Abstract
Objective. There 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. Methods. Following 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 (κ), and an intraclass correlation coefficient (ICC) for the complex system (ICC 0.7 for excellent). Results. Mean 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 (κ = 0.39, 95% confidence interval [95% CI] 0.1-0.52) but improved if dichotomized as mild/moderate versus severe (κ = 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 (κ = 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). Conclusion. We 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.
| Original language | English |
|---|---|
| Pages (from-to) | 425-430 |
| Number of pages | 6 |
| Journal | Arthritis Care and Research |
| Volume | 67 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2015 |
Fingerprint
ASJC Scopus subject areas
- Rheumatology
- Medicine(all)
Cite this
Validation of a novel radiographic scoring system for calcinosis affecting the hands of patients with systemic sclerosis. / Chung, Lorinda; Valenzuela, Antonia; Fiorentino, David; Stevens, Kathryn; Li, Shufeng; Harris, Jonathan; Hutchinson, Charles; Assassi, Shervin; Beretta, Lorenzo; Lakshminarayanan, Santhanam; Rodriguez-Reyna, Tatiana S.; Denton, Christopher P.; Taillefer, Rebecca G.; Herrick, Ariane L.; Baron, Murray.
In: Arthritis Care and Research, Vol. 67, No. 3, 01.03.2015, p. 425-430.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Validation of a novel radiographic scoring system for calcinosis affecting the hands of patients with systemic sclerosis
AU - Chung, Lorinda
AU - Valenzuela, Antonia
AU - Fiorentino, David
AU - Stevens, Kathryn
AU - Li, Shufeng
AU - Harris, Jonathan
AU - Hutchinson, Charles
AU - Assassi, Shervin
AU - Beretta, Lorenzo
AU - Lakshminarayanan, Santhanam
AU - Rodriguez-Reyna, Tatiana S.
AU - Denton, Christopher P.
AU - Taillefer, Rebecca G.
AU - Herrick, Ariane L.
AU - Baron, Murray
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Objective. There 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. Methods. Following 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 (κ), and an intraclass correlation coefficient (ICC) for the complex system (ICC 0.7 for excellent). Results. Mean 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 (κ = 0.39, 95% confidence interval [95% CI] 0.1-0.52) but improved if dichotomized as mild/moderate versus severe (κ = 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 (κ = 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). Conclusion. We 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.
AB - Objective. There 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. Methods. Following 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 (κ), and an intraclass correlation coefficient (ICC) for the complex system (ICC 0.7 for excellent). Results. Mean 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 (κ = 0.39, 95% confidence interval [95% CI] 0.1-0.52) but improved if dichotomized as mild/moderate versus severe (κ = 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 (κ = 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). Conclusion. We 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.
UR - http://www.scopus.com/inward/record.url?scp=84923292672&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84923292672&partnerID=8YFLogxK
U2 - 10.1002/acr.22434
DO - 10.1002/acr.22434
M3 - Article
C2 - 25155948
AN - SCOPUS:84923292672
VL - 67
SP - 425
EP - 430
JO - Arthritis care and research : the official journal of the Arthritis Health Professions Association
JF - Arthritis care and research : the official journal of the Arthritis Health Professions Association
SN - 0893-7524
IS - 3
ER -