TY - JOUR
T1 - Reliability assessment of the definition of ultrasound enthesitis in SpA
T2 - results of a large, multicentre, international, web-based study
AU - Di Matteo, Andrea
AU - Cipolletta, Edoardo
AU - Castaniti, Giulia Maria Destro
AU - Smerilli, Gianluca
AU - Airoldi, Carla
AU - Aydin, Sibel Zehra
AU - Becciolini, Andrea
AU - Bonfiglioli, Karina
AU - Bruns, Alessandra
AU - Carrara, Greta
AU - Cazenave, Tomas
AU - Ciapetti, Alessandro
AU - Cosatti, Micaela Ana
AU - de Agustín, Juan José
AU - Di Carlo, Marco
AU - Di Donato, Eleonora
AU - Di Geso, Luca
AU - Duran, Emine
AU - Elliott, Ashley
AU - Estrach, Cristina
AU - Farisogulları, Bayram
AU - Fiorenza, Alessia
AU - Fodor, Daniela
AU - Gabba, Alessandra
AU - Hernández-Díaz, Cristina
AU - Huang, Feng
AU - Hurnakova, Jana
AU - Li, Ling
AU - Jesus, Diogo
AU - Karadag, Omer
AU - Martire, Maria Victoria
AU - Massarotti, Marco
AU - Michelena, Xabier
AU - Musca, Alice Andreea
AU - Nair, Jagdish
AU - Okano, Tadashi
AU - Papalopoulos, Ioannis
AU - Rosemffet, Marcos
AU - Rovisco, João
AU - Rozza, Davide
AU - Salaffi, Fausto
AU - Satulu, Iulia
AU - Scioscia, Crescenzio
AU - Scirè, Carlo Alberto
AU - Sun, Fei
AU - Tamas, Maria Magdalena
AU - Tanimura, Shun
AU - Ventura-Rios, Lucio
AU - Voulgari, Paraksevi V.
AU - Vreju, Florentin Ananu
AU - Vukatana, Gentiana
AU - Wong, Ernest
AU - Yang, Jinshui
AU - Hereter, Johana Zacariaz
AU - Zanetti, Anna
AU - Grassi, Walter
AU - Filippucci, Emilio
N1 - Publisher Copyright:
© 2022 Oxford University Press. All rights reserved.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Objectives. To investigate the reliability of the OMERACT US Task Force definition of US enthesitis in SpA. Methods. In this web exercise, based on the evaluation of 101 images and 39 clips of the main entheses of the lower limbs, the elementary components included in the OMERACT definition of US enthesitis in SpA (hypoechoic areas, entheseal thickening, power Doppler signal at the enthesis, enthesophytes/calcifications, bone erosions) were assessed by 47 rheumatologists from 37 rheumatology centres in 15 countries. Inter- and intra-observer reliability of the US components of enthesitis was calculated using Light’s kappa, Cohen’s kappa, Prevalence And Bias Adjusted Kappa (PABAK) and their 95% CIs. Results. Bone erosions and power Doppler signal at the enthesis showed the highest overall inter-reliability [Light’s kappa: 0.77 (0.76–0.78), 0.72 (0.71–0.73), respectively; PABAK: 0.86 (0.86–0.87), 0.73 (0.73–0.74), respectively], followed by enthesophytes/calcifications [Light’s kappa: 0.65 (0.64–0.65), PABAK: 0.67 (0.67–0.68)]. This was moderate for entheseal thickening [Light’s kappa: 0.41 (0.41–0.42), PABAK: 0.41 (0.40–0.42)], and fair for hypoechoic areas [Light’s kappa: 0.37 (0.36–0.38); PABAK: 0.37 (0.37–0.38)]. A similar trend was observed in the intra-reliability exercise, although this was characterized by an overall higher degree of reliability for all US elementary components compared with the inter-observer evaluation. Conclusions. The results of this multicentre, international, web-based study show a good reliability of the OMERACT US definition of bone erosions, power Doppler signal at the enthesis and enthesophytes/calcifications. The low reliability of entheseal thickening and hypoechoic areas raises questions about the opportunity to revise the definition of these two major components for the US diagnosis of enthesitis.
AB - Objectives. To investigate the reliability of the OMERACT US Task Force definition of US enthesitis in SpA. Methods. In this web exercise, based on the evaluation of 101 images and 39 clips of the main entheses of the lower limbs, the elementary components included in the OMERACT definition of US enthesitis in SpA (hypoechoic areas, entheseal thickening, power Doppler signal at the enthesis, enthesophytes/calcifications, bone erosions) were assessed by 47 rheumatologists from 37 rheumatology centres in 15 countries. Inter- and intra-observer reliability of the US components of enthesitis was calculated using Light’s kappa, Cohen’s kappa, Prevalence And Bias Adjusted Kappa (PABAK) and their 95% CIs. Results. Bone erosions and power Doppler signal at the enthesis showed the highest overall inter-reliability [Light’s kappa: 0.77 (0.76–0.78), 0.72 (0.71–0.73), respectively; PABAK: 0.86 (0.86–0.87), 0.73 (0.73–0.74), respectively], followed by enthesophytes/calcifications [Light’s kappa: 0.65 (0.64–0.65), PABAK: 0.67 (0.67–0.68)]. This was moderate for entheseal thickening [Light’s kappa: 0.41 (0.41–0.42), PABAK: 0.41 (0.40–0.42)], and fair for hypoechoic areas [Light’s kappa: 0.37 (0.36–0.38); PABAK: 0.37 (0.37–0.38)]. A similar trend was observed in the intra-reliability exercise, although this was characterized by an overall higher degree of reliability for all US elementary components compared with the inter-observer evaluation. Conclusions. The results of this multicentre, international, web-based study show a good reliability of the OMERACT US definition of bone erosions, power Doppler signal at the enthesis and enthesophytes/calcifications. The low reliability of entheseal thickening and hypoechoic areas raises questions about the opportunity to revise the definition of these two major components for the US diagnosis of enthesitis.
KW - PsA
KW - enthesitis
KW - multicenter international study
KW - power Doppler signal
KW - reliability
KW - seronegative spondyloarthritis
KW - ultrasound
UR - https://www.scopus.com/pages/publications/85137382209
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=performanshacettepe&SrcAuth=WosAPI&KeyUT=WOS:000820585100001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1093/rheumatology/keac162
DO - 10.1093/rheumatology/keac162
M3 - Article
C2 - 35293988
AN - SCOPUS:85137382209
SN - 1462-0324
VL - 61
SP - 4863
EP - 4874
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 12
ER -