Responsiveness and reliability of MRI in knee osteoarthritis: a meta-analysis of published evidence
Responsiveness and reliability of MRI in knee osteoarthritis: a meta-analysis of published evidence
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DOI：
10.1016/j.joca.2010.10.030
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发表时间：
2011-05-01
影响因子：
7
通讯作者：
Losina, E.
中科院分区：
文献类型：
--
作者：
Hunter, D. J.;Zhang, W.;Losina, E.
目的：总结基于MRI的膝关节骨关节炎(OA)结构改变测量方法的响应性和可靠性方面的文献。方法：对截至2009年4月的文献进行检索。通过这次检索获得的1338篇摘要被初步筛选为相关性，其中243篇被选择用于数据提取。在这项分析中，我们提取了每个报告的滑膜关节组织的可靠性和响应性数据，因为它与膝关节骨关节炎的MRI测量有关。可靠性由读者间和读者内的类内相关性(ICC)或变异系数或kappa统计来定义。响应性被定义为标准化反应平均值(SRM)-随时间变化的平均值除以变化的标准差的比率。结果：可靠性分析包括84篇稿件的数据。读者间和读者内ICC为优(范围0.8-0.94)，定量和半定量测量的读者间和读者内kappa值均为中等至优秀(范围为0.52-0.88)。最低值(kappa=0.52)对应于半定量滑膜评分在读者内部的可靠性，最高值(ICC=0.94)对应于半定量软骨形态。定量测量胫股内侧关节软骨形态的混合SRM为-0.86(95%可信区间为-1.26~-0.46)。半定量测量内侧胫腓关节软骨形态的共用SRM为0.55(95%CI为0.47~0.64)。对于定量分析，SRM是负值，因为指示软骨丢失的量化值下降。对于半定量分析，表明软骨丢失的SRM是阳性的(分数增加)。结论：MRI在过去十年中有了很大的发展，其优势包括能够可视化单个组织的病理，使用定量和半定量技术可以可靠地测量并具有良好的响应性。(C)2011年国际骨性关节炎研究会。爱思唯尔有限公司出版。保留所有权利。
Objective: To summarize literature on the responsiveness and reliability of MRI-based measures of knee osteoarthritis (OA) structural change.Methods: A literature search was conducted using articles published up to the time of the search, April 2009. 1338 abstracts obtained with this search were preliminarily screened for relevance and of these, 243 were selected for data extraction. For this analysis we extracted data on reliability and responsiveness for every reported synovial joint tissue as it relates to MRI measurement in knee OA. Reliability was defined by inter- and intra-reader intra-class correlation (ICC), or coefficient of variation, or kappa statistics. Responsiveness was defined as standardized response mean (SRM) - ratio of mean of change over time divided by standard deviation of change. Random-effects models were used to pool data from multiple studies.Results: The reliability analysis included data from 84 manuscripts. The inter-reader and intra-reader ICC were excellent (range 0.8-0.94) and the inter-reader and intra-reader kappa values for quantitative and semi-quantitative measures were all moderate to excellent (range 0.52-0.88). The lowest value (kappa = 0.52) corresponded to semi-quantitative synovial scoring intra-reader reliability and the highest value (ICC = 0.94) for semi-quantitative cartilage morphology.The responsiveness analysis included data from 42 manuscripts. The pooled SRM for quantitative measures of cartilage morphometry for the medial tibiofemoral joint was -0.86 (95% confidence intervals (CI) -1.26 to -0.46). The pooled SRM for the semi-quantitative measurement of cartilage morphology for the medial tibiofernoral joint was 0.55 (95% CI 0.47-0.64). For the quantitative analysis, SRMs are negative because the quantitative value, indicating a loss of cartilage, goes down. For the semi-quantitative analysis, SRMs indicating a loss in cartilage are positive (increase in score).Conclusion: MRI has evolved substantially over the last decade and its strengths include the ability to visualize individual tissue pathologies, which can be measured reliably and with good responsiveness using both quantitative and semi-quantitative techniques. (C) 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.