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Related Experiment Videos

Modified sharp method: factors influencing reproducibility and variability.

H L Swinkels1, R F Laan, M A van 't Hof

  • 1Department of Rheumatology, University Medical Centre Nijmegen, The Netherlands.

Seminars in Arthritis and Rheumatism
|December 12, 2001
PubMed
Summary
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Radiographic scoring in rheumatoid arthritis shows variability. Factors like observer differences and follow-up time impact joint damage assessment, recommending progression scoring for clinical trials.

Area of Science:

  • Rheumatology
  • Radiology
  • Medical Imaging Analysis

Background:

  • Joint radiography is crucial for assessing rheumatoid arthritis (RA) joint damage progression.
  • Current radiographic scoring methods have limitations impacting clinical trial power.
  • This study analyzes factors influencing radiographic scoring variability in RA.

Purpose of the Study:

  • To investigate the impact of intraobserver variation, interobserver variation, follow-up time, and measurement frequency on radiographic scores.
  • To evaluate the reliability of van der Heijde's modification of the Sharp method in assessing RA progression.
  • To provide recommendations for optimizing radiographic assessment in clinical trials.

Main Methods:

  • 172 early-stage RA patients were followed for 6 years.

Related Experiment Videos

  • Hand and foot radiographs were taken twice yearly for the first 3 years.
  • Three observers scored the radiographs, with scoring repeated after 3 years to assess variability.

    • Main Results:

    • Significant differences in scoring were observed between individual observers.
    • Interobserver variability decreased with longer follow-up times.
    • Progression scores showed higher interobserver correlation and smaller differences than absolute scores.
    • Increased measurement frequency within a patient series led to higher scores.
    • Intraobserver correlation was high, with a training effect noted after 1 year.

    Conclusions:

    • Investigated factors significantly influence the variability of the modified Sharp method for radiographic scoring in RA.
    • Minimizing interobserver variation is critical for multicenter clinical trial design.
    • Progression scoring is recommended over absolute scoring for studies evaluating radiographic damage in RA.