Measurement instruments to evaluate diaper dermatitis in children: Systematic review of measurement properties.
Sibylle Reick, Marion Burckhardt, Rebecca Palm and 1 others
PMID 37209008WHAT IT FOUND
No measurement instrument for diaper dermatitis in children is currently recommended for use.
The three available scales have inconsistent validity and low-quality evidence, so standardized severity assessment remains unproven in clinical practice.
Key findings
01Current evidence does not support the use of any specific instrument to measure the severity of diaper dermatitis in children.
02The quality of evidence for the content validity of the three identified instruments was rated as moderate, very low, or low, with no other measurement properties adequately reported.
03The newDDS scale performed best among the reviewed instruments but still had high risk of bias and insufficient comprehensibility, preventing a recommendation for clinical or research use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only three instruments met inclusion criteria, limiting the scope of evaluation. The COSMIN methodology was adapted for clinician-reported outcomes, which may have affected the assessment of content validity. No instruments accounted for different skin colors or specific age groups beyond infants. Many other instruments used in research were excluded due to a lack of reported measurement properties.
Declared interests
The authors declare no conflicts of interest. No funding was provided for this review.
The easy way to misread this
Do not interpret the lack of a recommended instrument as evidence that assessment is unnecessary. Standardized severity evaluation may still enhance practice, but current tools are not validated enough to replace clinical judgment or support research trials without further development.