Validation of a Novel Radiographic Scoring System for Calcinosis Affecting the Hands of Patients With Systemic Sclerosis

被引：42

作者：

Chung, Lorinda ^{[1
]}

Valenzuela, Antonia ^{[1
]}

Fiorentino, David ^{[1
]}

Stevens, Kathryn ^{[2
]}

Li, Shufeng ^{[1
]}

Harris, Jonathan ^{[3
]}

Hutchinson, Charles ^{[4
]}

Assassi, Shervin ^{[5
]}

Beretta, Lorenzo ^{[6
]}

Lakshminarayanan, Santhanam ^{[7
]}

Rodriguez-Reyna, Tatiana S. ^{[8
]}

Denton, Christopher P. ^{[9
]}

Taillefer, Rebecca G. ^{[10
]}

Herrick, Ariane L. ^{[3
,11
,12
]}

Baron, Murray ^{[13
]}

机构：

[1] Stanford Univ, Sch Med, Palo Alto, CA 94304 USA

[2] Stanford Univ, Med Ctr, Palo Alto, CA 94304 USA

[3] Salford Royal Hosp, Salford, Lancs, England

[4] Univ Warwick, Coventry CV4 7AL, W Midlands, England

[5] Univ Texas Houston, Houston, TX USA

[6] Fdn IRCCS Ca Granda Osped Maggiore Policlin Milan, Milan, Italy

[7] Univ Connecticut, Sch Med, Storrs, CT 06268 USA

[8] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico

[9] Royal Free Hosp, London NW3 2QG, England

[10] Univ Montreal, Montreal, PQ, Canada

[11] Univ Manchester, Manchester, Lancs, England

[12] Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England

[13] McGill Univ, Jewish Gen Hosp, Montreal, PQ H3T 1E2, Canada

来源：

ARTHRITIS CARE & RESEARCH | 2015年 / 67卷 / 03期

关键词：

CONNECTIVE-TISSUE DISEASE; CUTIS; ASSOCIATION;

D O I：

10.1002/acr.22434

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveThere are currently no validated outcome measures to assess calcinosis severity in systemic sclerosis (SSc; scleroderma). We sought to develop and validate a novel radiographic scoring system for calcinosis affecting the hands of SSc patients for potential use in future clinical trials. MethodsFollowing a 1-hour teleconference training session, 12 investigators (8 rheumatologists, 1 dermatologist, and 3 radiologists) scored 12 hand radiographs in random order using 2 scoring systems (termed simple and complex) and re-scored 2 randomly assigned radiographs after a minimum of 24 hours. Interrater and intrarater reliability were assessed using a weighted kappa coefficient for the simple system (), and an intraclass correlation coefficient (ICC) for the complex system (ICC <0.4 for poor, 0.4-0.7 for moderate, and >0.7 for excellent). ResultsMean time to complete the complex scoring system was significantly longer than the simple scoring system (4.0 versus 0.4 minutes; P < 0.0001). Overall interrater reliability for the simple scoring system was poor ( = 0.39, 95% confidence interval [95% CI] 0.1-0.52) but improved if dichotomized as mild/moderate versus severe ( = 0.51, 95% CI 0.26-0.7). Interrater reliability was excellent for the complex scoring system (ICC 0.89, 95% CI 0.86-0.92). Intrarater reliability was moderate for the simple scoring system ( = 0.67, 95% CI 0.37-0.96) but almost perfect for the complex scoring system (ICC 0.93, 95% CI 0.89-0.97). ConclusionWe developed a novel radiographic scoring system that accounts for the area coverage, density, and anatomic location of calcinosis affecting the hands in patients with SSc. This scoring system is feasible with excellent reliability and should undergo further validation testing for use in clinical trials.

引用

页码：425 / 430

页数：6

共 14 条

[1] Radiological hand involvement in systemic sclerosis [J].