title: [Interobserver variation in the Red-Yellow-Black wound classification system].
abstract: Communicating wound descriptions between disciplines for treatment and wound care necessitates a simple and unequivocal classification system. The Red-Yellow-Black (RYB) system has been suggested to comply with these demands. The reliability of the RYB-system has, however only been investigated in small studies. The aim of this study was to determine interobserver homogeneity (group Kappa a.m. Schouten) of the RYB-system and further to examine whether interobserver homogeneity was dependent on educational level. One-hundred-and-twenty photo-slides of non-healing ulcers of various etiologies were shown to 21 observers who recorded their assessments in an entry form without discussing their assessments with the other observers. Eighty-nine percent of the possible assessments were completed. Observed agreement for all observers = 0.65; Kappa = 0.47. Kappa-coefficient in subgroup of nurses = 0.49, subgroup of physicians with less than three years of experience with wound treatment = 0.46 and for physicians with more than 10 years of experience with wound healing = 0.48. In conclusion, we demonstrated moderate interobserver agreement for using the RYB-characteristics. The RYB-system is useful for communication about wound care and treatment. However, continuous education and consensus meetings are advisable to increase agreement.
authors.affiliation: Videncenter for sårheling S, H:S Bispebjerg Hospital.
authors.forename: H F
authors.initials: HF
authors.lastname: Lorentzen
authors.forename: P
authors.initials: P
authors.lastname: Holstein
authors.forename: F
authors.initials: F
authors.lastname: Gottrup
mesh_terms: D006801:Humans; D007871:Leg Ulcer / Q000145:classification* / Q000175:diagnosis; D009369:Neoplasms / Q000150:complications; D015588:Observer Variation; D003668:Pressure Ulcer / Q000145:classification* / Q000175:diagnosis / Q000209:etiology; D017511:Pyoderma Gangrenosum / Q000145:classification / Q000175:diagnosis; D012883:Skin Ulcer / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D014456:Ulcer / Q000145:classification* / Q000175:diagnosis / Q000209:etiology; D014647:Varicose Ulcer / Q000145:classification / Q000175:diagnosis; D014657:Vasculitis / Q000150:complications; D014945:Wound Healing