Assessing the reliability and validity of the revised WCCNR Stomatitis Staging System for cancer therapy-induced stomatitis

Karin Olson, John Hanson, Joan Hamilton, Dawn Stacey, Margaret Eades, Deborah Gue, Harry Plummer, Karen Janes, Margaret Fitch, Debra Bakker, Pamela Baker, Catherine Oliver


Before developing interventions for stomatitis, nurses require a simple, valid and reliable approach to staging severity. The eight-item WCCNR was previously validated for chemotherapy-induced stomatitis. In this study, the validity and reliability of the WCCNRR, a shorter three-item tool for staging stomatitis caused by chemotherapy, radiotherapy, or both, was assessed. Pairs of data collectors evaluated 207 patients from 10 Canadian cancer centres. The WCCNRR correlated well with the MacDibbs Mouth Assessment (r=0.44, p=0.0002 to r=0.54, p<0.0001), a standardized tool for staging radiotherapy-induced stomatitis. Agreement between data collectors at five sites was acceptable (kappa=0.75); three additional sites were close to this target. Findings indicate that the WCCNRR is a valid and reasonably reliable tool for staging stomatitis due to cancer therapy.

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