Ultrasound joint examination by an automated system versus by a rheumatologist: from a patient perspective

Abstract

Background The Arthritis Ultrasound Robot (ARTHUR) is an automated system for ultrasound scanning of the joints of both hands and wrists, with subsequent disease activity scoring using artificial intelligence. The objective was to describe the patient’s perspective of being examined by ARTHUR, compared to an ultrasound examination by a rheumatologist. Further, to register any safety issues with the use of ARTHUR. Methods Twenty-five patients with rheumatoid arthritis (RA) had both hands and wrists examined by ultrasound, first by a rheumatologist and subsequently by ARTHUR. Patient-reported outcomes (PROs) were obtained after the examination by the rheumatologist and by ARTHUR. PROs regarding pain, discomfort and overall experience were collected, including willingness to be examined again by ARTHUR as part of future clinical follow-up. All ARTHUR examinations were observed for safety issues. Results There was no difference in pain or discomfort between the examination by a rheumatologist and by ARTHUR (p = 0.29 and p = 0.20, respectively). The overall experience of ARTHUR was described as very good or good by 92% (n = 23), with no difference compared to the examination by the rheumatologist (p = 0.50). All (n = 25) patients were willing to be examined by ARTHUR again, and 92% (n = 23) would accept ARTHUR as a regular part of their RA clinical follow up. No safety issues were registered. Conclusions Joint ultrasound examination by ARTHUR was safe and well-received, with no difference in PRO components compared to ultrasound examination by a rheumatologist. Fully automated systems for RA disease activity assessment could be important in future strategies for managing RA patients. Trial registration: The study was evaluated by the regional ethics committee (ID: S-20200145), which ruled it was not a clinical trial necessary for their approval. It was a quality assessment project, as there was no intervention to the patient. The study was hereafter submitted and registered to Odense University Hospital, Region of Southern Denmark as a quality assessment project and approved (ID: 20/55294).

What Bedside Skills Could the Modern Rheumatologist Possess? Part II. “Certain Technical Procedures”

“…The ACR offers formal certification in US competence 25 . Human performance of US may not ensure job security, as automated methods for US assessment of joints are being developed 26 …”

Artificial intelligence model for segmentation and severity scoring of osteophytes in hand osteoarthritis on ultrasound images

“…A new automated system has been developed to perform a quality ultrasound examination of the hands without needing a trained professional ( 9 ). The ARTHUR system can detect inflammatory arthritis in finger joints and wrist and score severity through AI ( 9 – 11 ). However, it cannot currently detect and grade osteophytes in hand OA.…”