Cargando…

Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis

Objectives. The aim of this study was to evaluate the association between two semi-quantitative Doppler US scoring systems (SQS), and the quantitative scoring (QS) of Doppler pixel count. Methods. Adult patients with RA and inadequate clinical response to anti-rheumatic therapy were examined with mu...

Descripción completa

Detalles Bibliográficos
Autores principales: Rezaei, Hamed, af Klint, Erik, Hammer, Hilde Berner, Terslev, Lene, D’Agostino, Maria Antonietta, Kisten, Yogan, Arnaud, Laurent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410929/
https://www.ncbi.nlm.nih.gov/pubmed/28123118
http://dx.doi.org/10.1093/rheumatology/kew385
_version_ 1783232762763804672
author Rezaei, Hamed
af Klint, Erik
Hammer, Hilde Berner
Terslev, Lene
D’Agostino, Maria Antonietta
Kisten, Yogan
Arnaud, Laurent
author_facet Rezaei, Hamed
af Klint, Erik
Hammer, Hilde Berner
Terslev, Lene
D’Agostino, Maria Antonietta
Kisten, Yogan
Arnaud, Laurent
author_sort Rezaei, Hamed
collection PubMed
description Objectives. The aim of this study was to evaluate the association between two semi-quantitative Doppler US scoring systems (SQS), and the quantitative scoring (QS) of Doppler pixel count. Methods. Adult patients with RA and inadequate clinical response to anti-rheumatic therapy were examined with musculoskeletal US (MSUS). Dorsal MSUS of the wrists, MCP and MTP 2–5 were performed. MSUS images with sign of synovitis were collected and the QS was measured. Five assessors blinded to the QS evaluated the images independently, according to either SQS method. Association between QS and SQS was studied using correlations and multilevel models taking into account the clustering of ratings at the rater, patient and joint levels. Results. Analysis of the 1190 ratings revealed a strong correlation (ρ = 0.89, P < 0.0001) and significant associations (P < 0.0001) between QS and SQS. Correlations between QS and SQS according to Szkudlarek et al. (ρ = 0.87, P < 0.0001) or Hammer et al. (ρ = 0.91, P < 0.0001) were similar. A total of 239 (20.1%) images were given a SQS grade that did not match that expected based on initial QS, using pre-defined cut-offs. Main explanations for discrepancies were different perceived region of interest (40.7%) and Doppler pixel count near cut-offs between SQS grades (32.3%). Conclusion. We showed that both SQS methods correlated well with QS to assess synovitis, but SQS methods are intrinsically limited when the Doppler pixel count is close to the cut-offs between the SQS grades. Analysis discrepancies between these methods may help further revision of criteria used to assess disease activity with MSUS in RA.
format Online
Article
Text
id pubmed-5410929
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-54109292017-05-04 Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis Rezaei, Hamed af Klint, Erik Hammer, Hilde Berner Terslev, Lene D’Agostino, Maria Antonietta Kisten, Yogan Arnaud, Laurent Rheumatology (Oxford) Clinical Science Objectives. The aim of this study was to evaluate the association between two semi-quantitative Doppler US scoring systems (SQS), and the quantitative scoring (QS) of Doppler pixel count. Methods. Adult patients with RA and inadequate clinical response to anti-rheumatic therapy were examined with musculoskeletal US (MSUS). Dorsal MSUS of the wrists, MCP and MTP 2–5 were performed. MSUS images with sign of synovitis were collected and the QS was measured. Five assessors blinded to the QS evaluated the images independently, according to either SQS method. Association between QS and SQS was studied using correlations and multilevel models taking into account the clustering of ratings at the rater, patient and joint levels. Results. Analysis of the 1190 ratings revealed a strong correlation (ρ = 0.89, P < 0.0001) and significant associations (P < 0.0001) between QS and SQS. Correlations between QS and SQS according to Szkudlarek et al. (ρ = 0.87, P < 0.0001) or Hammer et al. (ρ = 0.91, P < 0.0001) were similar. A total of 239 (20.1%) images were given a SQS grade that did not match that expected based on initial QS, using pre-defined cut-offs. Main explanations for discrepancies were different perceived region of interest (40.7%) and Doppler pixel count near cut-offs between SQS grades (32.3%). Conclusion. We showed that both SQS methods correlated well with QS to assess synovitis, but SQS methods are intrinsically limited when the Doppler pixel count is close to the cut-offs between the SQS grades. Analysis discrepancies between these methods may help further revision of criteria used to assess disease activity with MSUS in RA. Oxford University Press 2017-02 2016-11-14 /pmc/articles/PMC5410929/ /pubmed/28123118 http://dx.doi.org/10.1093/rheumatology/kew385 Text en © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Science
Rezaei, Hamed
af Klint, Erik
Hammer, Hilde Berner
Terslev, Lene
D’Agostino, Maria Antonietta
Kisten, Yogan
Arnaud, Laurent
Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis
title Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis
title_full Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis
title_fullStr Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis
title_full_unstemmed Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis
title_short Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis
title_sort analysis of correlation and causes for discrepancy between quantitative and semi-quantitative doppler scores in synovitis in rheumatoid arthritis
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410929/
https://www.ncbi.nlm.nih.gov/pubmed/28123118
http://dx.doi.org/10.1093/rheumatology/kew385
work_keys_str_mv AT rezaeihamed analysisofcorrelationandcausesfordiscrepancybetweenquantitativeandsemiquantitativedopplerscoresinsynovitisinrheumatoidarthritis
AT afklinterik analysisofcorrelationandcausesfordiscrepancybetweenquantitativeandsemiquantitativedopplerscoresinsynovitisinrheumatoidarthritis
AT hammerhildeberner analysisofcorrelationandcausesfordiscrepancybetweenquantitativeandsemiquantitativedopplerscoresinsynovitisinrheumatoidarthritis
AT terslevlene analysisofcorrelationandcausesfordiscrepancybetweenquantitativeandsemiquantitativedopplerscoresinsynovitisinrheumatoidarthritis
AT dagostinomariaantonietta analysisofcorrelationandcausesfordiscrepancybetweenquantitativeandsemiquantitativedopplerscoresinsynovitisinrheumatoidarthritis
AT kistenyogan analysisofcorrelationandcausesfordiscrepancybetweenquantitativeandsemiquantitativedopplerscoresinsynovitisinrheumatoidarthritis
AT arnaudlaurent analysisofcorrelationandcausesfordiscrepancybetweenquantitativeandsemiquantitativedopplerscoresinsynovitisinrheumatoidarthritis