PMID- 15170919
OWN - NLM
STAT- MEDLINE
DCOM- 20040914
LR  - 20161124
IS  - 0315-162X (Print)
IS  - 0315-162X (Linking)
VI  - 31
IP  - 6
DP  - 2004 Jun
TI  - Progression of rheumatoid arthritis on plain radiographs judged differently by 
      expert radiologists and rheumatologists.
PG  - 1088-94
AB  - OBJECTIVE: In a former study a panel of rheumatologists was used to assess which 
      progression in radiological joint damage due to rheumatoid arthritis (RA) on hand 
      and foot radiographs taken at one-year intervals was considered the minimally 
      clinically important difference (MCID). We compare the judgments of the panel of 
      rheumatologists with the judgments of 2 musculoskeletal radiologists. METHODS: 
      Two experienced musculoskeletal radiologists evaluated independently the same 
      hand and foot radiographs as assessed by the panel of rheumatologists. 
      Progression was defined as important if the radiologist would state it as 
      substantial progression in their report. Two readers, different from the 
      radiologists and rheumatologists, independently obtained the Sharp/van der Heijde 
      scores. Receiver operating characteristic curve analyses were performed to 
      quantify the minimally important progression defined by the radiologists 
      expressed in Sharp/van der Heijde change-scores. The change-score with the 
      highest accuracy represented the minimally important progression and was compared 
      with the MCID defined by the panel of rheumatologists for 4 different settings 
      (early versus advanced RA and mild versus high disease activity). RESULTS: The 
      minimally important progression defined by the radiologists was estimated at 6.5 
      Sharp/van der Heijde units. This was larger than the MCID defined by the panel of 
      rheumatologists in 3 of the 4 clinical settings (3.0-4.5 units) and similar to 
      the setting "advanced RA, mild disease activity." The panel of rheumatologists 
      was inclined to change therapy in cases not reported as substantially progressive 
      by the radiologists. The Sharp/van der Heijde progression scores of the 
      radiographs on which the radiologists and rheumatologists disagreed related 
      better with the rheumatologists' opinions. CONCLUSION: Changes that were not 
      regarded as substantial by the radiologists were judged clinically important by 
      the rheumatologists in 3 of the 4 clinical settings. Thus, the radiologists 
      appeared to be reserved in judging changes as important.
FAU - Bruynesteyn, Karin
AU  - Bruynesteyn K
AD  - Department of Internal Medicine, Division of Rheumatology and the Department of 
      Radiology, University Hospital Maastricht, Maastricht, The Netherlands.
FAU - Van Der Linden, Sjef
AU  - Van Der Linden S
FAU - Landewe, Robert
AU  - Landewe R
FAU - Gubler, Feikje
AU  - Gubler F
FAU - Weijers, Rene
AU  - Weijers R
FAU - Van Der Heijde, Desiree
AU  - Van Der Heijde D
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
SB  - IM
CIN - J Rheumatol. 2004 Jun;31(6):1026-8. PMID: 15170909
MH  - Arthritis, Rheumatoid/*diagnostic imaging
MH  - Arthrography/*standards/statistics & numerical data
MH  - Decision Making
MH  - Humans
MH  - Observer Variation
MH  - Radiology/*standards
MH  - Rheumatology/*standards
EDAT- 2004/06/02 05:00
MHDA- 2004/09/15 05:00
CRDT- 2004/06/02 05:00
PHST- 2004/06/02 05:00 [pubmed]
PHST- 2004/09/15 05:00 [medline]
PHST- 2004/06/02 05:00 [entrez]
AID - 0315162X-31-1088 [pii]
PST - ppublish
SO  - J Rheumatol. 2004 Jun;31(6):1088-94.