Article type
Year
Abstract
Background: There are over 5,000 trials of wound care interventions, many reporting change in wound size. Various methods of wound measurement are available, ranging from simple approaches (e.g. ruler) to technology-dependent techniques (e.g. computerised image analysis). No summaries of evidence on wound measurement techniques using full systematic review methods have been identified.
Objectives: To describe the validity, reliability and feasibility of different methods of estimating the size of pressure ulcers.
Methods: Studies assessing the agreement between at least two methods of pressure ulcer measurement, or the intra-rater reliability, inter-rater reliability or feasibility of at least one method, were eligible for inclusion. Fourteen electronic databases were searched, bibliographies scanned, and experts in the field contacted. Study selection, data extraction and validity assessment were performed by a single reviewer, with queries referred to supervisors. Methodological quality of primary studies was assessed using an adapted checklist, originally designed for use with evaluations of diagnostic accuracy. Studies were summarised using narrative description, grouped according to the wound variables being measured (diameter, depth, perimeter, surface area of wound opening, surface area of wound cavity, wound volume).
Results: Twelve eligible studies were identified overall, including seven evaluations of validity, eight of reliability, three of both validity and reliability, and three of feasibility. In terms of wound variables, there were two studies each for wound diameter, depth and perimeter, nine for the surface area of the wound opening, one for the surface area of the wound cavity, and five for wound volume. The methodological quality of studies was variable, the main problems being absent or inappropriate reference standard and failure to blind to findings of comparator method when interpreting measurement results. The implications of this review for the conduct of systematic reviews on measurement topics generally, and wound research specifically, will be discussed.
Conclusions: A variety of methods are available to use for measuring pressure ulcers. The validity, reliability and feasibility of methods, as well as the methodological quality of evaluations should be taken into account when considering which methods to use for both clinical practice and research.
Objectives: To describe the validity, reliability and feasibility of different methods of estimating the size of pressure ulcers.
Methods: Studies assessing the agreement between at least two methods of pressure ulcer measurement, or the intra-rater reliability, inter-rater reliability or feasibility of at least one method, were eligible for inclusion. Fourteen electronic databases were searched, bibliographies scanned, and experts in the field contacted. Study selection, data extraction and validity assessment were performed by a single reviewer, with queries referred to supervisors. Methodological quality of primary studies was assessed using an adapted checklist, originally designed for use with evaluations of diagnostic accuracy. Studies were summarised using narrative description, grouped according to the wound variables being measured (diameter, depth, perimeter, surface area of wound opening, surface area of wound cavity, wound volume).
Results: Twelve eligible studies were identified overall, including seven evaluations of validity, eight of reliability, three of both validity and reliability, and three of feasibility. In terms of wound variables, there were two studies each for wound diameter, depth and perimeter, nine for the surface area of the wound opening, one for the surface area of the wound cavity, and five for wound volume. The methodological quality of studies was variable, the main problems being absent or inappropriate reference standard and failure to blind to findings of comparator method when interpreting measurement results. The implications of this review for the conduct of systematic reviews on measurement topics generally, and wound research specifically, will be discussed.
Conclusions: A variety of methods are available to use for measuring pressure ulcers. The validity, reliability and feasibility of methods, as well as the methodological quality of evaluations should be taken into account when considering which methods to use for both clinical practice and research.