An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases

Smith, Vanessa; Beeckman, Sam; Herrick, Ariane L.; Decuman, Saskia; Deschepper, Ellen; Keyser, Filip De; Distler, Oliver; Foeldvari, Ivan; Ingegnoli, Francesca; Müller‐Ladner, Ulf; Riccieri, Valeria; Riemekasten, Gabriela; Sulli, Alberto; Voskuyl, Alexandre E.; Cutolo, Maurizio

doi:10.1093/rheumatology/kev441

Cited by 127 publications

(130 citation statements)

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“…Various previous studies report reliability of high magnification nailfold capillaroscopy, highlighting the implied need for standardisation [12,13,[16][17][18][19][20][21][22][23][24]. Some included only two observers [12,16,17,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…A very recent study from Smith et al reported that when observers were asked to assess a single capillary ('normal', 'abnormal' or 'not evaluable') an unspecified proportion of the images were ranked 'not evaluable' [23]. This indicates the complexities of capillaroscopic analysis, and how challenging interpretation can be at the individual capillary level as well as at both the 'patient' level (averaging across fingers) [17,21] and image/'finger' level (as in the current study).…”

Section: Discussionmentioning

confidence: 99%

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Intra-and inter-observer reliability of nailfold videocapillaroscopy — A possible outcome measure for systemic sclerosis-related microangiopathy

Dinsdale

Moore

O’Leary

et al. 2017

Microvascular Research

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intra-and inter-observer reliability of nailfold videocapillaroscopy — A possible outcome measure for systemic sclerosis-related microangiopathy

Dinsdale

Moore

O’Leary

et al. 2017

Microvascular Research

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“…In particular, the dermatoscope with magnification of the order of x10 is a small, inexpensive and easily portable piece of equipment that has been suggested to be comparable to videocapillaroscopy in routine clinical practice. As the study of capillary morphology provides clinically relevant information in the management of patients with scleroderma-spectrum diseases, the development of specific software to standardize and automatize the analysis is ongoing [3][4].…”

Section: Francesca Ingegnoli Academic Rheumatology Unit Universita Dmentioning

confidence: 99%

Sp0131 reliability in the Last 10 Years: Capillaroscopic Characteristics Versus Instrumental Detection

Herrick

2019

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Background:With nailfold capillaroscopy there are different aspects of reliability to consider, including reliability of qualitative image grading (e.g. ‘early”, ‘active” and ‘late”) and also of semi-quantitative and quantitative measures including capillary density, apical width and presence of giant capillaries. The reliability of image acquisition (i.e. test-retest reliability) is especially important if nailfold capillaroscopic parameters are to be used in longitudinal studies (e.g. clinical trials) which involve acquiring repeat images over time. Lastly when assessing reliability, it is important to recognise that the nailfold capillaries cannot always be clearly seen, and cannot therefore be evaluated.Objectives:To highlight the different aspects of reliability relating to nailfold capillaroscopy and how these have been addressed in studies over the last 10 years.Methods:Review of recent studies.Results:Intra–observer reliability has been shown in several studies to be higher than inter–observer.Assessment of ‘evaluability” varies between observers and therefore also needs to be taken into account when assessing reliability.Subject to evaluability, certain parameters demonstrate high intra– and inter–observer reliabilities. Reliability differs across different capillaroscopic parameters.Conclusion:Recent studies examining reliability of capillaroscopy suggest that certain parameters, including image grade, capillary density and apex width have high intra-and inter-observer reliabilities (subject to nailfold image evaluability, which remains a major challenge). Standardised training is likely to improve reliability.References:[1] Murray AK, Vail A, Moore TL, et al. The influence of measurement location on reliability of quantitative videocapillaroscopy in patients with SSc. Rheumatol 2012; 51 : 1323-30.[2] Overbury R, Murtaugh MA, Fisher A, et al. Primary care assessment of capillary abnormalities in patients with Raynaud”s phenomenon. Clin Rheumatol 2015; 34: 2135-40.[3] Smith V, Beeckman S, Herrick AL, et al. An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases. Rheumatol 2016; 55: 883-90.[4] Dinsdale G, Moore T, O”Leary N, et al. Intra-and inter-observer reliability of nailfold videocapillaroscopy - A possible outcome measure for systemic sclerosis-related microangiopathy. Microvascular Research 2017; 112: 1-6.[5] Dinsdale G, Moore T, O”Leary N, et al. Quantitative outcome measures for systemic sclerosis-related microangiopathy – reliability of image acquisition in nailfold capillaroscopy. Microvascular Research 2017;113:56-9.[6] Boulon C, Devos S, Mangin M, et al. Reproducibility of capillaroscopic classifications of systemic sclerosis: results from the SCLEROCAP study. Rheumatology 2017; 56: 1713-20.[7] Cutolo M, Melsens K, Herrick AL, et al. Reliability of simple capillaroscopic definitions in describing capillary morphology in rheumatic diseases. Rheumatology (Letter) 2018; 57: 757-9.Disclosure of Interests:None dec...

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“…In 2011, Mahbub and Harada23 reported that few capillaroscopic studies on VWF existed, and the ones that did commonly focused on capillary abnormalities on limb dropouts and/or morphology alterations. Smith et al 24 standardised the method of interpreting individual capillaries reliably and introduced a more practical way for novices to distinguish normal capillaries and abnormal capillaries individually after a quick training course.…”

Section: Introductionmentioning

confidence: 99%

Nailfold capillary morphological characteristics of hand-arm vibration syndrome: a cross-sectional study

Chen¹,

Chen²,

Xiao³

et al. 2016

BMJ Open

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ObjectiveThe purpose of this study was to investigate the characteristics of nailfold capillaroscopy associated with hand-arm vibration syndrome (HAVS).MethodsIn total, 113 male gold miners were recruited: 35 workers who were chronically exposed to vibration and developed vibration-induced white finger were defined as the HAVS group, 39 workers who were exposed to vibration but did not have HAVS were classified as the vibration-exposed controls (VEC) group, and 39 workers without vibration exposure were categorised as the non-VEC (NVEC) group. Video capillaroscopy was used to capture images of the 2nd, 3rd and 4th fingers of both hands. The following nailfold capillary characteristics were included: number of capillaries/mm, avascular areas, haemorrhages and enlarged capillaries. The experiments were carried out in the same winter. All characteristics were evaluated under blinded conditions.ResultsSignificant differences in all morphological characteristics existed between the groups (p<0.05). Avascular areas in the HAVS, VEC and NVEC groups appeared in 74.3%, 43.6% and 25.0% of participants, respectively. A higher percentage of participants had haemorrhages in the HAVS group (65.7%) compared with the other groups (VEC: 7.7% and NVEC: 7.5%). The number of capillaries/mm, input limb width, output limb width, apical width, and ratio of output limb and input limb all had more than 70% sensitivity or specificity of their cut-off value.ConclusionsNailfold capillary characteristics, especially the number of capillaries/mm, avascular areas, haemorrhages, output limb width, input limb width and apical width alterations, revealed significant associations with HAVS.

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An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases

Cited by 127 publications

References 11 publications

Intra-and inter-observer reliability of nailfold videocapillaroscopy — A possible outcome measure for systemic sclerosis-related microangiopathy

Intra-and inter-observer reliability of nailfold videocapillaroscopy — A possible outcome measure for systemic sclerosis-related microangiopathy

Sp0131 reliability in the Last 10 Years: Capillaroscopic Characteristics Versus Instrumental Detection

Nailfold capillary morphological characteristics of hand-arm vibration syndrome: a cross-sectional study

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