A systematic review of interrater reliability of pressure ulcer classification systems

Department of Nursing Science, Centre for Humanities and Health Sciences, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Journal of Clinical Nursing (Impact Factor: 1.26). 03/2009; 18(3):315-36. DOI: 10.1111/j.1365-2702.2008.02569.x
Source: PubMed


To review systematically the interrater reliability of pressure ulcer classification systems to find out which classification should be used in daily practice.
Pressure ulcer classification systems are important tools in research and practice. They aim at providing accurate and precise communication, documentation and treatment decisions. Pressure ulcer classifications are criticised for their low degree of interrater reliability.
Systematic review.
The data bases MEDLINE, EMBASE, CINAHL and the World Wide Web were searched. Original research studies estimating interrater reliability of pressure ulcer classification systems were included. Study selection, data extraction and quality assessment was conducted independently by two reviewers.
Twenty-four out of 339 potentially relevant studies were included in the final data synthesis. Due to the heterogeneity of the studies a meaningful comparison was impossible.
There is at present not enough evidence to recommend a specific pressure ulcer classification system for use in daily practice. Interrater reliability studies are required, in which comparable raters apply different pressure ulcer classification systems to comparable samples.
It is necessary to determine the interrater reliability of pressure ulcer classifications among all users in clinical practice. If interrater reliability is low the use of those systems is questionable. On the basis of this review there are no recommendations as to which system is to be given preference.

Download full-text


Available from: Kathrin Raeder
  • Source
    • "PUs are serious health problem [17, 18]. They cause pain and distress in the affected individuals. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective.The objective of this study is to determine the incidence of PUs, the distribution of PUs, common injuries contributing to the occurrence of PUs in patients admitted to the Department of Plastic and Reconstructive Surgery Kosovo for surgical interventions of PUs, localization of PUs in body, the topical treatment of pressure ulcers before surgical intervention, themethods of surgical interventions, number of surgical interventions, duration of treatment, complications, and mortality. Materials and Methods. This study includes 55 patients with PUs treated surgically in 2000–2010 period in the Department of Plastic and Reconstructive Surgery Kosovo. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Data processing was done with the statistical package In Stat 3. From statistical parameters arithmetic median and standard deviation were calculated. Data testing is done with 𝜒 2-test and the difference is significant if 𝑃 < 0.05. Conclusion. Despite preventive measures against PUs, the incidence of Pus remains high.
    Full-text · Article · Jan 2013
  • Source
    • "Therefore, there is a clear need for rigorous interrater and intrarater reliability and agreement studies to be performed in the future. Studies are also needed for investigating reliability in clinical practice (Kottner et al., 2009b; Innes and Straker, 1999; Hall et al., 2008; Bhat and Rockwood, 2005). We hope that the guidelines will help to improve the quality of reporting. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Results of reliability and agreement studies are intended to provide information about the amount of error inherent in any diagnosis, score, or measurement. The level of reliability and agreement among users of scales, instruments, or classifications is widely unknown. Therefore, there is a need for rigorously conducted interrater and intrarater reliability and agreement studies. Information about sample selection, study design, and statistical analysis is often incomplete. Because of inadequate reporting, interpretation and synthesis of study results are often difficult. Widely accepted criteria, standards, or guidelines for reporting reliability and agreement in the health care and medical field are lacking. The objective was to develop guidelines for reporting reliability and agreement studies. Eight experts in reliability and agreement investigation developed guidelines for reporting. Fifteen issues that should be addressed when reliability and agreement are reported are proposed. The issues correspond to the headings usually used in publications. The proposed guidelines intend to improve the quality of reporting.
    Full-text · Article · Jun 2011 · International journal of nursing studies
  • Source
    • "Systematic reviews on interrater reliability studies have reported that many reliability and agreement estimates are obtained during the course of larger cross-sectional or prospective study designs. Most of these investigations would have been missed when specific search terms like 'reliability' or 'agreement' were not used (Kottner et al., 2009b). If indexing is absent, these reliability and agreement investigations are hardly detectable. "

    Full-text · Article · Mar 2011 · International journal of nursing studies
Show more