TY - JOUR

T1 - Video clip assessment of a salivary gland ultrasound scoring system in Sjögren's syndrome using consensual definitions

T2 - An OMERACT ultrasound working group reliability exercise

AU - Jousse-Joulin, Sandrine

AU - D'Agostino, Maria Antonietta

AU - Nicolas, Celine

AU - Naredo, Esperanza

AU - Ohrndorf, Sarah

AU - Backhaus, Marina

AU - Tamborrini, Giorgio

AU - Chary-Valckenaere, Isabelle

AU - Terslev, Lene

AU - Iagnocco, Annamaria

AU - Collado, Paz

AU - Hernández-Díaz, Cristina

AU - Gandjbakhch, Frederique

AU - Schmidt, Wolfgang A.

AU - Filippou, Georgios

AU - Dejaco, Christian

AU - Stradner, Martin Helmut

AU - Mortada, Mohamed Atia

AU - Hoa Evar, Alojzija

AU - Chrysidis, Stavros

AU - El Mardenly, Ghada

AU - De Agustín, Juan José

AU - Thiele, Ralf

AU - Maccarter, Daryl K.

AU - Finzel, Stephanie

AU - Hanova, Petra

AU - Zabotti, Alen

AU - Glaser, Cornelia

AU - Alavi, Zarrin

AU - Hammenfors, Daniel Sten

AU - Gatineau, Florence

AU - Bruyn, George Aw W.

PY - 2019/4

Y1 - 2019/4

N2 - Objective To develop ultrasound (US) definitions and a US novel scoring system for major salivary gland (SG) lesions in patients with primary Sjögren's syndrome (pSS) and to test their intrareader and inter-reader reliability using US video clips. Methods Twenty-five rheumatologists were subjected to a three-round, web-based Delphi process in order to agree on (1) definitions and scanning procedure of salivary gland ultrasonography (SGUS): parotid, submandibular and sublingual glands (PG, SMG and SLG); (2) definitions for the elementary SGUS lesions in patients with Sjögren's syndrome; (3) scoring system for grading changes. The experts rated the statements on a 1-5 Likert scale. In the second step, SGUS video clips of patients with pSS and non-pSS sicca cases were collected containing various spectrums of disease severity followed by an intrareader and inter-reader reliability exercise. Each video clip was evaluated according to the agreed definitions. Results Consensual definitions were developed after three Delphi rounds. Among the three selected SGs, US assessment of PGs and SMGs was agreed on. Agreement was reached to score only greyscale lesions and to focus on anechoic/hypoechoic foci in a semiquantitative matter or, if not possible on a qualitatively (present/absent) evaluation of fatty or fibrous lesions. Intrareader reliability for detecting and scoring these lesions was excellent (Cohen's kappa 0.81) and inter-reader reliability was good (Light's kappa 0.66). Conclusion New definitions for developing a novel semiquantitative US score in patients with pSS were developed and tested on video clips. Inter-reader and intrareader reliabilities were good and excellent, respectively.

AB - Objective To develop ultrasound (US) definitions and a US novel scoring system for major salivary gland (SG) lesions in patients with primary Sjögren's syndrome (pSS) and to test their intrareader and inter-reader reliability using US video clips. Methods Twenty-five rheumatologists were subjected to a three-round, web-based Delphi process in order to agree on (1) definitions and scanning procedure of salivary gland ultrasonography (SGUS): parotid, submandibular and sublingual glands (PG, SMG and SLG); (2) definitions for the elementary SGUS lesions in patients with Sjögren's syndrome; (3) scoring system for grading changes. The experts rated the statements on a 1-5 Likert scale. In the second step, SGUS video clips of patients with pSS and non-pSS sicca cases were collected containing various spectrums of disease severity followed by an intrareader and inter-reader reliability exercise. Each video clip was evaluated according to the agreed definitions. Results Consensual definitions were developed after three Delphi rounds. Among the three selected SGs, US assessment of PGs and SMGs was agreed on. Agreement was reached to score only greyscale lesions and to focus on anechoic/hypoechoic foci in a semiquantitative matter or, if not possible on a qualitatively (present/absent) evaluation of fatty or fibrous lesions. Intrareader reliability for detecting and scoring these lesions was excellent (Cohen's kappa 0.81) and inter-reader reliability was good (Light's kappa 0.66). Conclusion New definitions for developing a novel semiquantitative US score in patients with pSS were developed and tested on video clips. Inter-reader and intrareader reliabilities were good and excellent, respectively.

KW - OMERACT

KW - primary sjögren syndrome

KW - reliability exercise

KW - salivary glands

KW - ultrasound

UR - http://www.scopus.com/inward/record.url?scp=85065071940&partnerID=8YFLogxK

U2 - 10.1136/annrheumdis-2019-215024

DO - 10.1136/annrheumdis-2019-215024

M3 - Journal article

C2 - 31036626

AN - SCOPUS:85065071940

VL - 78

SP - 967

EP - 973

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 7

ER -