Improving domain definition and outcome instrument selection: Lessons learned for OMERACT from imaging

D'Agostino, Maria Antonietta; Beaton, Dorcas; Maxwell, Lara; Cembalo, Sam Michel; Hoens, Alison M.; Hofstetter, Catherine; Zăbălan, Codruța; Bird, Paul; Christensen, Robin; Wit, Maarten de; Doria, A.; Maksymowych, Walter P.; Oo, Win Min; Østergaard, Mikkel; Şerban, Teodora; Sloan, Victor S.; Terslev, Lene; Rossum, Marion A. van; Conaghan, Philip G.; Boers, Maarten

doi:10.1016/j.semarthrit.2021.08.004

Cited by 19 publications

(5 citation statements)

References 20 publications

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“…30 Recent consensus-based deliberations conducted by imaging and methodology experts of the OMERACT consortium have resulted in the drafting of a framework of recommendations aimed at reducing the sources of variability for imaging-based instruments. 31 Moreover, it was considered essential that these be implemented in operational guidelines for the application of an imaging instrument because reader reliability, especially for detecting change, influences responsiveness and the ability of an instrument to discriminate between therapeutic interventions. The recommendations stipulated the importance of a clear description of the scoring framework, the availability of reference standards such as an atlas of images and a systematic process for training using validated KT tools.…”

Section: Rmd Open Rmd Open Rmd Openmentioning

confidence: 99%

Validation of SPARCC MRI-RETIC e-tools for increasing scoring proficiency of MRI sacroiliac joint lesions in axial spondyloarthritis

Maksymowych,

Hadsbjerg,

Østergaard

et al. 2024

RMD Open

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BackgroundThe Spondyloarthritis Research Consortium of Canada (SPARCC) developers have created web-based calibration modules for the SPARCC MRI sacroiliac joint (SIJ) scoring methods. We aimed to test the impact of applying these e-modules on the feasibility and reliability of these methods.MethodsThe SPARCC-SIJRETICe-modules contain cases with baseline and follow-up scans and an online scoring interface. Visual real-time feedback regarding concordance/discordance of scoring with expert readers is provided by a colour-coding scheme. Reliability is assessed in real time by intraclass correlation coefficient (ICC), cases being scored until ICC targets are attained. Participating readers (n=17) from the EuroSpA Imaging project were randomised to one of two reader calibration strategies that each comprised three stages. Baseline and follow-up scans from 25 cases were scored after each stage was completed. Reliability was compared with a SPARCC developer, and the System Usability Scale (SUS) assessed feasibility.ResultsThe reliability of readers for scoring bone marrow oedema was high after the first stage of calibration, and only minor improvement was noted following the use of the inflammation module. Greater enhancement of reader reliability was evident after the use of the structural module and was most consistently evident for the scoring of erosion (ICC status/change: stage 1 (0.42/0.20) to stage 3 (0.50/0.38)) and backfill (ICC status/change: stage 1 (0.51/0.19) to stage 3 (0.69/0.41)). The feasibility of both e-modules was evident by high SUS scores.ConclusionThe SPARCC-SIJRETICe-modules are feasible, effective knowledge transfer tools, and their use is recommended before using the SPARCC methods for clinical research and tria

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Section: Rmd Open Rmd Open Rmd Openmentioning

confidence: 99%

Validation of SPARCC MRI-RETIC e-tools for increasing scoring proficiency of MRI sacroiliac joint lesions in axial spondyloarthritis

Maksymowych,

Hadsbjerg,

Østergaard

et al. 2024

RMD Open

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“…The requirements for imaging technologies to be used as outcome measurement instruments have been previously defined 26 . For instance, to support the use of the MSUS as an outcome measurement instrument in RA clinical research, several MSUS scoring systems have been proposed and further validated 27–32 .…”

Section: Discussionmentioning

confidence: 99%

“…The requirements for imaging technologies to be used as outcome measurement instruments have been previously defined. 26 For instance, to support the use of the MSUS as an outcome measurement instrument in RA clinical research, several MSUS scoring systems have been proposed and further validated. [27][28][29][30][31][32] Of interest, a recent meta-analysis evaluating the diagnostic test accuracy of USs compared with MRI for the detection of synovitis in patients with RA determined that the MSUS had low diagnostic test accuracy for knee synovitis in RA (AUC 0.61).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy Study of the Pediatric‐Specific Ultrasound Scoring System for the Knee Joint in Children With Juvenile Idiopathic Arthritis

