Objective: The aim of this exercise from the OMERACT ultrasound subgroup on Sjögren's syndrome (pSS) was to develop and assess the reliability of a consensus-based semiquantitative colour Doppler (CD) ultrasound scoring system for pathologic salivary gland vascularization in patients with pSS. Methods: Using the Delphi method a CD 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 (κ) 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 κ values (95% confidence interval) = 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 κ = 0.84 (0.73-0.92) and 0.70 (0.64-0.76), respectively. Conclusion: The consensus-based CD ultrasound 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. Keywords: colour Doppler ultrasound; primary Sjögren’s syndrome; salivary gland vascularization; scoring system.
Hočevar, A., Bruyn, G. A., Terslev, L., De Agustin, J. J., Maccarter, D., Chrysidis, S., Collado, P., Dejaco, C., Fana, V., Filippou, G., Finzel, S., Gandjbakhch, F., Hanova, P., Hammenfors, D., Hernandez-Diaz, C., Iagnocco, A., Mortada, M. A., Inanc, N., Naredo, E., Ohrndorf, S., Perko, N., Schmidt, W. A., Tamborrini, G., Tomšič, M., Chary-Valckenaere, I., Zabotti, A., Keen, H. I., Pineda, C., D'Agostino, M. A., Jousse-Joulin, S., Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise, <<RHEUMATOLOGY>>, 2021; (N/A): N/A-N/A. [doi:10.1093/rheumatology/keab876] [http://hdl.handle.net/10807/198141]
Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise
Dejaco, Christian;D'Agostino, Maria Antonietta;
2021
Abstract
Objective: The aim of this exercise from the OMERACT ultrasound subgroup on Sjögren's syndrome (pSS) was to develop and assess the reliability of a consensus-based semiquantitative colour Doppler (CD) ultrasound scoring system for pathologic salivary gland vascularization in patients with pSS. Methods: Using the Delphi method a CD 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 (κ) 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 κ values (95% confidence interval) = 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 κ = 0.84 (0.73-0.92) and 0.70 (0.64-0.76), respectively. Conclusion: The consensus-based CD ultrasound 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. Keywords: colour Doppler ultrasound; primary Sjögren’s syndrome; salivary gland vascularization; scoring system.
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