Achieving consensus in ultrasonography synovitis scoring in rheumatoid arthritis. 2014

Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
Division of Rheumatology, National University Hospital, Singapore City, Singapore; Yong Loo Lin School of Medicine, National University, Singapore City, Singapore.

OBJECTIVE Ultrasonography is sensitive for synovitis detection but interobserver variation in both acquisition and image interpretation is still a concern. The objective was to assess if a short collegiate consensus would improve inter-observer reliability in scoring of synovitis. METHODS Eight rheumatologists (Singapore) participated in a 1-day consensus meeting divided into: (i) still-image interpretation and consensus followed by; (ii) image acquisition and interpretation, according to definitions and synovitis scoring rules endorsed by Outcome Measures in Rheumatology (OMERACT) and TUI (Targeted Ultrasound Initiative). Interobserver reliability of semiquantitative scoring in B-mode, Power Doppler (PDUS) and European League Against Rheumatism (EULAR)-OMERACT PDUS composite score was assessed by intraclass correlation co-efficient (ICC). Agreement at the joint region level was calculated using prevalence-adjusted-biased-adjusted-kappa (PABAK). RESULTS For B-mode still images, ICC was good at 0.75 (95% CI 0.66-0.82) while for PDUS images this was excellent at ICC = 0.88 (95% CI 0.83-0.92) with ICC improving by 12% for B-mode and 13% for PDUS respectively. During image acquisition and interpretation, B-mode scoring showed ICC = 0.75 (95% CI 0.66-0.84) while for PDUS the ICC was lower at 0.59 (95% CI 0.48-0.72). The ICC for OMERACT PDUS composite synovitis scoring was good at 0.77 (95% CI 0.68-0.85). At the joint level, agreement varied with PABAK being excellent in the small joints of the hands but poor to fair in the wrists, elbows, ankles and metatarsophalangeal joints, and no agreement at the knees (PABAK range -0.34 to 0.85). CONCLUSIONS A consensus meeting was useful in improving interobserver variation in US synovitis scoring of still images, but image acquisition and interpretation especially in non-hand joints require further standardization.

UI MeSH Term Description Entries
D007596 Joints Also known as articulations, these are points of connection between the ends of certain separate bones, or where the borders of other bones are juxtaposed. Joint
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001172 Arthritis, Rheumatoid A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated. Rheumatoid Arthritis
D012720 Severity of Illness Index Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder. Illness Index Severities,Illness Index Severity
D012846 Singapore Country of islands in Southeastern Asia, islands between Malaysia and Indonesia. The capital is Singapore.
D013585 Synovitis Inflammation of the SYNOVIAL MEMBRANE. Plica Syndrome,Synovial Plica Syndrome,Synovial Hypertrophy,Synovial Thickening,Hypertrophies, Synovial,Hypertrophy, Synovial,Plica Syndrome, Synovial,Synovial Hypertrophies,Synovial Thickenings,Synovitides,Thickening, Synovial,Thickenings, Synovial
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face
D015588 Observer Variation The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material). Bias, Observer,Interobserver Variation,Intraobserver Variation,Observer Bias,Inter-Observer Variability,Inter-Observer Variation,Interobserver Variability,Intra-Observer Variability,Intra-Observer Variation,Intraobserver Variability,Inter Observer Variability,Inter Observer Variation,Inter-Observer Variabilities,Inter-Observer Variations,Interobserver Variabilities,Interobserver Variations,Intra Observer Variability,Intra Observer Variation,Intra-Observer Variabilities,Intra-Observer Variations,Intraobserver Variabilities,Intraobserver Variations,Observer Variations,Variabilities, Inter-Observer,Variabilities, Interobserver,Variabilities, Intra-Observer,Variabilities, Intraobserver,Variability, Inter-Observer,Variability, Interobserver,Variability, Intra-Observer,Variability, Intraobserver,Variation, Inter-Observer,Variation, Interobserver,Variation, Intra-Observer,Variation, Intraobserver,Variation, Observer,Variations, Inter-Observer,Variations, Interobserver,Variations, Intra-Observer,Variations, Intraobserver,Variations, Observer
D018608 Ultrasonography, Doppler Ultrasonography applying the Doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. (Stedman, 25th ed) Doppler Ultrasonography,Doppler Ultrasound,Doppler Ultrasound Imaging,Doppler Ultrasound Imagings,Doppler Ultrasounds,Imaging, Doppler Ultrasound,Imagings, Doppler Ultrasound,Ultrasound Imaging, Doppler,Ultrasound Imagings, Doppler,Ultrasound, Doppler,Ultrasounds, Doppler

Related Publications

Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
April 1999, Pathology international,
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
June 2011, BMC musculoskeletal disorders,
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
January 2017, RMD open,
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
September 2014, International journal of rheumatic diseases,
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
September 1972, Journal of chronic diseases,
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
January 2018, Rheumatology (Oxford, England),
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
January 2017, RMD open,
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
January 2022, Journal of medical ultrasound,
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
January 2006, Scandinavian journal of rheumatology,
Peter P Cheung, and Kok Ooi Kong, and Li-Ching Chew, and Faith L Chia, and Weng Giap Law, and Tsui Yee Lian, and York Kiat Tan, and Yew Kuang Cheng
May 2010, Annals of the rheumatic diseases,
Copied contents to your clipboard!