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The measurement properties of assessment tools for chronic wounds: A systematic review
Department of Public Health and Primary Care, Ghent University, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Belgium; Wound Care Center, Ghent University Hospital, Belgium.
School of Health, University of Applied Sciences Western Switzerland, HES-SO Genève, Geneva, Switzerlan.
Centre for Medical Education, School of Medicine, Cardiff University, Cardiff, United Kingdom.
Department of Public Health and Primary Care, Ghent University, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent, Belgium.
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2021 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 121, article id 103998Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Chronic wounds are an increasing problem in the aging population, patients experience a lower health-related quality of life and the care for these patients is associated with high costs. Thorough wound assessments facilitate objective monitoring of wound status and progress. A wound assessment tool can guide clinicians in these wound assessments and in recording wound progress or deterioration.

OBJECTIVE: Systematically identify assessment tools for chronic wounds, investigate their measurement properties, and summarize the data per assessment tool.

DESIGN: Systematic review

METHODS: The databases Medline (PubMed interface), Embase, CINAHL, and CENTRAL were systematically searched until May 2020 (updated in February 2021). Studies reporting the development and/or the evaluation of measurement properties of assessment tools for chronic wounds were included. The "Consensus-based Standards for the selection of health Measurement Instruments" risk of Bias checklist was applied to evaluate the methodological quality of the included studies. Each reported measurement property was rated against criteria for good measurement properties. The evidence was summarized and the quality of the evidence was graded using a modified Grades of Recommendation, Assessment, Development, and Evaluation approach. Study selection, data extraction and quality appraisal were conducted independently by two reviewers and double-checked by a third reviewer.

RESULTS: Twenty-seven studies describing the measurement properties of fourteen assessment tools for chronic wounds were included. None of the studies reported a content validity evaluation by a relevance study or a comprehensiveness study in professionals. Six articles reported the development or revision of an existing assessment tool. The reported measurement properties included: structural validity (5 studies), reliability (18 studies), hypotheses testing for construct validity (18 studies) and responsiveness (7 studies). Internal consistency, cross-cultural validity / measurement invariance and measurement error were not reported. If criterion validity was assessed, the results were allocated to hypotheses testing for construct validity as no 'gold standard' is available.

CONCLUSIONS: Fourteen assessment tools for chronic wounds were identified. Construct validity (by hypotheses testing) and responsiveness of the Pressure Ulcer Scale for Healing version 3.0 were supported by sufficient ratings based on moderate to high level quality of evidence. Reliability of the (Revised) Photographic Wound Assessment Tool had a sufficient rating based on moderate quality of evidence. The ratings of the measurement properties of the other wound assessment tools were either insufficient or indeterminate, or a sufficient result was supported by low to very low quality of evidence. Registration number in PROSPERO: CRD42020183920. Tweetable abstract: "A systematic review giving a clear overview of the measurement properties of available assessment tools for chronic wounds."

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 121, article id 103998
Keywords [en]
Chronic wound, Decision support systems, Foot ulcer, Leg ulcer, Measurement properties, Pressure ulcer, Reliability, Systematic review, Validity
National Category
Dermatology and Venereal Diseases
Identifiers
URN: urn:nbn:se:oru:diva-93443DOI: 10.1016/j.ijnurstu.2021.103998ISI: 000685438800010PubMedID: 34237439Scopus ID: 2-s2.0-85109128690OAI: oai:DiVA.org:oru-93443DiVA, id: diva2:1584573
Note

Funding agencies:

EduWond

Ghent University

Wound Care Education Partnership of Ghent University Association (Ghent University)

Wound Care Education Partnership of Ghent University Association (Howest University of Applied Sciences)

Wound Care Education Partnership of Ghent University Association (HoGent University of Applied Sciences)

Wound Care Education Partnership of Ghent University Association (Artevelde University of Applied Sciences)

Available from: 2021-08-12 Created: 2021-08-12 Last updated: 2021-12-29Bibliographically approved

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Beeckman, Dimitri

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