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Abstract Number: 781

A Patient Based Reliability Exercise of Omeract Ultrasound Definitions in Giant Cell Arteritis

Valentin S. Schäfer1, Stavros Chrysidis2, Christian Dejaco3, Christina Duftner4, Annamaria Iagnocco5, George A. W. Bruyn6, Greta Carrara7, MA D'Agostino8, Eugenio De Miguel9, Andreas P Diamantopoulos10, Ulrich Fredberg11, Wolfgang Hartung12, Alojzija Hočevar13, Tanaz A. Kermani14, Matthew J. Koster15, Tove Lorenzen16, Pierluigi Macchioni17, Marcin Milchert18, Uffe Møller Døhn19, Chetan Mukhtyar20, Cristina Ponte21, Sofia Ramiro22, Carlo Alberto Scirè23, Lene Terslev24, Kenneth J. Warrington15, Bhaskar Dasgupta25 and Wolfgang A. Schmidt26, 1Immanuel Krankenhaus Berlin, Medical Center for Rheumatology Berlin-Buch, Berlin, Germany, 2Department of Rheumatology, Hospital of Southwest Denmark, Esbjerg, Denmark, 3Rheumatology and Immunology, Medical University Graz, Graz, Austria, 4Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria, 5Academic Rheumatology Unit, Università degli Studi di Torino, Torino, Italy, 6Rheumatology, MC Groep, Loenga, Netherlands, 7Epidemiology Unit, Italian Society for Rheumatology, Milano, Italy, 8Rheumatology, Versailles-Saint Quentin en Yvelines University, Boulogne-Billancourt, France, 9Medicine, Universidad Autonoma Madrid, MADRID, Spain, 10Martina Hansens Hospital, Bærum, Oslo, Norway, 11Diagnostic Centre, Silkeborg Regional Hospital, 8600 Silkeborg, Denmark, 12Department of Rheumatology/Clinical Immunology, Asklepios Medical Center, 93077 Bad Abbach, Germany, 13Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, 14Rheumatology, University of California Los Angeles, Los Angeles, CA, 15Rheumatology, Mayo Clinic, Rochester, MN, 16Diagnostic Centre, Region Hospital Silkeborg, Silkeborg, Denmark, 17Arcispedale Santa Maria Nuova, Reggio Emilia, Italy, 18Pomeranian Medical University, Szczecin,, Szczecin, Poland, 19Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Copenhagen Center for Arthritis Research (COPECARE), Glostrup, Denmark, 20Norfolk and Norwich University Hospital, Norwich, United Kingdom, 21Rheumatology Department, Hospital de Santa Maria - Centro Hospital Lisboa Norte, Lisbon, Portugal, 22Rheumatology, Department of Rheumatology, LUMC, Leiden, Netherlands, Leiden, Netherlands, 23Italian Society for Rheumatology, Milan, Italy, 24Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Denmark, Copenhagen, Denmark, 25Rheumatology, Southend University Hospital NHS Foundation Trust, Southend, UK, Westcliff-on-Sea, United Kingdom, 26Medical Center for Rheumatology and Clinical Immunology Berlin-Buch, Immanuel Krankenhaus Berlin, Berlin, Germany

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: giant cell arteritis, outcomes, patient health, ultrasonography and vasculitis

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Session Information

Date: Sunday, November 5, 2017

Session Title: Vasculitis Poster I: Large Vessel Vasculitis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: To test the reliability of recently established consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls.

Methods: A preliminary one-day meeting was held in Southend, United Kingdom. One year later, a full three-day meeting according to OMERACT ultrasound group guidelines for patient based reliability testing was conducted in Berlin, Germany. This meeting included a 6-hour training session for standardization of examination technique and ultrasound machine settings. In both exercises 6-18 MHz linear ultrasound transducers of high quality ultrasound machines were used. Bilateral common superficial temporal arteries with frontal and parietal branches as well as axillary arteries were examined at two time points by 12 sonographers for normal findings, halo sign and compression sign using consensus-based definitions. In the preliminary meeting, 4 patients had longstanding established GCA, 1 patient had severe arteriosclerosis; and 1 normal control was included. In the second meeting, 4 GCA patients with more recent diagnosis and 2 healthy controls were examined. Inter- and intra-observer reliability was calculated.

Results: In the preliminary exercise, inter-reader reliabilities were fair to moderate for the overall diagnosis of GCA (Light’s kappa, 0.29-0.51) and poor to fair for identifying vasculitis in the respective anatomical segments (Light’s kappa, 0.02-0.46). Intra-reader reliabilities were moderate (Cohen’s kappa, 0.32-0.64). In the main exercise, inter-reader reliability was good to excellent (Light’s kappa, 0.76-0.86) for the overall diagnosis of GCA and moderate to good (Light’s kappa, 0.46-0.71) for identifying vasculitis in the respective anatomical segments. Intra-reader reliability was excellent for diagnosis of GCA (Cohen’s kappa, 0.91) and good (Cohen’s kappa, 0.71-0.80) for the anatomical segments.

Conclusion: The patient based reliability for ultrasound definitions of halo and compression sign of temporal and for halo sign of axillary artery is good to excellent in recent onset GCA. Training of a standardized examination protocol is crucial for achieving specific results and good inter- and intra-observer reliabilities. The reliability in established disease requires further study.


Disclosure: V. S. Schäfer, None; S. Chrysidis, None; C. Dejaco, Merck Sharp and Dohme GmbH, 5,Merck Sharp and Dohme GmbH, 7,Merck Sharp and Dohme GmbH, 8; C. Duftner, None; A. Iagnocco, None; G. A. W. Bruyn, None; G. Carrara, None; M. D'Agostino, BMS, AbbVie, Novartis, 8; E. De Miguel, None; A. P. Diamantopoulos, Roche Pharmaceuticals, 8,BMS, 8; U. Fredberg, None; W. Hartung, None; A. Hočevar, None; T. A. Kermani, None; M. J. Koster, None; T. Lorenzen, None; P. Macchioni, None; M. Milchert, None; U. M. Døhn, None; C. Mukhtyar, None; C. Ponte, None; S. Ramiro, None; C. A. Scirè, None; L. Terslev, None; K. J. Warrington, None; B. Dasgupta, None; W. A. Schmidt, None.

To cite this abstract in AMA style:

Schäfer VS, Chrysidis S, Dejaco C, Duftner C, Iagnocco A, Bruyn GAW, Carrara G, D'Agostino M, De Miguel E, Diamantopoulos AP, Fredberg U, Hartung W, Hočevar A, Kermani TA, Koster MJ, Lorenzen T, Macchioni P, Milchert M, Døhn UM, Mukhtyar C, Ponte C, Ramiro S, Scirè CA, Terslev L, Warrington KJ, Dasgupta B, Schmidt WA. A Patient Based Reliability Exercise of Omeract Ultrasound Definitions in Giant Cell Arteritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/a-patient-based-reliability-exercise-of-omeract-ultrasound-definitions-in-giant-cell-arteritis/. Accessed June 1, 2023.
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