Feasibility and reliability of the spondyloarthritis research consortium of Canada sacroiliac joint structural score in children

Pamela F. Weiss, Walter P. Maksymowych, Robert G. Lambert, Jacob L. Jaremko, David M. Biko, Joel Paschke, Timothy G. Brandon, Rui Xiao, Nancy A. Chauvin

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1411-1417
Number of pages7
JournalJournal of Rheumatology
Volume45
Issue number10
DOIs
StatePublished - Oct 1 2018

Fingerprint

Sacroiliac Joint
Canada
Exercise
Ankylosis
Pediatrics
Metaplasia
Sclerosis
Research
Calibration
Reading
Fats
Reproducibility of Results
Magnetic Resonance Imaging
Joints

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Weiss, Pamela F. ; Maksymowych, Walter P. ; Lambert, Robert G. ; Jaremko, Jacob L. ; Biko, David M. ; Paschke, Joel ; Brandon, Timothy G. ; Xiao, Rui ; Chauvin, Nancy A. / Feasibility and reliability of the spondyloarthritis research consortium of Canada sacroiliac joint structural score in children. In: Journal of Rheumatology. 2018 ; Vol. 45, No. 10. pp. 1411-1417.
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title = "Feasibility and reliability of the spondyloarthritis research consortium of Canada sacroiliac joint structural score in children",
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.",
author = "Weiss, {Pamela F.} and Maksymowych, {Walter P.} and Lambert, {Robert G.} and Jaremko, {Jacob L.} and Biko, {David M.} and Joel Paschke and Brandon, {Timothy G.} and Rui Xiao and Chauvin, {Nancy A.}",
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doi = "10.3899/jrheum.171329",
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Weiss, PF, Maksymowych, WP, Lambert, RG, Jaremko, JL, Biko, DM, Paschke, J, Brandon, TG, Xiao, R & Chauvin, NA 2018, 'Feasibility and reliability of the spondyloarthritis research consortium of Canada sacroiliac joint structural score in children', Journal of Rheumatology, vol. 45, no. 10, pp. 1411-1417. https://doi.org/10.3899/jrheum.171329

Feasibility and reliability of the spondyloarthritis research consortium of Canada sacroiliac joint structural score in children. / Weiss, Pamela F.; Maksymowych, Walter P.; Lambert, Robert G.; Jaremko, Jacob L.; Biko, David M.; Paschke, Joel; Brandon, Timothy G.; Xiao, Rui; Chauvin, Nancy A.

In: Journal of Rheumatology, Vol. 45, No. 10, 01.10.2018, p. 1411-1417.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Feasibility and reliability of the spondyloarthritis research consortium of Canada sacroiliac joint structural score in children

AU - Weiss, Pamela F.

AU - Maksymowych, Walter P.

AU - Lambert, Robert G.

AU - Jaremko, Jacob L.

AU - Biko, David M.

AU - Paschke, Joel

AU - Brandon, Timothy G.

AU - Xiao, Rui

AU - Chauvin, Nancy A.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - 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.

AB - 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.

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