Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis

Rezaei, Hamed; Klint, Erik af; Hammer, Hilde Berner; Terslev, Lene; D’Agostino, Maria; Kisten, Y.; Arnaud, Laurent

doi:10.1093/rheumatology/kew385

Cited by 16 publications

(7 citation statements)

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“…The ultrasound examinations included gray scale (GS) and power or color Doppler scored semiquantitatively on a four‐point scale (0 = no, 1 = minor, 2 = moderate, 3 = major presence of GS or Doppler) of 36 joints (wrists [radiocarpal, midcarpal, radioulnar joints scored separately], metacarpophalangeal 1‐5, proximal interphalangeal 2‐3, elbow, knee, tibiotalar, and metatarsophalangeal 1‐5 as well as the extensor carpi ulnaris and tibialis posterior tendons) according to Outcome Measures in Rheumatology (OMERACT) and the Norwegian ultrasound atlas (14,15). A sum score for all joints and tendons was calculated at the patient level separately for GS and for Doppler.…”

Section: Methodsmentioning

confidence: 99%

Fatigue Is Not Associated With Objective Assessments of Inflammation During Tocilizumab Treatment of Patients With Rheumatoid Arthritis

Hammer

Agular

Terslev

2021

ACR Open Rheumatology

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Objective. In patients with rheumatoid arthritis (RA), the relation between fatigue and disease activity is not established, and our objective was to explore in post hoc analyses the associations between fatigue and subjective as well as objective assessments of inflammation during follow-up of patients with RA initiating biologic treatment.Methods. In a Nordic multicenter study, patients with RA starting tocilizumab were examined for fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue sum score) as well as patient-reported outcome measures (PROMs) (patient's global disease activity, joint pain, and Health Assessment Questionnaire Disability Index), clinical examinations (examiner's global disease activity, 28 tender/swollen joint counts), laboratory variables (erythrocyte sedimentation rate, C-reactive protein), and ultrasound assessments (semiquantitative scoring [0-3]) of gray scale and Doppler of 36 joints and 4 tendons) at baseline and 4, 12, and 24 weeks. The associations were explored by using nonparametric tests, including the Wilcoxon rank test, the Mann-Whitney U test, Spearman correlations, and a linear regression and linear mixed model.Results. One hundred ten patients were included (83% female, mean [SD] age 55.6 [12.1] years, mean [SD] RA duration 8.7 [9.5] years, 81% anti-cyclic citrullinated peptide positive). Fatigue, PROMs, and clinical, laboratory, and ultrasound variables all decreased significantly during follow-up, already at 4 weeks (P < 0.001). Fatigue was both cross-sectionally and longitudinally associated with PROMs, whereas there were no or low associations with clinical, laboratory, or ultrasound assessments of inflammation. Baseline fatigue was predictive of PROMs at 12 and 24 weeks (P < 0.05 and P < 0.001, respectively) but not of any objective assessments.Conclusion. Fatigue was primarily associated with subjective assessments of disease activity. Thus, the present study supports fatigue to reflect other aspects of RA disease activity than inflammation.ClinicalTrials.gov identifier: NCT02046616.

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Section: Methodsmentioning

confidence: 99%

Fatigue Is Not Associated With Objective Assessments of Inflammation During Tocilizumab Treatment of Patients With Rheumatoid Arthritis

Hammer

Agular

Terslev

2021

ACR Open Rheumatology

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“…Furthermore, ultrasound is used in clinical trials for assessing treatment response and remission. The components defining synovitis (synovial hypertrophy and hyperemia) are usually scored separately using a semi-quantitative scoring system (0–3) for indicating the grade of severity of the individual synovitis component [5]. In the recently published OMERACT-EULAR combined scoring system [1], it is suggested to apply the highest score of the two components as the final score for the joint.…”

