Effect of Online Training on the Reliability of Assessing Sacroiliac Joint Radiographs in Axial Spondyloarthritis: A Randomized, Controlled Study.

IF 3.6 2区医学 Q2 RHEUMATOLOGY Journal of Rheumatology Pub Date : 2024-10-15 DOI:10.3899/jrheum.2024-0075

Anna E F Hadsbjerg, Mikkel Østergaard, Joel Paschke, Raphael Micheroli, Susanne J Pedersen, Adrian Ciurea, Michael J Nissen, Kristyna Bubova, Stephanie Wichuk, Manouk de Hooge, Simon Krabbe, Ashish J Mathew, Monika Gregová, Marie Wetterslev, Karel Gorican, Karlo Pintaric, Ziga Snoj, Burkhard Möller, Alexander Bernatschek, Maurice Donzallaz, Robert G Lambert, Walter P Maksymowych

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Abstract

Objective: Radiographic assessment of sacroiliac joints (SIJs) according to the modified New York (mNY) criteria is key in the classification of axial spondyloarthritis but has moderate interreader agreement. We aimed to investigate the improvements of the reliability in scoring SIJ radiographs after applying an online real-time iterative calibration (RETIC) module, in addition to a slideshow and video alone.

Methods: Nineteen readers, randomized to 2 groups (A or B), completed 3 calibration steps: (1) review of manuscripts, (2) review of slideshow and video with group A completing RETIC, and (3) re-review of slideshow and video with group B completing RETIC. The RETIC module gave instant feedback on readers' gradings and continued until predefined reliability (κ) targets for mNY positivity/negativity were met. Each step was followed by scoring different batches of 25 radiographs (exercises I to III). Agreement (κ) with an expert radiologist was assessed for mNY positivity/negativity and individual lesions. Improvements by training strategies were tested by linear mixed models.

Results: In exercises I, II, and III, mNY κ were 0.61, 0.76, and 0.84, respectively, in group A; and 0.70, 0.68, and 0.86, respectively, in group B (ie, increasing, mainly after RETIC completion). Improvements were observed for grading both mNY positivity/negativity and individual pathologies, both in experienced and, particularly, inexperienced readers. Completion of the RETIC module in addition to the slideshow and video caused a significant κ increase of 0.17 (95% CI 0.07-0.27; P = 0.002) for mNY-positive and mNY-negative grading, whereas completion of the slideshow and video alone did not (κ = 0.00, 95% CI -0.10 to 0.10; P = 0.99).

Conclusion: Agreement on scoring radiographs according to the mNY criteria significantly improved when adding an online RETIC module, but not by slideshow and video alone.

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在线培训对轴向脊柱关节炎患者骶髂关节X光片评估可靠性的影响--一项随机对照研究。

目的：根据修改后的纽约（mNY）标准对骶髂关节（SIJ）进行放射学评估是axSpA分类的关键，但读片者之间的一致性一般。我们的目的是研究除了幻灯片和视频外，在应用在线实时迭代校准（RETIC）模块后，对 SIJ X 光片进行评分的可靠性改进情况：19名读者随机分为2组（A/B），完成3个校准步骤：I）审稿；II）审阅幻灯片和视频，A 组完成 RETIC；III）重新审阅幻灯片和视频，B 组完成 RETIC。RETIC 模块会即时反馈读者的评分，并一直持续到达到 mNY 阳性/阴性的预定信度（kappa）目标为止。每个步骤之后都要对不同批次的 25 张射线照片进行评分（练习 I-III）。评估与放射科专家在 mNY+/mNY- 和单个病变方面的一致性（kappa）。结果：在练习 I/II/III 中，A 组的 mNY kappa 分别为 0.61/0.76/0.84，B 组为 0.70/0.68/0.86。有经验的读者，尤其是缺乏经验的读者，在对 mNY+/mNY- 和单个病理进行分级时都有所改进。除幻灯片和视频外，完成 RETIC 模块可使 mNY+/mNY- 分级的 kappa 显著提高 0.17（CI：0.07-0.27，P=0.002），而仅完成幻灯片和视频则没有提高（0.0；CI -0.10-+0.10，P=0.99）：结论：增加在线 RETIC 模块后，根据 mNY 标准对放射照片进行评分的一致性显著提高，但仅靠幻灯片和视频评分的一致性则没有提高。

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来源期刊

Journal of Rheumatology 医学-风湿病学

CiteScore

6.50

自引率

5.10%

发文量

285

审稿时长

1 months

期刊介绍： The Journal of Rheumatology is a monthly international serial edited by Earl D. Silverman. The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 41 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.