1. Video clip assessment of a salivary gland ultrasound scoring system in Sjögren’s syndrome using consensual definitions: an OMERACT ultrasound working group reliability exercise
- Author
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Lene Terslev, Stavros Chrysidis, Daryl K. MacCarter, Florence Gatineau, Mohamed Mortada, Frédérique Gandjbakhch, Georgios Filippou, Annamaria Iagnocco, Stephanie Finzel, Alen Zabotti, Isabelle Chary-Valckenaere, Cristina Hernández-Díaz, Maria Antonietta D'Agostino, Daniel Hammenfors, Juan José de Agustín, Marina Backhaus, Wolfgang A. Schmidt, George A W Bruyn, Martin H Stradner, Céline Nicolas, Giorgio Tamborrini, Ghada El Mardenly, Ralf G. Thiele, Alojzija Hočevar, Sandrine Jousse-Joulin, Zarrin Alavi, Sarah Ohrndorf, Cornelia Glaser, Petra Hanova, Christian Dejaco, Esperanza Naredo, Paz Collado, Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Rhumatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Rheumatology Severo Ochoa University Hospital, Madrid, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Faculty of Medicine, University of Zürich, Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Copenhagen Center for Arthritis Research,Copenhagen (Center for Rheumatology and Spine Diseases), Università degli studi di Torino (UNITO), Severo Ochoa Hospital, Musculoskeletal Ultrasound Laboratory, Mexico, Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Medical Centre for Rheumatology, Berlin, Rheumatology Unit [Siena], Rheumatology, Medical University Graz, Rheumatology and Immunology, Graz, Rheumatology Zagazig, Department of Rheumatology (Dep Rheumato - Ljubljana - SLOVENIE), University Medical Centre Slovenia, Rheumatology, Esbjerg, Rheumatology Department, Cairo, Rheumatology, Barcelona, Department of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester [USA], Rheumatology, North Valley Hospital, Whitefish, Montana, Rheumatology and Clinical Immunology, University Medical Center Freiburg, Institute of rheumatology, Rheumatology, Hana CB spol sro, Ceske Budejovice, Rheumatology Clinic, Academic Hospital S.M. Della Misericordia, Udine, Department of Rheumatology and Immunology, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Clinical Science and Department of Rheumatology, Bergen, and MC Groep Hospitals, Lelystad
- Subjects
medicine.medical_specialty ,Scoring system ,Consensus ,Settore MED/16 - REUMATOLOGIA ,Delphi Technique ,salivary glands ,[SDV]Life Sciences [q-bio] ,Immunology ,education ,Sensitivity and Specificity ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Computer-Assisted ,Rheumatology ,Major Salivary Gland ,Image Interpretation, Computer-Assisted ,Immunology and Allergy ,Medicine ,Humans ,030212 general & internal medicine ,CLIPS ,Image Interpretation ,Reliability (statistics) ,computer.programming_language ,Ultrasonography ,030203 arthritis & rheumatology ,Salivary gland ,business.industry ,ultrasound ,Ultrasound ,OMERACT ,primary sjögren syndrome ,reliability exercise ,Reproducibility of Results ,medicine.anatomical_structure ,Sjogren's Syndrome ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Radiology ,Sjogren s ,business ,computer ,Kappa - Abstract
ObjectiveTo develop ultrasound (US) definitions and a US novel scoring system for major salivary gland (SG) lesions in patients with primary Sjögren’s syndrome (pSS) and to test their intrareader and inter-reader reliability using US video clips.MethodsTwenty-five rheumatologists were subjected to a three-round, web-based Delphi process in order to agree on (1) definitions and scanning procedure of salivary gland ultrasonography (SGUS): parotid, submandibular and sublingual glands (PG, SMG and SLG); (2) definitions for the elementary SGUS lesions in patients with Sjögren’s syndrome; (3) scoring system for grading changes. The experts rated the statements on a 1–5 Likert scale. In the second step, SGUS video clips of patients with pSS and non-pSS sicca cases were collected containing various spectrums of disease severity followed by an intrareader and inter-reader reliability exercise. Each video clip was evaluated according to the agreed definitions.ResultsConsensual definitions were developed after three Delphi rounds. Among the three selected SGs, US assessment of PGs and SMGs was agreed on. Agreement was reached to score only greyscale lesions and to focus on anechoic/hypoechoic foci in a semiquantitative matter or, if not possible on a qualitatively (present/absent) evaluation of fatty or fibrous lesions. Intrareader reliability for detecting and scoring these lesions was excellent (Cohen’s kappa 0.81) and inter-reader reliability was good (Light’s kappa 0.66).ConclusionNew definitions for developing a novel semiquantitative US score in patients with pSS were developed and tested on video clips. Inter-reader and intrareader reliabilities were good and excellent, respectively.
- Published
- 2019
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