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2017 ; 3
(1
): e000427
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gab.com Text
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English Wikipedia
Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound
taskforce-Part 2: reliability and application to multiple joints of a
standardised consensus-based scoring system
#MMPMID28948984
Terslev L
; Naredo E
; Aegerter P
; Wakefield RJ
; Backhaus M
; Balint P
; Bruyn GAW
; Iagnocco A
; Jousse-Joulin S
; Schmidt WA
; Szkudlarek M
; Conaghan PG
; Filippucci E
; D'Agostino MA
RMD Open
2017[]; 3
(1
): e000427
PMID28948984
show ga
OBJECTIVES: To test the reliability of new ultrasound (US) definitions and
quantification of synovial hypertrophy (SH) and power Doppler (PD) signal,
separately and in combination, in a range of joints in patients with rheumatoid
arthritis (RA) using the European League Against Rheumatisms-Outcomes Measures in
Rheumatology (EULAR-OMERACT) combined score for PD and SH. METHODS: A stepwise
approach was used: (1) scoring static images of metacarpophalangeal (MCP) joints
in a web-based exercise and subsequently when scanning patients; (2) scoring
static images of wrist, proximal interphalangeal joints, knee and
metatarsophalangeal joints in a web-based exercise and subsequently when scanning
patients using different acquisitions (standardised vs usual practice). For
reliability, kappa coefficients (?) were used. RESULTS: Scoring MCP joints in
static images showed substantial intraobserver variability but good to excellent
interobserver reliability. In patients, intraobserver reliability was the same
for the two acquisition methods. Interobserver reliability for SH (?=0.87) and PD
(?=0.79) and the EULAR-OMERACT combined score (?=0.86) were better when using a
'standardised' scan. For the other joints, the intraobserver reliability was
excellent in static images for all scores (?=0.8-0.97) and the interobserver
reliability marginally lower. When using standardised scanning in patients, the
intraobserver was good (?=0.64 for SH and the EULAR-OMERACT combined score, 0.66
for PD) and the interobserver reliability was also good especially for PD (?
range=0.41-0.92). CONCLUSION: The EULAR-OMERACT score demonstrated moderate-good
reliability in MCP joints using a standardised scan and is equally applicable in
non-MCP joints. This scoring system should underpin improved reliability and
consequently the responsiveness of US in RA clinical trials.
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