Dorien De Meyer

Towards an international language for incontinence-associated dermatitis (IAD): Design and evaluation of psychometric properties of the Ghent Global IAD Categorization Tool (GLOBIAD) in 30 countries

Incontinence‐associated dermatitis (IAD) is a specific type of irritant contact dermatitis with different severity levels. An internationally accepted instrument to assess the severity of IAD in adults, with established diagnostic accuracy, agreement and reliability, is needed to support clinical practice and research.

Independent risk factors for the development of skin erosion due to incontinence (incontinence-associated dermatitis category 2) in nursing home residents: results from a multivariate binary regression analysis.

The aim of this study was to identify characteristics independently associated with a higher risk of developing skin damage because of incontinence [incontinence‐associated dermatitis (IAD) category 2] in nursing home residents. As part of a larger randomised controlled trial, IAD incidence was monitored for 1 month in a sample of 381 incontinent residents using a validated IAD Severity Categorisation Tool. Data on demographical, physical, functional and psychological characteristics were collected. The overall IAD incidence (category 1–2) was 30·0%, and 6% of the participants developed skin damage (IAD category 2). Residents who developed IAD category 2 were less mobile [odds ratio (OR) 2·72, 95% confidence interval (CI) 1·06–6·94], had more friction and shear issues (OR 2·54; 95% CI 1·02–6·33) and had more erythema due to incontinence (OR 3·02; 95% CI 1·04–8·73) before IAD category 2 occurrence. Care providers should give full attention to risk factors to both detect residents at risk for IAD development and to start prevention in time.

Core outcome domains in incontinence-associated dermatitis research

AIM To report the development of a core set of outcome domains for clinical research involving adults with incontinence-associated dermatitis or at risk, independently from any geographical location or skin colour. BACKGROUND The management of incontinence-associated dermatitis is important in caring for incontinent patients. The lack of comparability of clinical trial outcomes is a major challenge in the field of evidence-based incontinence-associated dermatitis prevention and treatment. Core outcome sets may therefore be helpful to improve the value of clinical incontinence-associated dermatitis research. DESIGN Systematic literature review, patient interviews and consensus study using Delphi procedure. METHODS A list of outcome domains was generated through a systematic literature review (no date restrictions-April 2016), consultation of an international steering committee and three patient interviews. The project team reviewed and refined the outcome domains prior to starting a three-round Delphi procedure conducted between April-September 2017. The panellists, including healthcare providers, researchers and industry were invited to rate the importance of the outcome domains. RESULTS We extracted 1,852 outcomes from 244 articles. Experts proposed 56 and patients 32 outcome domains. After refinement, 57 panellists from 17 countries rated a list of 58 outcome domains. The final list of outcome domains includes erythema, erosion, maceration, IAD-related pain and patient satisfaction. CONCLUSION Erythema, erosion, maceration, incontinence-associated dermatitis -related pain and patient satisfaction are the most important outcome domains to be measured in incontinence-associated dermatitis trials. Based on this international consensus on what to measure, the question of how to measure these domains now requires consideration. Registration: This project has been registered in the Core Outcome Measures in Effectiveness Trials (COMET Initiative) database and is part of the Cochrane Skin Group-Core Outcomes Set Initiative (CSG-COUSIN).

建立失禁相关性皮炎(IAD)相关国际通用术语:在30个国家/地区进行根特全球(IAD)分类工具(GLOBIAD)心理测量特性的设计和评估

几十年来,婴儿尿布皮炎(尿布疹)的最佳预防和治疗方法一直都是研究热点。然而,这种皮肤问题也会出现在成人身上,这时被称作失禁相关性皮炎(IAD)。它是刺激性接触性皮炎(一种由接触刺激物而非致敏物导致的湿疹)的一种特殊类型,由皮肤与尿液或粪便长时间接触导致。很难确切知道IAD患者究竟有多少,因为目前尚无一套国际公认的诊断标准(例如,一份可用于鉴别疾病的特定症状和标准清单)将其与其他有类似症状的皮肤病(如压力性溃疡)区分开来。目前存在十种不同的量表/工具(即疾病诊断和严重程度排序方法),但有些十分复杂,因而需要有一种量表/工具来确保研究结果具有可比性。因此,来自13个国家/地区的34位专家携手合作,共同开发出了一款工具,取名为GLOBIAD,于2015年启用。该工具随后被翻译成14种不同的语言。30个国家/地区的823位专家使用GLOBIAD对34张IAD照片进行了分类,并检验结果是否匹配,从而测试了该工具的准确性。该研究发现,GLOBIAD的开发是一项重大进展,有助于在全球临床实践和研究中,对IAD进行更好的系统评估。但是,这种工具还有待进一步验证。