journal · 2022Article
- Preliminary Exploration of Main Elements for Systematic Classification Development: Case Study of Patient Safety Incidents.JMIR formative research · 2022Article
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27 authors.
Funding
Abstract
backgroundSkin tears are acute wounds that are frequently misdiagnosed and under-reported. A standardized and globally adopted skin tear classification system with supporting evidence for diagnostic validity and reliability is required to allow assessment and reporting in a consistent way.
objectivesTo measure the validity and reliability of the International Skin Tear Advisory Panel (ISTAP) Classification System internationally.
methodsA multicountry study was set up to validate the content of the ISTAP Classification System through expert consultation in a two-round Delphi procedure involving 17 experts from 11 countries. An online survey including 24 skin tear photographs was conducted in a convenience sample of 1601 healthcare professionals from 44 countries to measure diagnostic accuracy, agreement, inter-rater reliability and intrarater reliability of the instrument.
resultsA definition for the concept of a 'skin flap' in the area of skin tears was developed and added to the initial ISTAP Classification System consisting of three skin tear types. The overall agreement with the reference standard was 0·79 [95% confidence interval (CI) 0·79-0·80] and sensitivity ranged from 0·74 (95% CI 0·73-0·75) to 0·88 (95% CI 0·87-0·88). The inter-rater reliability was 0·57 (95% CI 0·57-0·57). The Cohen's Kappa measuring intrarater reliability was 0·74 (95% CI 0·73-0·75).
conclusionsThe ISTAP Classification System is supported by evidence for validity and reliability. The ISTAP Classification System should be used for systematic assessment and reporting of skin tears in clinical practice and research globally. What's already known about this topic? Skin tears are common acute wounds that are misdiagnosed and under-reported too often. A skin tear classification system is needed to standardize documentation and description for clinical practice, audit and research. What does this study add? The International Skin Tear Advisory Panel Classification System was psychometrically tested in 1601 healthcare professionals from 44 countries. Diagnostic accuracy was high when differentiating between type 1, 2 and 3 skin tears using a set of validated photographs.
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