Evidence map›Paper›PMID 31605618›Full record

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.

H Van Tiggelen, K LeBlanc, K Campbell, K Woo, S Baranoski, Y Y Chang, A M Dunk, M Gloeckner, H Hevia, S Holloway and 17 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04625426 naterminatednot on this map

Evaluate the Efficacy of Two Advanced Skin Treatment Regimens in Treating Incontinence-associated Dermatitis: Cluster Randomization Study

TypeinterventionalSponsorTan Tock Seng HospitalRan2019 to 2020Enrolled86ConditionsIncontinence-associated DermatitisArms3M Cavilon No-Rinse Skin Cleanser and 3M Cavilon Advanced Skin Protectant, Conveen EasiCleanse and Conveen Critic Barrier, Standard cleansing and Conveen Critic Barrier
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  5. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors.

H Van TiggelenSkin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care.ORCID 0000-0002-4373-5491
K LeBlancSchool of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
K CampbellSchool of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
K WooSchool of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
S BaranoskiNursing Advisory Board, Rasmussen College, Romeoville/Joliet, IL, U.S.A.
Y Y ChangDivision of Nursing, Speciality Nursing (Wound Care), Singapore General Hospital, Bukit Merah, Singapore.
A M DunkTissue Viability Unit, Canberra Hospital, Canberra Health Services, Canberra, ACT, Australia.
M GloecknerUnityPoint Health Trinity, Rock Island, Illinois and Bettendorf, IA, U.S.A.
H HeviaNursing School, Nursing Department, Andrés Bello University, Viña del Mar, Chile.
S HollowayCentre for Medical Education, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, U.K.
P IdensohnCliniCare Medical Centre, Ballito, KwaZulu-Natal, South Africa.
A KaradağSchool of Nursing, Koc University, Istanbul, Turkey.
E KorenLeumit HMO, Vascular Ulcer Clinic, Geula, Jerusalem, Israel.
J KottnerSkin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care.ORCID 0000-0003-0750-3818
D LangemoCollege of Nursing, University of North Dakota, Grand Forks, ND, U.S.A.
K OuseyInstitute of Skin Integrity and Infection Prevention, Department of Nursing and Midwifery, University of Huddersfield, Huddersfield, U.K.
A PokornáDepartment of Nursing, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
M RomanelliDepartment of Dermatology, University of Pisa, Pisa, Italy.
V L C G SantosSchool of Nursing, Medical-Surgical Nursing Department, University of São Paulo, São Paulo, Brazil.
S SmetWound Care Center.
G TariqWound Care Unit, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, U.A.E.
K Van den BusscheSkin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care.ORCID 0000-0001-5308-8729
A Van HeckeUniversity Centre for Nursing and Midwifery, Department of Public Health and Primary Care.ORCID 0000-0003-3576-7159
S VerhaegheUniversity Centre for Nursing and Midwifery, Department of Public Health and Primary Care.ORCID 0000-0002-2063-5033
H VuagnatCentre for Wounds and Wound Healing, University Hospitals of Geneva, Geneva, Switzerland.
A WilliamsWound and Ostomy Care, Reston Hospital Center, Reston, VA, U.S.A.
D BeeckmanSkin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care.ORCID 0000-0003-3080-8716

Funding

International Skin Tear Advisory Panel (ISTAP)
6 · The paper itself

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.

Indexed as

LacerationsSoft Tissue InjuriesHumansReproducibility of ResultsSkinSurveys and Questionnaires

Identifiers

PMID31605618
PMCPMC7384145

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.