Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score).
Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score).
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DOI：
10.1016/j.joca.2011.05.004
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发表时间：
2011-08
影响因子：
7
通讯作者：
Roemer, F. W.
中科院分区：
文献类型：
--
作者：
Hunter, D. J.;Guermazi, A.;Lo, G. H.;Grainger, A. J.;Conaghan, P. G.;Boudreau, R. M.;Roemer, F. W.
在努力发展半定量评分方法的基础上确定现有工具的局限性，整合专家读者的经验与所有可用的评分工具和出版的数据比较不同的评分系统，我们迭代开发了MRI骨关节炎膝关节评分（MOAKS）。本报告的目的是描述仪器及其可靠性。MOAKS工具细化了BML评分（提供区域划分和跨区域评分）、软骨评分（亚区域评估），并细化了椎间盘形态学要素（增加了椎间盘肥大、部分浸渍和进行性部分浸渍）评分。在培训和校准会议后，两名专家阅片员分别读取了20个膝关节的MRI。此外，一名阅片人在4周后重新阅读相同的20个MRI，以随机顺序评估评估者内可靠性。此处提供的分析针对评估者内和评估者间可靠性（使用线性加权Kappa和总体一致率计算）。除了胫骨软骨面积（kappa=0.36）和胫骨骨赘（kappa=0.49）的评定者间可靠性;以及胫骨BML病变数量（kappa=0.54）、Hoffa滑膜炎（kappa=0.42）的评定者间可靠性外，使用kappa统计的所有可靠性指标均非常好（0.61-0.8）或达到近乎完美的一致性（0.81-1.0）。只有Hoffa滑膜炎的评估者内可靠性和胫骨和髌骨骨赘的评估者间可靠性显示总体一致率<75%。MOAKS评分显示，对于评估的大多数功能，可靠性非常好。进一步的迭代开发和研究将包括对其有效性和响应性的评估。
In an effort to evolve semi-quantitative scoring methods based upon limitations identified in existing tools, integrating expert readers’ experience with all available scoring tools and the published data comparing the different scoring systems, we iteratively developed the MRI Osteoarthritis Knee Score (MOAKS). The purpose of this report is to describe the instrument and its reliability. The MOAKS instrument refines the scoring of BMLs (providing regional delineation and scoring across regions), cartilage (sub-regional assessment), and refines the elements of meniscal morphology (adding meniscal hypertrophy, partial maceration and progressive partial maceration) scoring. After a training and calibration session two expert readers read MRIs of 20 knees separately. In addition, one reader re-read the same 20 MRIs 4 weeks later presented in random order to assess intra-rater reliability. The analyses presented here are for both intra- and inter-rater reliability (calculated using the linear weighted kappa and overall percent agreement). With the exception of inter-rater reliability for tibial cartilage area (kappa=0.36) and tibial osteophytes (kappa=0.49); and intra-rater reliability for tibial BML number of lesions (kappa=0.54), Hoffa-synovitis (kappa=0.42) all measures of reliability using kappa statistics were very good (0.61-0.8) or reached near perfect agreement (0.81-1.0). Only intra-rater reliability for Hoffa-synovitis, and inter-rater reliability for tibial and patellar osteophytes showed overall percent agreement < 75%. MOAKS scoring shows very good to excellent reliability for the large majority of features assessed. Further iterative development and research will include assessment of its validation and responsiveness.
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作者：
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