1. Validity, reproducibility, and responsiveness of a twelve-joint simplified power doppler ultrasonographic assessment of joint inflammation in rheumatoid arthritis
- Author
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Luz García, Roser Tuneu, Francisco Javier Toyos, M. Pujol, José Salaberri, Gerardo Iglesias, Juan José Aznar, Angel Bustos Aragón, Esperanza Naredo, Juan Pablo valdazo, Xavier Miquel, César Díaz, Pilar Morales, Eva Galindez, Eugenio Chamizo, Alfredo Willisch, Olga Martínez, Cristina Campos, Carmen Cabrales Vargas, Juan José de Agustín, J. Medina, Amalia Rueda, G Salvador, Inmaculada Ros, Jaime Calvo-Alén, Manuel Rodriguez, Antonio Juan-Mas, Dolores Mínguez, Carlos Armas, Angels Puigdollers, Teresa Ruiz, José Manuel Rodríguez-heredia, Manuel Páez, Isabel González-cruz, Emilio Giner, Enrique Raya, Hèctor Corominas, Meritxell Sallés, C. Moragues, Noemi Garrido, José luis Cuadra, and Jesús Garrido
- Subjects
Adult ,Male ,medicine.medical_specialty ,Immunology ,Arthritis ,Inflammation ,Arthritis, Rheumatoid ,Power doppler ,Rheumatology ,Internal medicine ,Synovitis ,medicine ,Humans ,Immunology and Allergy ,Pharmacology (medical) ,Prospective Studies ,Prospective cohort study ,Aged ,Aged, 80 and over ,Reproducibility ,business.industry ,Reproducibility of Results ,Ultrasonography, Doppler ,Middle Aged ,medicine.disease ,Surgery ,Rheumatoid arthritis ,Female ,medicine.symptom ,Nuclear medicine ,business - Abstract
Objective To investigate the validity, reproducibility, and responsiveness of a simplified power Doppler ultrasound (PDUS) assessment of joint inflammation compared with a comprehensive 44-joint PDUS assessment in patients with rheumatoid arthritis (RA) who started therapy with a biologic agent. Methods A total of 160 patients with active RA who started a biologic agent were prospectively recruited in 18 Spanish centers. The patients underwent clinical and laboratory assessment and blinded PDUS examination at baseline and 6 months. A PDUS examination of 128 synovial sites in 44 joints was performed. US synovitis and PD signal were semiquantitatively graded from 1 to 3 in all synovial sites. US count and index for synovitis and PD signal were obtained. PDUS intraobserver and interobserver reliability were evaluated. A process of data reduction based on the frequency of involvement of synovial sites by both synovitis and PD signal was conducted. Construct and discriminant validity of a simplified PDUS assessment was investigated. Results A PDUS simplified assessment including 24 synovial sites from 12 joints detected 100% of patients with synovitis and 91% of patients with PD signal. There was a highly significant correlation between the 44-joint count and index for synovitis and PD signal and the 12-joint count and index for synovitis and PD signal at baseline and 6 months (r = 0.84–0.90, P < 0.0005). The smallest detectable difference was lower than the mean change in simplified PDUS variables. Conclusion A 12-joint PDUS assessment of RA joint inflammation may be a valid, feasible method for multicenter monitoring of therapeutic response to biologic agents.
- Published
- 2008