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Identification of calcium pyrophosphate deposition disease (CPPD) by ultrasound: reliability of the OMERACT definitions in an extended set of joints—an international multiobserver study by the OMERACT Calcium Pyrophosphate Deposition Disease Ultrasound Subtask Force
Annals of the Rheumatic Diseases ( IF 27.4 ) Pub Date : 2018-03-13 , DOI: 10.1136/annrheumdis-2017-212542
Georgios Filippou , Carlo Alberto Scirè , Antonella Adinolfi , Nemanja S Damjanov , Greta Carrara , George A W Bruyn , Tomas Cazenave , Maria Antonietta D’Agostino , Andrea Delle Sedie , Valentina Di Sabatino , Mario Enrique Diaz Cortes , Emilio Filippucci , Frederique Gandjbakhch , Marwin Gutierrez , Daryl K Maccarter , Mihaela Micu , Ingrid Möller Parera , Gaël Mouterde , Mohamed Atia Mortada , Esperanza Naredo , Carlos Pineda , Francesco Porta , Anthony M Reginato , Iulia Satulu , Wolfgang A Schmidt , Teodora Serban , Lene Terslev , Violeta Vlad , Florentin Ananu Vreju , Pascal Zufferey , Panagiotis Bozios , Carmela Toscano , Valentina Picerno , Annamaria Iagnocco

Objectives To assess the reliability of the OMERACT ultrasound (US) definitions for the identification of calcium pyrophosphate deposition disease (CPPD) at the metacarpal-phalangeal, triangular fibrocartilage of the wrist (TFC), acromioclavicular (AC) and hip joints. Methods A web-based exercise and subsequent patient-based exercise were carried out. A panel of 30 OMERACT members, participated at the web-based exercise by evaluating twice a set of US images for the presence/absence of CPPD. Afterwards, 19 members of the panel met in Siena, Italy, for the patient-based exercise. During the exercise, all sonographers examined twice eight patients for the presence/absence of CPPD at the same joints. Intraoberserver and interobserver kappa values were calculated for both exercises. Results The web-based exercise yielded high kappa values both in intraobserver and interobserver evaluation for all sites, while in the patient-based exercise, inter-reader agreement was acceptable for the TFC and the AC. TFC reached high interobserver and intraobserver k values in both exercises, ranging from 0.75 to 0.87 (good to excellent agreement). AC reached moderate kappa values, from 0.51 to 0.85 (moderate to excellent agreement) and can readily be used for US CPPD identification. Conclusions Based on the results of our exercise, the OMERACT US definitions for the identification of CPPD demonstrated to be reliable when applied to the TFC and AC. Other sites reached good kappa values in the web-based exercise but failed to achieve good reproducibility at the patient-based exercise, meaning the scanning method must be further refined.

中文翻译:

通过超声识别焦磷酸钙沉积病 (CPPD):扩展关节组中 OMERACT 定义的可靠性——由 OMERACT 焦磷酸钙沉积病超声子工作组进行的一项国际多观察者研究

目的 评估 OMERACT 超声 (US) 定义用于识别掌指骨、腕部三角纤维软骨 (TFC)、肩锁 (AC) 和髋关节焦磷酸钙沉积病 (CPPD) 的可靠性。方法进行了基于网络的练习和随后的基于患者的练习。一个由 30 名 OMERACT 成员组成的小组通过两次评估一组美国图像中是否存在 CPPD 来参与基于网络的练习。之后,该小组的 19 名成员在意大利锡耶纳会面,进行以患者为基础的练习。在练习过程中,所有超声检查员对 8 名患者的同一关节处是否存在 CPPD 进行了两次检查。计算两个练习的内部观察者和观察者间 kappa 值。结果 基于网络的练习在所有站点的观察者内和观察者间评估中都产生了高 kappa 值,而在基于患者的练习中,TFC 和 AC 的读者间一致性是可以接受的。TFC 在两个练习中都达到了较高的观察者间和观察者内 k 值,范围从 0.75 到 0.87(一致性好到极好)。AC 达到了中等 kappa 值,从 0.51 到 0.85(中等至极好的一致性),可以很容易地用于美国 CPPD 识别。结论 根据我们的练习结果,用于识别 CPPD 的 OMERACT US 定义在应用于 TFC 和 AC 时被证明是可靠的。其他网站在基于网络的练习中达到了良好的 kappa 值,但在基于患者的练习中未能实现良好的可重复性,这意味着必须进一步完善扫描方法。
更新日期:2018-03-13
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