Section: Introductionmentioning

confidence: 99%

Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials

et al. 2019

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Objective To assess if the right hand, the dominant hand, or the hand with more clinically swollen joints (SwJ) is per se the most inflamed and exhibits the greatest change during treatment and hence preferred for unilateral scoring of synovitis by ultrasound in rheumatoid arthritis (RA) patients. Methods Using data from two previously published Norwegian RA patient cohorts initiating treatment, bilateral metacarpophalangeal joint 1–5, proximal phalangeal joint 2+3, and wrists were evaluated by ultrasound. Using a 0–3 scoring system a grey-scale (GS), power Doppler (PD) and global synovitis score (GLOESS) was calculated for each hand (0–30). For precision, a difference of < ± 3 in sum score was pre-specified as indicating clinically insignificant difference in inflammatory activity for all three scores. Results Four hundred thirty-seven RA patients were included. Baseline ultrasound inflammation was statistically significantly higher in hands with more vs fewer SwJ ([mean difference, 95%CI] GS sum score 2.21[1.30 to 3.12], PD sum score 1.70 [0.94 to 2.47] and GLOESS 2.31[1.36 to 3.26]) and also exhibited significantly more change for all sum scores at 3 months follow-up (GS sum score 1.34 [0.60 to 2.08], PD sum score 1.17 [0.44 to 1.91], and GLOESS 1.43 [0.63 to 2.22]). No such differences were found between the dominant and the non-dominant or the right and the left hands at any time points. Conclusion The hand with clinically more SwJ is statistically more inflammatory active according to GS, Doppler, and GLOESS sum scores, exhibits a change during treatment, and is potentially the best choice for unilateral scoring systems. Electronic supplementary material The online version of this article (10.1186/s13075-019-1930-y) contains supplementary material, which is available to authorized users.

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“…For most of the patients, the symptoms of GA and Rheumatoid Arthritis(RA) are similar, so it is easy to ignore the condition and delay the optimal treatment time. Therefore, we also distinguished the two by the difference of biochemical indicators.Furthermore, principal component analysis (PCA), orthogonal partial least squares discrimination analysis (OPLS-DA), non-repetitive one-way ANOVA [18], correlation analysis [19] and multiple logistic regression analysis [20] were used to screen the important indicators affecting GA in each stage, and to distinguish GA and RA.Finally, multiple logistic regression was used to establish a clinical diagnosis model [21], so as to improve the success rate of clinical diagnosis and prediction.The overview of study design was indicated in Figure S1.…”

Section: Figure 1 Abridged General View Of the Evolution Of Gouty Armentioning

confidence: 99%

Establishment of A Clinical Diagnostic Model for Gouty Arthritis Based on Serum Biochemical Profile: A Prospective Study

Lyu

Ding

Yang

et al. 2020

Preprint

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Objective Gouty arthritis is a chronic disease caused by purine metabolism disorder. The progress of the disease is relatively clear, divided into four stages. Clinical judgment of the stage of gouty arthritis is generally based on blood uric acid levels, bursa fluid examination, there are false positive cases. This paper attempts to construct a clinical diagnostic model based on routine blood test data, so as to avoid tedious procedures such as cystic fluid examination and predict the development direction of the disease. Methods Serum samples from 579 patients were collected and divided into training set (379 cases) and validation set (200 cases). Through a series of multivariate statistical analysis and correlation analysis, 12 serum biochemical indicators were selected as risk factors for gouty arthritis to obtain the serum biochemical spectrum of gouty arthritis. Based on the biochemical indicators of 379 patients, the clinical diagnosis model of gouty arthritis was established and visualized with R language to predict the probability of patients at different stages, and the stage with the highest probability was used as the diagnosis result, and the evaluation model of 200 patients was used. Results The total ROC of the clinical diagnosis model was 0.95, and the Kappa coefficient of the clinical diagnosis model was 0.80. Conclusion This model can be applied to clinical prediction and basic research to improve the accuracy of gouty arthritis staging.

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Analysis of correlation and causes for discrepancy between quantitative and semi-quantitative Doppler scores in synovitis in rheumatoid arthritis

Cited by 16 publications

References 28 publications

Fatigue Is Not Associated With Objective Assessments of Inflammation During Tocilizumab Treatment of Patients With Rheumatoid Arthritis

Fatigue Is Not Associated With Objective Assessments of Inflammation During Tocilizumab Treatment of Patients With Rheumatoid Arthritis

Assessing synovitis in the hands in patients with rheumatoid arthritis by ultrasound: an agreement study exploring the most inflammatory active side from two Norwegian trials

Establishment of A Clinical Diagnostic Model for Gouty Arthritis Based on Serum Biochemical Profile: A Prospective Study

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