Reliability of the OMERACT Giant cell arteritis Ultrasonography Score (OGUS): results of a patient-based exercise involving experts and non-experts in vascular ultrasonography
Christian Dejaco,
Stavros Chrysidis,
Sara Monti,
Cristina Ponte,
Peter Mandl,
Lene Terslev,
Bhaskar Dasgupta,
Alojzija Hočevar,
Christina Duftner,
Wolfgang Schmidt,
Carlos Pineda,
Eugenio De Miguel,
Andreas P Diamantopoulos,
Helen Keen,
Kati Mykkänen,
George A Bruyn,
Wolfgang Hartung,
Maria Antonietta D’Agostino,
Nikitas Gkikopoulos,
Luca Seitz,
Adela-Cristina Sarbu,
Eva Manger,
Berit Dalsgaard Nielsen,
Norbert Redlinger,
Veerendra Chadachan,
Maria Correyero,
Giovanni Fulvio,
Vesselina Kurteva,
Paolo Mercatelli,
Irina Midtgard,
Raili Muller,
Duriad Reffat
Affiliations
Christian Dejaco
Rheumatology, Brunico Hospital, Brunico, Italy
Stavros Chrysidis
Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
Sara Monti
Rheumatology, Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo Pavia, Pavia, PV, Italy
Cristina Ponte
Rheumatology, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Portugal
Peter Mandl
Internal Medicine 3, Division of Rheumatology, Medical University Vienna, Vienna, Austria
Lene Terslev
Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark
Bhaskar Dasgupta
Department of Rheumatology, Southend University Hospital, Westcliff-on-Sea, UK
Alojzija Hočevar
Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
Christina Duftner
Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Tirol, Austria
Wolfgang Schmidt
Immanuel Krankenhaus Berlin, Standort Berlin-Wannsee, Berlin, Germany
Carlos Pineda
Division of Musculoskeletal and Rheumatic Disorders, Instituto Nacional de Rehabilitacion Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
Eugenio De Miguel
Hospital Universitario La Paz, Madrid, Spain
Andreas P Diamantopoulos
Internal Medicine, Section of Rheumatology, Akershus University Hospital, Lorenskog, Norway
Helen Keen
Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Tirol, Austria
Kati Mykkänen
Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
George A Bruyn
Tergooi MC Hospitals, Hilversum, Netherlands
Wolfgang Hartung
Rheumatology / Clinical Immunology, Asklepios Clinic, Bad Abbach, Germany
Maria Antonietta D’Agostino
Foundation Policlinico Universitario Agostino gemelli IRCSS, Rome, Italy
Nikitas Gkikopoulos
Department for Rheumatology, Schulthess Klinik, Zurich, Switzerland
Luca Seitz
Department of Rheumatology and Immunology, University of Bern, Bern, Switzerland
Adela-Cristina Sarbu
Department of Rheumatology and Immunology, Inselspital, Bern, Switzerland
Eva Manger
Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Tirol, Austria
Berit Dalsgaard Nielsen
Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
Norbert Redlinger
Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Tirol, Austria
Veerendra Chadachan
Department of Internal Medicine (Vascular Medicine), Tan Tock Seng Hospital, Singapore
Maria Correyero
Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
Giovanni Fulvio
Department of Clinical and Experimental Medicine, University of Pisa, Rheumatology Unit, Pisa, Italy
Vesselina Kurteva
Klinik Favoriten, 2. Medizinische Abteilung mit Rheumatologie und Osteologie, Vienna, Austria
Objective To test the reliability of the Outcome Measures in Rheumatology Giant cell arteritis (GCA) Ultrasonography Score (OGUS) and other composite scores in a patient-based exercise involving experts and non-experts in vascular ultrasonography.Methods Six GCA patients were scanned twice (two rounds separated ≥3 hours) by 12 experts and 12 non-experts. Non-experts received 90 min of theoretical and 240 min of practical training between rounds 1 and 2. Ultrasonography was conducted on temporal arteries (common superficial, frontal and parietal branches) and axillary arteries bilaterally to calculate the OGUS, the Southend score and the Halo count. Inter-reader and intra-reader reliability were assessed by intraclass correlation coefficient (ICC).Results Mean age of GCA patients was 78±5.1 years, 2 (33.3%) were women, and all were in clinical remission. Expert inter-reader ICC of the OGUS was 0.60 in both rounds, 0.40 in round 1 and 0.51 in round 2 for the Southend score and 0.45 and 0.52, respectively, for the Halo count. Median ICCs for intra-reader reliability were 0.86, 0.73 and 0.65 for the OGUS, Southend score and Halo count, respectively.For non-experts, inter-reader ICCs in round 1 were 0.20 for the OGUS, 0.20 for a normalised Southend score (=score divided by available segments) and 0.35 for a normalised Halo count. After training, inter-reader reliability ICCs improved to 0.52, 0.29 and 0.54, respectively.Conclusion Inter-reader reliability was fair to moderate, and intra-reader reliability was good for OGUS, Southend score and Halo count among experts. Inter-reader reliability of non-experts in vascular ultrasonography improved after the training.
