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Title: Predicting delayed healing: The diagnostic accuracy of a venous leg ulcer risk assessment tool.
Austin Authors: Edwards, Helen E;Parker, Christina N;Miller, Charne;Gibb, Michelle;Kapp, Suzanne;Ogrin, Rajna;Anderson, Jacinta;Coleman, Kerrie;Smith, Dianne;Finlayson, Kathleen J
Affiliation: Faculty of Health, Queensland University of Technology, Brisbane, Australia
Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
Wound Management Innovation Cooperative Research Centre, Australia
La Trobe University, Melbourne, Australia
Alfred Health Clinical School, Melbourne, Australia
Department of Nursing, School of Health Sciences, The University of Melbourne, Melbourne, Australia
Austin Health, Heidelberg, Victoria, Australia
Centre for wound management, RDNS Institute, St. Kilda, Australia
Royal District Nursing Service, Brisbane, Australia
Multidisciplinary Skin Integrity Service, Royal Brisbane & Womens Hospital, Brisbane, Australia
Issue Date: Apr-2018 2017-12-26
Publication information: International wound journal 2018; 15(2): 258-265
Abstract: The aim of this study was to validate a newly developed tool that can predict the risk of failure to heal of a venous leg ulcer in 24 weeks. The risk assessment tool was validated, and performance of the tool was assessed using Area Under the Receiver Operating Characteristic Curve (AUC) analysis. Retrospective and prospective validation was conducted through multi-site, longitudinal studies. In the retrospective study (n = 318), 30% of ulcers did not heal within 24 weeks, with the tool demonstrating an AUC of 0.80 (95% CI, 0.68-0.93, P < .001) for the total score. In the prospective study across 10 clinical sites (n = 225), 31% (n = 68) of ulcers did not heal within 24 weeks. Participants were classified with the RAT at enrolment as being at low risk (27%), moderate risk (53%) or high risk (20%) of delayed healing; the proportion of wounds unhealed at 24 weeks was 6%, 29% and 59%, respectively. Validation results of the total score indicated good discrimination and goodness of fit with an AUC of 0.78 (95% CI, 0.71-0.85, P < .001). Validation of this risk assessment tool offers assurance that realistic outcomes can be predicted for patients, and scores can guide early decisions on interventions to address specific risk factors for failing to heal, thus promoting timely healing.
DOI: 10.1111/iwj.12859
ORCID: 0000-0002-4192-7254
PubMed URL: 29277969
Type: Journal Article
Subjects: delayed healing
risk assessment tool
venous leg ulcer
Appears in Collections:Journal articles

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