Inter and Intra-observer Reliability of Assessment for Nailfold Capillary Abnormalities in Rheumatic Patients with Raynaud’s Phenomenon

Chunxiao Wang¹, Haiyan Xu², Xiaoli Jiang³, Feifei Jiang⁴ and Yue Zhuang⁵, ¹University of Electronic Science and Technology of China, Chengdu, China, ²Department of Endocrinology, Metabolism, Rheumatology and Immunology, Dazhou Hospital of Integrated Traditional Chinese and Western Medicine, Dazhou, China, ³Department of Neurology, Nanchong Gaoping District People's Hospital, Nanchong, China, ⁴Department of nephrology, rheumatology and immunology, Jinniu District People's Hospital of Chengdu, Chengdu, China, ⁵Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China

Meeting: ACR Convergence 2023

Keywords: Raynaud's phenomenon

Session Information

Date: Tuesday, November 14, 2023

Title: (1862–1894) Imaging of Rheumatic Diseases Poster II

Session Type: Poster Session C

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

Background/Purpose: To investigate the consistency of rheumatologists’ assessment of nailfold capillaroscopy images of patients with Raynaud’s phenomenon (RP).

Methods: Nailfold video capillaroscopy(NVC), with a 200x magnification, was used to acquire images from6 digits (the second, third and fourth fingers of both hands) of patients with RP. According to the European League Against Rheumatism Study Group on Microcirculation in Rheumatic Diseases (EULAR SG MC/RD) standardized capillaroscopy evaluation chart, 5 trained rheumatologists classified all NVC images into five patterns: “normal”, “non-specific”, “early”, “active” and “late”, and their majority votes derived the gold standard. Two months later, one-fifth of these images were randomly selected for a second assessment by the same rheumatologists. Intra-class correlation coefficient (ICC) was used to analyze inter and intra-observer reliability, and Student’s t test was used to compare ICC scores.

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Results: We enrolled 302 participants with RP, 15 of them with primary and 287 with secondary RP. A total of 3805 high-resolution NVC images were obtained, with an average of 13.3 images per patient. The intra-observer reliability of assessment was higher than the inter- (ICC0.894 within and 0.645 between observers, p=0.001). There was poor reliability among rheumatologists for the evaluation of normal and non-specific patterns (inter-observer ICC 0.480 and 0.428 respectively). Agreement for the identification of active and late patterns (inter-observer ICC 0.508 and 0.513, respectively) is higher than for the early pattern (0.387, p=0.001).

Conclusion: Relatively low reliability between observers is one of the major problems in manual assessment of nailfold capillaries of RP patients. Methods to improve the consistency need to be proposed.

Disclosures: C. Wang: None; H. Xu: None; X. Jiang: None; F. Jiang: None; Y. Zhuang: None.

To cite this abstract in AMA style:

Wang C, Xu H, Jiang X, Jiang F, Zhuang Y. Inter and Intra-observer Reliability of Assessment for Nailfold Capillary Abnormalities in Rheumatic Patients with Raynaud’s Phenomenon [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/inter-and-intra-observer-reliability-of-assessment-for-nailfold-capillary-abnormalities-in-rheumatic-patients-with-raynauds-phenomenon/. Accessed .

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