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Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • Alojzija Hočevar
  • George A Bruyn
  • Lene Terslev
  • Juan Jose De Agustin
  • Daryl MacCarter
  • Stavros Chrysidis
  • Paz Collado
  • Christian Dejaco
  • Viktoria Fana
  • Gerogios Filippou
  • Stephanie Finzel
  • Frederique Gandjbakhch
  • Petra Hanova
  • Daniel Hammenfors
  • Cristina Hernandez-Diaz
  • Annamaria Iagnocco
  • Mohamed Atia Mortada
  • Nevsun Inanc
  • Esperanza Naredo
  • Sarah Ohrndorf
  • Nejc Perko
  • Wolfgang A Schmidt
  • Giorgio Tamborrini
  • Matija Tomšič
  • Isabelle Chary-Valckenaere
  • Alen Zabotti
  • Helen I Keen
  • Carlos Pineda
  • Maria-Antonietta D'Agostino
  • Sandrine Jousse-Joulin
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OBJECTIVE: The aim of this exercise from the OMERACT Ultrasound subgroup on Sjögren's syndrome was to develop and assess the reliability of a consensus-based semiquantitative colour Doppler US scoring system for pathologic salivary gland vascularization in patients with primary Sjögren's syndrome (pSS).

METHODS: Using the Delphi method, a colour Doppler semiquantitative scoring system for vascularization of bilateral parotid and submandibular glands was developed and tested in static images and on patients (9 pSS patients and 9 sonographers). Intra-reader and inter-reader reliability of grading the salivary glands were computed by weighted Cohen and Light's kappa analysis, respectively.

RESULTS: The consensus-based semiquantitative score was: grade 0, no visible vascular signals; grade 1, focal, dispersed vascular signals; grade 2, diffuse vascular signals detected in <50% of the gland; grade 3, diffuse vascular signals in >50% of the gland. In static images, the intra- and inter-reader reliability showed excellent kappa values (95% CI) of 0.90 (0.87, 0.93) and 0.80 (0.74, 0.84), respectively, for all four salivary glands together. In patients, the intra- and inter-reader reliability for all four salivary glands together was kappa = 0.84 (0.73, 0.92) and 0.70 (0.64, 0.76), respectively.

CONCLUSION: The consensus-based colour Doppler US scoring for the evaluation of salivary gland vascularization in pSS showed a good inter-reader reliability and excellent intra-reader reliability in static images and in patients. The clinical application of the developed scoring system should be tested in clinical settings.

TidsskriftRheumatology (Oxford, England)
Udgave nummer8
Sider (fra-til)3341-3350
Antal sider10
StatusUdgivet - 3 aug. 2022

Bibliografisk note

© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email:

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