Camilleri Annelise, Gatt Alfred, Formosa Cynthia
Department of Health, Malta.
Faculty of Health Sciences, University of Malta, Malta.
J Tissue Viability. 2020 Nov;29(4):284-290. doi: 10.1016/j.jtv.2020.09.002. Epub 2020 Sep 6.
The need to classify, score and describe diabetic foot ulcerations is needed for accurate clinical documentation. An agreed wound classification can improve communication between health care professionals, and improve ease of discussion regarding potential outcomes. This study aimed to determine the inter-rater reliability between four validated wound classification systems.
A prospective non-experimental comparative study was conducted. Forty patients with diabetes presenting with a new or long-standing ulceration were recruited. Each ulcer was graded/scored by three clinicians using four widely used classification systems; namely the University of Texas, SINBAD, Meggitt-Wagner and the PEDIS scoring systems.
All classifications had a satisfactory inter-rater agreement when evaluated by three raters of various clinical experience, however, the strength of the agreement varied between classifications. The Meggitt-Wagner system had an almost perfect agreement, the SINBAD and UT systems had a strong inter-rater agreement whilst the PEDIS had a moderate inter-rater agreement.
Results of study serve as assurance and provides the evidence that these systems may be reliably used by different clinicians, even those with varied experience in wound care.
准确的临床记录需要对糖尿病足溃疡进行分类、评分和描述。达成一致的伤口分类可以改善医护人员之间的沟通,并便于讨论潜在的结果。本研究旨在确定四种经过验证的伤口分类系统之间的评分者间信度。
进行了一项前瞻性非实验性比较研究。招募了40例患有新发或长期溃疡的糖尿病患者。三名临床医生使用四种广泛使用的分类系统对每个溃疡进行分级/评分,即德克萨斯大学分类系统、SINBAD分类系统、梅吉特-瓦格纳分类系统和PEDIS评分系统。
当由具有不同临床经验的三名评分者进行评估时,所有分类的评分者间一致性均令人满意,然而,不同分类之间一致性的强度有所不同。梅吉特-瓦格纳系统几乎完全一致,SINBAD和UT系统具有很强的评分者间一致性,而PEDIS系统具有中等程度的评分者间一致性。
研究结果提供了保证,并证明这些系统可被不同的临床医生可靠地使用,即使是那些在伤口护理方面经验各异的医生。