Outcome measurement instruments for erythema associated with incontinence‐associated dermatitis: Systematic review

Abstract

Aim To: (a) examine which outcome measurement instruments for erythema associated with incontinence‐associated dermatitis (IAD) with supporting evidence about measurement properties are available; (b) evaluate the methodological quality of the studies and the quality of the measurement properties; and (c) identify eligible instruments to measure erythema in incontinence‐associated dermatitis research. Design Systematic review. Data sources MEDLINE, EMBASE, CINAHL and CENTRAL were systematically searched until July 2018 (update December 2018). Additional input was gathered from 151 incontinence‐associated dermatitis experts. Cited and citing references of included studies were screened. Review Methods The COSMIN Risk of Bias checklist was applied to evaluate the methodological quality of the studies. Reported measurement properties were rated against criteria for good measurement properties. Results Fourteen studies, describing 10 measurement instruments, were included. In five instruments, erythema was captured as a separate concept, two studies provided empirical evidence about the measurement properties. The most studied measurement properties were reliability (9 studies), measurement error (4 studies) and criterion validity (4 studies). In one study, internal consistency was examined. Conclusion No instrument measuring exclusively erythema associated with incontinence‐associated dermatitis exists. There is no single composite incontinence‐associated dermatitis measurement instrument that outperforms others. Development or adaption of an instrument to measure erythema associated with incontinence‐associated dermatitis is one option to solve this challenge. Impact The evidence about measurement properties of instruments measuring erythema associated with incontinence‐associated dermatitis has not been summarized to date. The lack of an instrument should trigger activities to measure this domain accurately in future clinical trials.

Only the best instruments should be used to measure core outcomes

“…The findings from van Zuuren et al 5 . are comparable to many other areas where many different OMIs are used for similar outcome domains with insufficient or unknown measurement properties 6–8 . Having identified core domains is critical, but is only one step towards a complete COS. In addition to efforts to select and to define core outcome domains according to the highest methodological standards, the same attention must be paid to identify and to develop OMIs.…”

Measurement instruments to evaluate diaper dermatitis in children: Systematic review of measurement properties

“…The unpublished ‘Diaper dermatitis scale_spanish’ by Garcia Molina (2018) was found by citation tracking via the systematic review by De Meyer et al (2019). The original English version of the ‘Clinical Evaluation Scale for Characterization of the Severity of Diaper Dermatitis’ (Brown et al, (2006) as cited in Stamatas and Tierney (2014, p. 2)) was not included due to lack of reported measurement properties.…”

Prevention and Care for Incontinence-Associated Dermatitis Among Older Adults: A Systematic Review

“…De Meyer et al (2019) reported on 10 instruments for measuring erythema associated with IAD in all age groups. 31 We found seven instruments for use in older adults. Although there is some overlap between what they reported and those we found, the seven instruments might be better suited for assessing IAD in older adults because the authors recommended, approved, and used them in this vulnerable population.…”

“…Outcomes of intervention evaluation for older adults are the same as in other populations. 9 , 14 , 31 , 34 , 35 Outcomes may be placed into three categories: statistical measures, medical indicators, and research instrument evaluation based on the specific purposes of the studies and assortment of outcomes. The time frame of outcome evaluation varied among the articles we reviewed, depending on the type of intervention/outcome.…”