Assessing the reliability and validity of the revised WCCNR stomatitis staging system for cancer therapy-induced stomatitis.

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 WCCNR R , 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 WCCNR R  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 WCCNR R is a valid and reasonably reliable tool for staging stomatitis due to cancer therapy.