Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
Department of Occupational Therapy, Royal Adelaide Hospital, Adelaide, Australia.
Skin Res Technol. 2022 Jul;28(4):497-539. doi: 10.1111/srt.13159. Epub 2022 Apr 12.
The objective of this review is to examine the reliability and measurement error of devices that measure transepidermal water loss (TEWL).
TEWL is a physiological property of skin which increases when the epidermis is damaged. It is, therefore, a commonly utilised measure of skin barrier integrity. Devices measuring TEWL are available as open, semi-open or closed chamber. Studies of reliability examine the consistency of measurement, and/or responsiveness whereas measurement error scores in absolute terms the amount of error due to sources of variation.
Studies examining the reliability and/or measurement error of TEWL measurement devices were included. Studies that only report on measurement of TEWL outcomes without examination of reliability and/or measurement error were excluded.
The search strategy aimed to locate published and unpublished studies. Databases searched included PubMed, Embase, CINAHL and Web of Science, utilising identified keywords and limited to studies in English. Grey literature sources were searched to identify any unpublished documents. Study selection using the inclusion criteria was then assessed by two reviewers for methodological quality utilising the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias tool to assess the reliability and measurement error of outcome measurement instruments.
A total of 22 devices were examined in the 38 included studies. The quality of study design was on average rated as 'Adequate' however reliability and measurement error statistical methods were on average rated as 'Doubtful'.
TEWL measurement devices were found to demonstrate good reliability and frequently correlated with other devices. However, measurement error was highly variable but improves under in vitro conditions. Future research should consider risk of bias factors when designing studies.
本综述旨在检验测量经皮水分流失（TEWL）的设备的可靠性和测量误差。
TEWL 是皮肤的生理特性，当表皮受损时会增加。因此，它是衡量皮肤屏障完整性的常用指标。测量 TEWL 的设备有开放式、半开放式或密闭式室。可靠性研究检验测量的一致性和/或反应性，而测量误差则以绝对值的形式衡量由于变异源引起的误差量。
纳入了检验 TEWL 测量设备可靠性和/或测量误差的研究。仅报告 TEWL 测量结果而未检验可靠性和/或测量误差的研究被排除在外。
搜索策略旨在定位已发表和未发表的研究。搜索的数据库包括 PubMed、Embase、CINAHL 和 Web of Science，利用已确定的关键词，并限于英文研究。还搜索了灰色文献来源，以确定任何未发表的文件。然后，使用纳入标准，由两名评审员评估研究选择的方法学质量，使用共识基础的健康测量仪器选择标准（COSMIN）来评估结果测量仪器的可靠性和测量误差风险工具。
在纳入的 38 项研究中，共检查了 22 种设备。研究设计质量的平均评分为“适当”，但可靠性和测量误差统计方法的平均评分为“可疑”。
发现 TEWL 测量设备具有良好的可靠性，并且经常与其他设备相关。然而，测量误差变化很大，但在体外条件下有所改善。未来的研究在设计研究时应考虑偏倚风险因素。
