Scoring radiographic progression in ankylosing spondylitis: should we use the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) or the Radiographic Ankylosing Spondylitis Spinal Score (RASSS)?
Scoring radiographic progression in ankylosing spondylitis: should we use the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) or the Radiographic Ankylosing Spondylitis Spinal Score (RASSS)?
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DOI：
10.1186/ar4144
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发表时间：
2013-01-17
影响因子：
4.9
通讯作者：
van der Heijde D
中科院分区：
文献类型：
--
作者：
Ramiro S;van Tubergen A;Stolwijk C;Landewé R;van de Bosch F;Dougados M;van der Heijde D
影像学损伤是轴位SpA的核心结局之一，通常采用改良斯托克强直性脊柱炎（AS）脊柱评分（mSASSS）进行评估。或者，在大多数进展发生在下胸椎节段的假设下，提出了影像学AS脊柱评分（RASSS），其中包括下胸椎。我们旨在比较mSASSS和RASSS的性能。采用AS国际研究（OASIS）中随访患者的两年一次的脊柱X线片（由两名阅片者独立评分）。共195例患者至少有一次X线片（12年随访）。我们评估了椎体角（VC）评分的可及性，以及两种评分方法的状态和2年进展评分。为了评估将胸段纳入评分的潜在额外价值，确定了每个脊柱节段（颈椎、胸椎和腰椎）对2年总RASSS进展的相对贡献（%），并与预期贡献进行比较，假设将发生平衡的节段进展，与每个节段的部位数量成比例。mSASSS可以在总共809张X线照片中评分，RASSS在其中的78%中评分。在后者的58%中，评分基于1 - 2个可用的胸部VC评分，其余2 - 3个因缺失而进行插补。有520个两年mSASSS间期可用，其中63%的RASSS进展可以评估。mSASSS和RASSS的平均（SD）2年间期进展评分（330个间期）分别为2.0（3.6）和2.4（4.4），产生了相似的效应量（mSASSS 0.57和RASSS 0.55）。仅5%的病例发生了胸段的排他性进展。观察到的（14%）和预期（16%）对胸段进展的贡献之间无显著差异（P = 0.70）。确定脊柱放射学损伤的RASSS通常是不可能的，或者受到非贡献性插补的强烈影响。与mSASSS相比，RASSS方法中胸部VC的贡献可忽略不计，并且不证明额外的评分工作是合理的。
Radiographic damage is one of the core outcomes in axial SpA and is usually assessed with the modified Stoke Ankylosing Spondylitis (AS) Spine Score (mSASSS). Alternatively, the Radiographic AS Spinal Score (RASSS) is proposed, which includes the lower thoracic vertebrae, under the hypothesis that most progression occurs in these segments. We aimed to compare the mSASSS and RASSS with regard to performance. Two-yearly spinal radiographs from patients followed in the Outcome in AS International Study (OASIS) were used (scored independently by two readers). A total of 195 patients had at least one radiograph (12-year follow-up) to be included. We assessed the accessibility of vertebral corners (VCs) for scoring, as well as status and 2-year progression scores of both scoring methods. To assess the potential additional value of including the thoracic segment in the score, the relative contribution (in %) to the 2-year total RASSS progression of each spinal segment (cervical, thoracic and lumbar) was determined, and compared to the expected contribution, under the assumption that a balanced segmental progression would occur, proportional to the number of sites per segment. The mSASSS could be scored in a total of 809 radiographs and the RASSS in 78% of these. In 58% of the latter, the score was based on one to two available thoracic VCs scores, and the remaining two to three were imputed because they were missing. There were 520 two-year mSASSS intervals available, and in 63% of them RASSS progression could be assessed. The mean (SD) 2-year interval progression score (330 intervals) was 2.0 (3.6) for the mSASSS and 2.4 (4.4) for the RASSS, yielding a similar effect size (mSASSS 0.57 and RASSS 0.55). Exclusive progression of the thoracic segment occurred in only 5% of the cases. There was no significant difference between the observed (14%) and expected (16%) contribution to progression of the thoracic segment (P = 0.70). The determination of RASSS for radiographic damage of the spine is frequently impossible or strongly influenced by non-contributory imputation. In comparison to the mSASSS, the contribution of thoracic VCs in the RASSS method is negligible, and does not justify the additional scoring efforts.
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影响因子：
27.4
作者：
Wanders, A;Landewé, R;van der Heijde, D
通讯作者：
van der Heijde, D
影响因子：
4.9
作者：
van der Heijde D;Salonen D;Weissman BN;Landewé R;Maksymowych WP;Kupper H;Ballal S;Gibson E;Wong R;Canadian (M03-606) study group;ATLAS study group
通讯作者：
ATLAS study group
影响因子：
--
作者：
van der Heijde, D.;Landewe, R.;Davis, J. C., Jr.
通讯作者：
Davis, J. C., Jr.
DOI：
10.1002/art.24425
发表时间：
2009-06-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Baraliakos, X.;Listing, J.;Braun, J.
通讯作者：
Braun, J.
影响因子：
27.4
作者：
Wanders, A;Landewé, R;van der Heijde, D
通讯作者：
van der Heijde, D