Vega‐Fernandez,

Rogers,

Sproles

et al. 2023

Arthritis Care & Research

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ObjectiveTo validate the Pediatric Arthritis Ultrasound Scoring System for the knee joint (PAUSS‐knee) in children with juvenile idiopathic arthritis (JIA).MethodsChildren with JIA prospectively received a musculoskeletal ultrasound (MSUS) examination of the knee and a physical examination to determine presence/absence of clinical arthritis were enrolled in this study. MSUS images were scored using the PAUSS‐knee, a semiquantitative MSUS scoring system (0‐normal to 3‐severe) for B‐mode and Power Doppler‐mode. A subset of participants in addition to MSUS also received an MRI of the knee. MRI was scored according to the combined Juvenile Arthritis MRI Scoring (JAMRIS) system. Spearman's correlations (rs) were used to calculate the associations between variables. Test characteristics of the PAUSS‐knee were calculated with MRI as reference standard. Inflammatory biomarkers were assessed in synovial fluid from involved knees.ResultsEighty children with JIA contributed 112 MSUS knees and 25 MRIs of the knee. Forty‐one percent (n=46) of the knees had clinical evidence of arthritis. The B‐mode PAUSS‐knee score moderately correlated with arthritis determined clinically (rs=0.54, p<0.001), and strongly correlated with the JAMRIS score (rs=0.75, p<0.001). Compared to MRI, the area under the curve for the B‐mode PAUSS‐knee was 0.92. For a cutoff >1 the B‐mode PAUSS‐knee had a sensitivity of 83% and specificity of 82%. Biomarker analysis indicates IL‐2R levels correlate with PAUSS score.ConclusionOur data indicates that PAUSS‐knee has excellent diagnostic test accuracy for the diagnosis of arthritis when compared to MRI. The PAUSS‐knee has the potential to effectively inform JIA medical decision making in real‐time.This article is protected by copyright. All rights reserved.

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“…Recent consensus-based deliberations conducted by imaging and methodology experts of the Outcome Measures in Rheumatology (OMERACT) consortium have resulted in the drafting of a framework of recommendations aimed at reducing source of variability for imaging-based instruments 32 . Moreover, it was considered essential that these be implemented in operational guidelines for the application of an imaging instrument because reader reliability, especially for detecting change, in uences responsiveness and the ability of an instrument to discriminate between therapeutic interventions.…”

Section: Discussionmentioning

confidence: 99%

Validation of SPARCC MRI-RETIC E-Tools for Increasing Scoring Proficiency of MRI Sacroiliac Joint Lesions in Axial Spondyloarthritis

Maksymowych,

Hadsbjerg,

Østergaard

et al. 2023

Preprint

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Background. The Spondyloarthritis Research Consortium of Canada (SPARCC) developers have created novel web-based calibration modules for the SPARCC MRI Sacroiliac Joint (SIJ) inflammation and structural scoring methods (SPARCC-SIJRETIC−INF, SPARCC-SIJRETIC−STR) based on DICOM images and real-time iterative feedback (RETIC). We aimed to test the impact of applying these modules on feasibility and inter-observer reliability (status/change) of the SPARCC SIJ methods. Methods The SPARCC-SIJRETIC modules each contain 50 DICOM axial spondyloarthritis (axSpA) cases with baseline and follow-up scans and an online scoring interface. Continuous visual real-time feedback regarding concordance/discordance of scoring per SIJ quadrant (bone marrow edema (BME), erosion, fat lesion) or halves (backfill, ankylosis) with expert readers is provided by a color-coding scheme. Reliability is assessed in real-time by intra-class correlation coefficient (ICC), cases being scored until ICC targets are attained. Participating readers (n = 17) from the EuroSpA Imaging project were randomized, stratified by reader expertise with SPARCC-SIJ, to one of two reader calibration strategies that each comprised 3 stages. Baseline and follow-up scans from 25 cases were scored using SPARCC-SIJ after each stage was completed; none of these 75 cases were included in the SPARCC-SIJRETIC modules. Reliability was compared to an expert radiologist (SPARCC developer), and the Systems Usability Scale (SUS) assessed feasibility. Results The reliability of EuroSpA readers for scoring BME was high (ICC status/change ≥ 0.80) even after the first stage of calibration, and only minor improvement was noted following the use of the SPARCC-SIJRETIC−INF module. Greater enhancement of reader reliability from stages 1 to 3 was evident after the use of the SPARCC-SIJRETIC−STR module, especially for inexperienced readers, and was most consistently evident for the scoring of erosion (ICC status/change: stage 1 (0.42/0.20) to stage 3 (0.50/0.38)) and backfill (ICC status/change: stage 1 (0.51/0.19) to stage 3 (0.69/0.41)). The feasibility of both RETIC modules was evident by reading time per case of readers after calibration being comparable to SPARCC developers and by the high SUS scores reported by most readers. Conclusion The SPARCC-SIJRETIC modules are feasible, effective knowledge transfer tools for the SPARCC MRI SIJ scoring methods. They are recommended for routine calibration of readers before using these methods for clinical research and trials.

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Improving domain definition and outcome instrument selection: Lessons learned for OMERACT from imaging

Cited by 19 publications

References 20 publications

Validation of SPARCC MRI-RETIC e-tools for increasing scoring proficiency of MRI sacroiliac joint lesions in axial spondyloarthritis

Validation of SPARCC MRI-RETIC e-tools for increasing scoring proficiency of MRI sacroiliac joint lesions in axial spondyloarthritis

Diagnostic Accuracy Study of the Pediatric‐Specific Ultrasound Scoring System for the Knee Joint in Children With Juvenile Idiopathic Arthritis

Validation of SPARCC MRI-RETIC E-Tools for Increasing Scoring Proficiency of MRI Sacroiliac Joint Lesions in Axial Spondyloarthritis

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