Pamela F Weiss1,2, Walter P Maksymowych3,4, Robert G Lambert3,4, Jacob L Jaremko3,4, David M Biko3,4, Joel Paschke3,4, Timothy G Brandon3,4, Rui Xiao3,4, Nancy A Chauvin3,4. 1. From the Departments of Pediatrics and Radiology, Division of Rheumatology, and Center for Pediatric Clinical Effectiveness (CPCE) at the Children's Hospital of Philadelphia; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Medicine at the University of Alberta; Department of Radiology and Diagnostic Imaging, University of Alberta; Canadian Research and Education (CaRE) Arthritis Organization, Edmonton, Alberta, Canada. weisspa@email.chop.edu. 2. P.F. Weiss, MD, MSCE, Department of Pediatrics, Division of Rheumatology at the Children's Hospital of Philadelphia and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania; W.P. Maksymowych, MD, FRCP, Department of Medicine at the University of Alberta; R.G. Lambert, MB BCh, FRCR, FRCPC, Department of Radiology and Diagnostic Imaging at the University of Alberta; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging at the University of Alberta; D.M. Biko, MD, Department of Radiology at the Children's Hospital of Philadelphia; J. Paschke, BSc, CaRE Arthritis; T.G. Brandon, MPH, Department of Pediatrics, Division of Rheumatology at the Children's Hospital of Philadelphia; R. Xiao, PhD, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania; Department of Radiology and Diagnostic Imaging, University of Alberta; N.A. Chauvin, MD, Department of Radiology at the Children's Hospital of Philadelphia. weisspa@email.chop.edu. 3. From the Departments of Pediatrics and Radiology, Division of Rheumatology, and Center for Pediatric Clinical Effectiveness (CPCE) at the Children's Hospital of Philadelphia; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Medicine at the University of Alberta; Department of Radiology and Diagnostic Imaging, University of Alberta; Canadian Research and Education (CaRE) Arthritis Organization, Edmonton, Alberta, Canada. 4. P.F. Weiss, MD, MSCE, Department of Pediatrics, Division of Rheumatology at the Children's Hospital of Philadelphia and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania; W.P. Maksymowych, MD, FRCP, Department of Medicine at the University of Alberta; R.G. Lambert, MB BCh, FRCR, FRCPC, Department of Radiology and Diagnostic Imaging at the University of Alberta; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging at the University of Alberta; D.M. Biko, MD, Department of Radiology at the Children's Hospital of Philadelphia; J. Paschke, BSc, CaRE Arthritis; T.G. Brandon, MPH, Department of Pediatrics, Division of Rheumatology at the Children's Hospital of Philadelphia; R. Xiao, PhD, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania; Department of Radiology and Diagnostic Imaging, University of Alberta; N.A. Chauvin, MD, Department of Radiology at the Children's Hospital of Philadelphia.
Abstract
OBJECTIVE: There is a critical need for measures to evaluate structural progression in the pediatric sacroiliac joint (SIJ). We aimed to evaluate the construct validity and reliability of the Spondyloarthritis Research Consortium of Canada SIJ Structural Score (SSS) in children with suspected or confirmed juvenile spondyloarthritis. METHODS: The SSS assesses structural lesions of the SIJ on magnetic resonance imaging (MRI) through the cartilaginous part of the joint. We conducted 3 sequential reading exercises with 6 readers (1 adult and 3 pediatric radiologists, 1 adult and 1 pediatric rheumatologist). Each exercise was preceded by a calibration module. Interobserver reliability was assessed using intraclass correlation coefficients (ICC). Prespecified acceptable reliability thresholds were ICC > 0.5 for erosion, backfill, and sclerosis, and ICC > 0.7 for ankylosis and fat metaplasia. RESULTS: The SSS had face validity and was feasible to score in pediatric cases for all 3 reading exercises. Of the cases used in the 3 exercises, 58% were male and the median age was 14 years (range 6.8-18.7 yrs). After calibration, median ICC across all readers for each SSS component were the following: erosion 0.67 (interquartile range 0.54-0.80), backfill 0.33 (0.19-0.52), fat metaplasia 0.74 (0.62-0.85), sclerosis 0.63 (0.48-0.77), and ankylosis 0.44 (0.28-0.62). Prespecified reliability thresholds were achieved in the third exercise for erosion, sclerosis, and fat metaplasia but not for backfill or ankylosis. CONCLUSION: The SSS was feasible to score and had acceptable reliability for pediatric SIJ MRI evaluation. The ICC improved with additional calibration and reading exercises, even for readers with limited experience.
OBJECTIVE: There is a critical need for measures to evaluate structural progression in the pediatric sacroiliac joint (SIJ). We aimed to evaluate the construct validity and reliability of the Spondyloarthritis Research Consortium of Canada SIJ Structural Score (SSS) in children with suspected or confirmed juvenile spondyloarthritis. METHODS: The SSS assesses structural lesions of the SIJ on magnetic resonance imaging (MRI) through the cartilaginous part of the joint. We conducted 3 sequential reading exercises with 6 readers (1 adult and 3 pediatric radiologists, 1 adult and 1 pediatric rheumatologist). Each exercise was preceded by a calibration module. Interobserver reliability was assessed using intraclass correlation coefficients (ICC). Prespecified acceptable reliability thresholds were ICC > 0.5 for erosion, backfill, and sclerosis, and ICC > 0.7 for ankylosis and fat metaplasia. RESULTS: The SSS had face validity and was feasible to score in pediatric cases for all 3 reading exercises. Of the cases used in the 3 exercises, 58% were male and the median age was 14 years (range 6.8-18.7 yrs). After calibration, median ICC across all readers for each SSS component were the following: erosion 0.67 (interquartile range 0.54-0.80), backfill 0.33 (0.19-0.52), fat metaplasia 0.74 (0.62-0.85), sclerosis 0.63 (0.48-0.77), and ankylosis 0.44 (0.28-0.62). Prespecified reliability thresholds were achieved in the third exercise for erosion, sclerosis, and fat metaplasia but not for backfill or ankylosis. CONCLUSION: The SSS was feasible to score and had acceptable reliability for pediatric SIJ MRI evaluation. The ICC improved with additional calibration and reading exercises, even for readers with limited experience.
Entities:
Keywords:
CALIBRATION; DISEASE PROGRESSION; MAGNETIC RESONANCE IMAGING; SACROILIAC JOINT; SPONDYLOARTHRITIS
Authors: Pamela F Weiss; Robert C Fuhlbrigge; Emily von Scheven; Daniel J Lovell; Robert A Colbert; Hermine I Brunner Journal: Arthritis Care Res (Hoboken) Date: 2022-04-15 Impact factor: 5.178
Authors: Michael L Francavilla; Suraj D Serai; Timothy G Brandon; David M Biko; Dmitry Khrichenko; Jie C Nguyen; Rui Xiao; Nancy A Chauvin; Liya Gendler; Pamela F Weiss Journal: ACR Open Rheumatol Date: 2021-11-10
Authors: Timothy G Brandon; Rui Xiao; Rosemary G Peterson; Nancy A Chauvin; Michael L Francavilla; David M Biko; Dax G Rumsey; Matthew L Stoll; Pamela F Weiss Journal: Pediatr Rheumatol Online J Date: 2021-12-02 Impact factor: 3.054
Authors: Pamela F Weiss; Walter P Maksymowych; Rui Xiao; David M Biko; Michael L Francavilla; Robert G Lambert; Jacob L Jaremko; Merav Heshin-Bekenstein; Timothy G Brandon; Nancy A Chauvin Journal: Arthritis Res Ther Date: 2020-03-24 Impact factor: 5.156