Consensus-based semi-quantitative ultrasound scoring system for gout lesions: Results of an OMERACT Delphi process and web-reliability exercise

Sara Nysom Christiansen, Georgios Filippou, Carlo Alberto Scirè, Peter V Balint, George Aw Bruyn, Nicola Dalbeth, Christian Dejaco, Andrea Delle Sedie, Emilio Filippucci, Hilde B Hammer, Annamaria Iagnocco, Helen I Keen, Eugene Y Kissin, Juhani Koski, Peter Mandl, Julia Martin, Eugenio De Miguel, Ingrid Möller, Esperanza Naredo, Carlos PinedaWolfgang A Schmidt, Sarah Stewart, Maria Antonietta D'Agostino, Lene Terslev, on the behalf of the OMERACT Ultrasound working group

Abstract

OBJECTIVE: This study aimed to develop (1) a new ultrasound definition for aggregates and (2) a semi-quantitative ultrasound scoring system (0-3) for tophus, double contour and aggregates. Furthermore, the intra- and inter-reader reliabilities of both the re-defined aggregates and the semi-quantitative scoring system were assessed using static image exercises.

METHODS: Thirty-seven rheumatologists were invited. A Delphi process was used for re-defining aggregates and for selecting a semi-quantitative scoring system with >75% agreement obligate for reaching consensus. Subsequently, a web-based exercise on static ultrasound images was conducted in order to assess the reliability of both the re-defined aggregates and the semi-quantitative scoring system.

RESULTS: Twenty rheumatologists contributed to all rounds of the Delphi and image exercises. A consensual re-definition of aggregates was obtained after three Delphi rounds but needed an overarching principle for scoring aggregates in patients. A consensus-based semi-quantitative ultrasound scoring system for gout lesions was developed after two Delphi rounds. The re-definition of aggregates showed good intra- and inter-reader reliability (κ-values 0.71 and 0.61). The reliabilities of the scoring system were good for all lesions with slightly higher intra-reader (κ-values 0.74-0.80) than inter-reader reliabilities (κ-values 0.61-0.67).

CONCLUSION: A re-definition of aggregates was obtained with a good reliability when assessing static images. The first consensus-based semi-quantitative ultrasound scoring system for gout-specific lesions was developed with good inter- and intra-reader reliability for all lesions when tested in static images. The next step is to assess the reliabilities when scoring lesions in patients.

Original languageEnglish
JournalSeminars in Arthritis and Rheumatism
Volume51
Issue number3
Pages (from-to)644-649
Number of pages6
ISSN0049-0172
DOIs
Publication statusPublished - Jun 2021

Keywords

  • Consensus
  • Exercise
  • Gout/diagnostic imaging
  • Humans
  • Observer Variation
  • Reproducibility of Results
  • Ultrasonography

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