1. Fast track algorithm: How to differentiate a 'scleroderma pattern' from a 'non-scleroderma pattern'
- Author
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Francesca Ingegnoli, Amber Vanhaecke, Satoshi Kubo, Ellen Deschepper, Valeria Riccieri, Maurizio Cutolo, Ulrich A. Walker, Oliver Distler, Vanessa Smith, Jaap M van Laar, Ulf Müller-Ladner, Miguel G. Guerra, Marwin Gutierrez, Alberto Sulli, Eric Hachulla, Ivan Foeldvari, Ariane L. Herrick, Madelon C. Vonk, Christopher P. Denton, University of Zurich, and Smith, Vanessa
- Subjects
capillaroscopy ,Microscopic Angioscopy/methods ,Review ,Scleroderma, Localized/diagnosis ,"Scleroderma patterns" ,Scleroderma ,Microscopic Angioscopy ,Scleroderma, Localized ,eular study group on microcirculation in rheumatic diseases ,EULAR Study Group on Microcirculation in Rheumatic Diseases ,Medicine and Health Sciences ,Immunology and Allergy ,scleroderma ,CLASSIFICATION CRITERIA ,Reliability (statistics) ,ABNORMALITIES ,10051 Rheumatology Clinic and Institute of Physical Medicine ,MICROSCOPY ,Reliability ,MICROVASCULAR DAMAGE ,Localized/diagnosis ,localized ,2723 Immunology and Allergy ,“scleroderma patterns” ,Fast track ,Algorithm ,Algorithms ,algorithm ,experts ,novices ,reliability ,humans ,microscopic angioscopy ,reproducibility of results ,scleroderma, localized ,scleroderma, systemic ,algorithms ,Immunology ,Novices ,Decision tree ,610 Medicine & health ,AMERICAN-COLLEGE ,Capillaroscopy ,Experts ,Scleroderma patterns ,NAILFOLD VIDEOCAPILLAROSCOPY ASSESSMENT ,Rheumatic Diseases ,medicine ,Journal Article ,EULAR Study Group on Microcirculation in ,Humans ,SIMPLE CAPILLAROSCOPIC DEFINITIONS ,2403 Immunology ,Scleroderma, Systemic ,business.industry ,Systemic/diagnosis ,SYSTEMIC-SCLEROSIS ,External validation ,Reproducibility of Results ,EULAR Study Group on Microcirculation in Rheumatic Diseases, Capillaroscopy, Reliability, “Scleroderma patterns”, Novices, Experts, Algorithm ,systemic ,medicine.disease ,Scleroderma, Systemic/diagnosis ,Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] ,MORPHOLOGY ,business ,Kappa ,Rheumatism - Abstract
Contains fulltext : 215793.pdf (Publisher’s version ) (Open Access) OBJECTIVES: This study was designed to propose a simple "Fast Track algorithm" for capillaroscopists of any level of experience to differentiate "scleroderma patterns" from "non-scleroderma patterns" on capillaroscopy and to assess its inter-rater reliability. METHODS: Based on existing definitions to categorise capillaroscopic images as "scleroderma patterns" and taking into account the real life variability of capillaroscopic images described standardly according to the European League Against Rheumatism (EULAR) Study Group on Microcirculation in Rheumatic Diseases, a fast track decision tree, the "Fast Track algorithm" was created by the principal expert (VS) to facilitate swift categorisation of an image as "non-scleroderma pattern (category 1)" or "scleroderma pattern (category 2)". Mean inter-rater reliability between all raters (experts/attendees) of the 8th EULAR course on capillaroscopy in Rheumatic Diseases (Genoa, 2018) and, as external validation, of the 8th European Scleroderma Trials and Research group (EUSTAR) course on systemic sclerosis (SSc) (Nijmegen, 2019) versus the principal expert, as well as reliability between the rater pairs themselves was assessed by mean Cohen's and Light's kappa coefficients. RESULTS: Mean Cohen's kappa was 1/0.96 (95% CI 0.95-0.98) for the 6 experts/135 attendees of the 8th EULAR capillaroscopy course and 1/0.94 (95% CI 0.92-0.96) for the 3 experts/85 attendees of the 8th EUSTAR SSc course. Light's kappa was 1/0.92 at the 8th EULAR capillaroscopy course, and 1/0.87 at the 8th EUSTAR SSc course. CONCLUSION: For the first time, a clinical expert based fast track decision algorithm has been developed to differentiate a "non-scleroderma" from a "scleroderma pattern" on capillaroscopic images, demonstrating excellent reliability when applied by capillaroscopists with varying levels of expertise versus the principal expert and corroborated with external validation.
- Published
- 2019