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.
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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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-patient-based-reliability-exercise-of-omeract-ultrasound-definitions-in-giant-cell-arteritis/