Examination of intra and interrater reliability with a new ultrasonographic reference atlas for scoring of synovitis in patients with rheumatoid arthritis
Examination of intra and interrater reliability with a new ultrasonographic reference atlas for scoring of synovitis in patients with rheumatoid arthritis
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DOI：
10.1136/ard.2011.152926
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发表时间：
2011-11-01
影响因子：
27.4
通讯作者：
Haavardsholm, Espen A.
中科院分区：
文献类型：
--
作者：
Hammer, Hilde Berner;Bolton-King, Pernille;Haavardsholm, Espen A.
目的应用B超和能量多普勒超声对类风湿关节炎（RA）滑膜炎进行半定量（0-3分）评分。目的是评估的可靠性BM和PD检查与一个新的超声图谱作为reference.Methods的BM和PD的代表性超声图像（包括分数0-3）从24个不同的关节收集，开发一个超声图谱。10例RA患者由5名风湿病学家进行两次评估，对双侧16个关节进行BM和PD评分（0-3（掌指关节1-5，腕关节（桡腕关节、腕间关节、桡尺关节）、肘关节、膝关节、距小腿和跖趾关节1-5），结果BM/PD诊断符合率的中位数（范围）为73.1（70.3-80.6）/83.7（76.7-87.6），与加权值接近一致率为98.1（96.2-99.7）/98.0（96.8-98.4）。BM和PD的中位数（范围）分别为0.77（0.70-0.83）和0.83（0.73-0.86）。BM/PD评分的组内相关系数（ICC）为0.95（0.93-0.99）/0.97（0.95-0.99），评分者间ICC为0.95（0.86-0.99）/0.97（0.94-1.00）。32个关节的评分完成时间中位数为15 min（范围12-20 min）。结论以超声图谱为参考，BM和PD评分具有较高的评价者内和评价者间信度。这一新的图谱可能是一个有用的资源，在临床实践和研究。
Objective Synovitis in patients with rheumatoid arthritis (RA) may be scored semiquantitatively (0-3) for B-mode (BM) and power Doppler (PD) ultrasonography. The objective was to assess the reliability of BM and PD examinations with a novel ultrasonographic atlas as reference.Methods Representative ultrasound images (including scores 0-3) of BM and PD from 24 different joints were collected to develop an ultrasonographic atlas. Ten RA patients were assessed twice by five rheumatologists performing BM and PD scoring (0-3) of 16 joints bilaterally (metacarpophalangeal 1-5, wrist (radiocarpal, intercarpal, radioulnar), elbow, knee, talocrural and metatarsophalangeal 1-5), with the novel ultrasonographic atlas as a reference.Results The median (range) percentages of exact agreements for BM/PD assessments were 73.1 (70.3-80.6)/83.7 (76.7-87.6) and for close agreement 98.1 (96.2-99.7)/98.0 (96.8-98.4) with weighted. values of median (range) 0.77 (0.70-0.83) for BM and 0.83 (0.73-0.86) for PD. The intrarater intraclass correlation coefficients (ICC) for BM/PD scores were 0.95 (0.93-0.99)/0.97 (0.95-0.99) and interrater ICC were 0.95 (0.86-0.99)/0.97 (0.94-1.00). Scoring of 32 joints was completed in median 15 min (range 12-20).Conclusion With the use of an ultrasonographic atlas as reference high intra and interrater reliability was found for BM and PD scoring. This novel atlas may be a useful resource in clinical practice and research.