Reading radiographs in pairs or in chronological order influences radiological progression in osteoarthritis
Reading radiographs in pairs or in chronological order influences radiological progression in osteoarthritis
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DOI：
10.1093/rheumatology/kei044
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发表时间：
2005-11-01
期刊：
影响因子：
5.5
通讯作者：
Kloppenburg, M
中科院分区：
文献类型：
--
作者：
Botha-Scheepers, S;Watt, I;Kloppenburg, M
目标。目的：确定多个部位的骨性关节炎(OA)患者在2年的随访期内，不同的X线片读取顺序对变化敏感度的影响。在基线和2年后获得至少两个关节部位的20例骨性关节炎患者的X线片，并根据两位读者的共识进行评分。手、髋关节和胫股关节的关节间隙变窄(JSN)和骨赘分级(0~3)。颈椎(C2-7)和腰椎(L1-S1)的椎间隙狭窄(DSN)和前路骨赘的分级(0-3)。电影通过两种不同的程序阅读：成对的，时间顺序未知的和按时间顺序的。放射学进展被定义为JSN、DSN或骨赘总分至少增加一级。采用标准化反应方法(SRM)对两种方法进行比较。手、髋关节、膝关节和脊柱的JSN或DSN进展分数变化的SRM分别为0.00、0.00、0.32、0.13和0.38、0.32、0.56、0.18。手部、髋部、膝部和脊柱的骨赘进展评分变化的SRM分别为0.39、0.20、0.32、0.38和0.41、0.37、0.56、0.66。在评估骨性关节炎的放射进展时，按时间顺序阅读一系列X线片往往比成对阅读时间顺序未知的两年内的变化更敏感。
Objective. To determine the influence of the order in which a series of radiographs were read on the sensitivity to change over a 2-yr follow-up period in patients with osteoarthritis (OA) at multiple sites.Methods. Radiographs of 20 patients with OA in at least two joint sites were obtained at baseline and after 2 yr, and scored according to the consensus of two readers. Joint space narrowing (JSN) and osteophytes were graded (0-3) in the hand, hip and tibiofemoral joints. The cervical (C2-7) and lumbar spine disc spaces (L1-S1) were graded (0-3) for disc space narrowing (DSN) and anterior osteophytes. Films were read by two different procedures: in pairs, with an unknown time sequence and in chronological order. Radiological progression was defined as an increase of at least one grade in JSN, DSN or osteophyte total scores. The two procedures were compared using standardized response means (SRM).Results. The SRM for changes in JSN or DSN progression scores in the hands, hips, knees and spine were, respectively, 0.00, 0.00, 0.32, 0.13 and 0.38, 0.32, 0.56, 0.18 for the paired and chronological readings. The SRM for changes in osteophyte progression scores in the hands, hips, knees and spine were, respectively, 0.39, 0.20, 0.32, 0.38 and 0.41, 0.37, 0.56, 0.66 for the paired and chronological readings.Conclusion. When assessing radiological progression in OA, reading a series of radiographs in chronological order tended to be more sensitive to change over a 2-yr follow-up period than reading in pairs with an unknown time sequence.