ISTAP system shows validity for classification of skin tears

  • Van Tiggelen H & al.
  • Br J Dermatol
  • 12 Oct 2019

  • International Clinical Digest
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Takeaway

  • The International Skin Tear Advisory Panel (ISTAP) classification system showed good diagnostic accuracy for skin tears in a multinational study.

Why this matters

  • Skin tears are often misdiagnosed and underreported, necessitating a standardised classification system.

Key results

  • The ISTAP system had overall agreement of 0.79 (95% CI, 0.79-0.80) with the reference standard.
    • 0.86 (95% CI, 0.85-0.86) for type 1 tears.
    • 0.75 (95% CI, 0.74-0.75) for type 2 tears.
    • 0.76 (95% CI, 0.76-0.77) for type 3 tears.
  • Mean sensitivity was 0.88 (95% CI, 0.87-0.88) for type 1 tears, 0.77 (95% CI, 0.76-0.77) for type 2 tears, and 0.74 (95% CI, 0.73-0.75) for type 3 tears.
  • Mean specificity was 0.92 (95% CI, 0.92-0.93) for type 1 tears, 0.86 (95% CI, 0.86-0.87) for type 2 tears, and 0.91 (95% CI, 0.90-0.91) for type 3 tears.
  • Inter-rater reliability was 0.57 (95% CI, 0.57-0.57).
  • Intra-rater reliability was 0.74 (95% CI, 0.73-0.75).

Study design

  • The ISTAP classification system was measured for diagnostic accuracy, agreement, and reliability using an online survey of 24 skin tear photographs including 1,601 healthcare professionals from 44 countries.
  • Funding: ISTAP.

Limitations

  • Photographs used for assessment.

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