Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Ultrasound (US) is a sensitive method for detecting osteophytes (OP) in hand osteoarthritis (HOA). To improve the reliability of scoring OP, an US atlas has recently been published including representative OP images of finger joints scored semi-quantitatively 0 to 3 [1].
As an OMERACT exercise we wanted to explore the reliability of OP scoring of finger joints in dynamic examinations of HOA patients with use of an US atlas as reference.
Methods:
One sonographer with limited experience (AM) and one experienced sonographer (HBH) had developed an US atlas of OP in HOA [1]. Together with 8 experienced sonographers a dynamic reliability exercise was performed on scoring of OP in finger joints in patients with HOA. To gain consensus on the scoring method, a reliability test on static images was performed previous to the study, including images of each of the 15 joints to be examined (CMC1, MCP 1-5, PIP 1-5 and DIP 2-5). The images were scored individually by all the sonographers twice (several weeks apart and in a new order the second time) using the US atlas as reference, and the results collected by e-mail showed high reliability (kappa values >0.9). During the dynamic reliability exercise in patients, 5 high-end US machines (GE logic E9) were used and a paper version of the US atlas was available for the sonographers. In 10 HOA patients (5 patients examined each day for two days, all women, median (range) age 74.5 (53-77) years, all fulfilling the ACR criteria) 30 joints were examined twice with at least 3hrs interval. The intra-and inter-examiner reliability was explored by use of kappa statistics (Cohen and Light’s). The prevalence of observed lesions and the percentage of exact agreement (PEA) on a 4 levels (0-3) scale and the percentage of close agreement (PCA, ≤ 1 score difference) were also calculated.
Results:
Good to excellent intra-examiner reliability was found for all sonographers with median (range) weighed kappa values 0.80 (0.68-0.89). The prevalence of OP scores was quite evenly distributed (mean values score 0 =20%, score 1= 26%, score 2= 21% and score 3=33%). The inter-examiner reliability was also good, with mean weighted kappa 0.66 (95%CI 0.63-0.68) the first day and 0.67 (95%CI 0.65-0.70) the second day. There was high agreement between first and second OP scoring (table; PEA=Percentage exact agreement, PCA=Percentage close agreement).
|
|
Rater 1 |
Rater 2 |
Rater 3 |
Rater 4 |
Rater 5 |
Rater 6 |
Rater 7 |
Rater 8 |
Rater 9 |
Rater 10 |
|
PEA |
86 |
85 |
85 |
78 |
78 |
77 |
75 |
75 |
75 |
66 |
|
PCA |
99 |
100 |
99 |
99 |
99 |
98 |
100 |
98 |
98 |
97 |
Conclusion:
The present study shows that using a reference US atlas resulted in very good intra-and inter- observer reliability for dynamic scoring of OP images in patients with finger joint OA. This suggests that US could be developed as a future tool for trials on HOA patients.
Reference
- Mathiessen A et al. Ultrasonographic assessment of osteophytes in 127 patients with hand osteoarthritis: exploring reliability and associations with MRI, radiographs and clinical joint findings. Ann Rheum Dis 2013;72:51–56.
Disclosure:
H. B. Hammer,
None;
A. Mathiessen,
None;
A. Iagnocco,
None;
E. Filippucci,
None;
F. Gandjbakhch,
None;
M. C. Kortekaas,
None;
I. Möller,
None;
E. Naredo,
None;
R. J. Wakefield,
None;
P. Aegerter,
None;
M. A. d’Agostino,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/high-reliability-was-found-for-ultrasound-scoring-of-osteophytes-in-patients-with-hand-osteoarthritis-using-an-atlas-as-reference-an-omeract-initiative/