Frontiers in Medicine (Nov 2020)
Salivary Gland Ultrasonography in Sjögren's Syndrome: A European Multicenter Reliability Exercise for the HarmonicSS Project
- Alen Zabotti,
- Sara Zandonella Callegher,
- Annarita Tullio,
- Arso Vukicevic,
- Arso Vukicevic,
- Alojzija Hocevar,
- Vera Milic,
- Giacomo Cafaro,
- Marina Carotti,
- Konstantina Delli,
- Orazio De Lucia,
- Diana Ernst,
- Francesco Ferro,
- Angelica Gattamelata,
- Giuseppe Germanò,
- Ivan Giovannini,
- Daniel Hammenfors,
- Daniel Hammenfors,
- Malin V. Jonsson,
- Malin V. Jonsson,
- Sandrine Jousse-Joulin,
- Sandrine Jousse-Joulin,
- Pierluigi Macchioni,
- Simone Parisi,
- Carlo Perricone,
- Martin Helmut Stradner,
- Nenad Filipovic,
- Nenad Filipovic,
- Athanasios G. Tzioufas,
- Francesca Valent,
- Salvatore De Vita
Affiliations
- Alen Zabotti
- Rheumatology Clinic, Department of Medical Area, Academic Hospital S. Maria della Misericordia, University of Udine, Udine, Italy
- Sara Zandonella Callegher
- Rheumatology Clinic, Department of Medical Area, Academic Hospital S. Maria della Misericordia, University of Udine, Udine, Italy
- Annarita Tullio
- Institute of Epidemiology, Academic Hospital 'Santa Maria della Misericordia', Udine, Italy
- Arso Vukicevic
- Faculty of Engineering Science, University of Kragujevac, Kragujevac, Serbia
- Arso Vukicevic
- Bioengineering Research and Development Center (BioIRC), Kragujevac, Serbia
- Alojzija Hocevar
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Vera Milic
- Institute of Rheumatology, Belgrade, Serbia
- Giacomo Cafaro
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy
- Marina Carotti
- Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
- Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Orazio De Lucia
- 0Unit of Clinical Rheumatology, Department of Rheumatology and Medical Sciences, Aziende Socio Sanitarie Territoriali (ASST) Centro Traumatologico Ortopedico G. Pini-Centri Traumatologici Ortopedici (CTO), Milan, Italy
- Diana Ernst
- 1Clinic for Immunology and Rheumatology, Hannover Medical School, Hannover, Germany
- Francesco Ferro
- 2Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Angelica Gattamelata
- 3Department of Internal Medicine and Medical Specialties, Rheumatology, Sapienza University of Rome, Rome, Italy
- Giuseppe Germanò
- 4Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera Arcispedale Santa Maria Nuova (ASMN), Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
- Ivan Giovannini
- Rheumatology Clinic, Department of Medical Area, Academic Hospital S. Maria della Misericordia, University of Udine, Udine, Italy
- Daniel Hammenfors
- 5Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Daniel Hammenfors
- 6Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
- Malin V. Jonsson
- 5Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Malin V. Jonsson
- 7Section for Oral and Maxillofacial Radiology, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Sandrine Jousse-Joulin
- 8Rheumatology Department, Centre Hospitalier Universitaire (CHU) de Brest, Univ Brest, Brest, France
- Sandrine Jousse-Joulin
- 9UMR 1227, Lymphocytes B et Autoimmunité (LBAI), Inserm, Univ Brest, Brest, France
- Pierluigi Macchioni
- 4Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera Arcispedale Santa Maria Nuova (ASMN), Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
- Simone Parisi
- 0Unit of Rheumatology, Department of General and Specialty Medicine, Città della Salute e della Scienza, Turin, Italy
- Carlo Perricone
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy
- Martin Helmut Stradner
- 1Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
- Nenad Filipovic
- Faculty of Engineering Science, University of Kragujevac, Kragujevac, Serbia
- Nenad Filipovic
- Bioengineering Research and Development Center (BioIRC), Kragujevac, Serbia
- Athanasios G. Tzioufas
- 2Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Francesca Valent
- Institute of Epidemiology, Academic Hospital 'Santa Maria della Misericordia', Udine, Italy
- Salvatore De Vita
- Rheumatology Clinic, Department of Medical Area, Academic Hospital S. Maria della Misericordia, University of Udine, Udine, Italy
- DOI
- https://doi.org/10.3389/fmed.2020.581248
- Journal volume & issue
-
Vol. 7
Abstract
Objectives: Salivary gland ultrasonography (SGUS) is increasingly applied for the management of primary Sjögren's syndrome (pSS). This study aims to: (i) compare the reliability between two SGUS scores; (ii) test the reliability among sonographers with different levels of experience.Methods: In the reliability exercise, two four-grade semi-quantitative SGUS scoring systems, namely De Vita et al. and OMERACT, were tested. The sonographers involved in work-package 7 of the HarmonicSS project from nine countries in Europe were invited to participate. Different levels of sonographers were identified on the basis of their SGUS experience and of the knowledge of the tested scores. A dedicated atlas was used as support for SGUS scoring.Results: Twenty sonographers participated in the two rounds of the reliability exercise. The intra-rater reliability for both scores was almost perfect, with a Light's kappa of 0.86 for the De Vita et al. score and 0.87 for the OMERACT score. The inter-rater reliability for the De Vita et al. and the OMERACT score was substantial with Light's Kappa of 0.75 and 0.77, respectively. Furthermore, no significant difference was noticed among sonographers with different levels of experience.Conclusion: The two tested SGUS scores are reliable for the evaluation of major salivary glands in pSS, and even less-expert sonographers could be reliable if adequately instructed.
Keywords
- Sjögren's syndrome
- scoring system
- classification criteria
- reliability exercise
- salivary gland ultrasonography
