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Iterative development and reliability of the OMERACT hand osteoarthritis MRI scoring system
Ida K Haugen1, Mikkel Østergaard, Iris Eshed
1From the Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Rheumatology, Copenhagen University Hospitals at Glostrup, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Molecular Medicine and Pathology, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Rheumatology, St. George Hospital, Sydney, Australia; St. George Clinical School, University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié Salpêtriere Hospital, APHP, Université Pierre et Marie Curie, Paris, France; Departments of Radiology and Medicine, University of California San Francisco, San Francisco, CA, USA; Synarc Inc., Newark, California, USA; Spire Sciences Inc., Boca Raton, Florida, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine USA; Section of Musculoskeletal Disease, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
Objective:
To develop and test the interreader reliability of the OMERACT Hand Osteoarthritis Magnetic Resonance Scoring System (HOAMRIS) for assessment of structural and inflammatory hand OA features in the interphalangeal joints.
Methods:
The HOAMRIS was developed through an iterative process. Selection of features and their scaling was agreed upon through consensus by members of the OMERACT Magnetic Resonance Imaging (MRI) Task Force, using the Oslo Hand Osteoarthritis (OA) MRI Score system as a template. Two reliability exercises were performed, in which 6 and 4 readers participated, respectively. After the first exercise, an atlas was developed and used in the second exercise to facilitate reading. In each exercise, readers independently scored 8 MRI scans from the Oslo Hand OA cohort (coronal/axial short-tau inversion recovery and coronal/axial/sagittal T1-weighted fat-suppressed pre-/post-Gadolinium images). Interreader reliability was assessed by intraclass correlation coefficients (ICC), percentage exact and close agreement (PEA/PCA).
Results:
The preliminary OMERACT HOAMRIS included assessment of synovitis, erosive damage, cysts, osteophytes, cartilage space loss, malalignment, and bone marrow lesions (BML), of which all were scored on a 0-3 scale for normal, mild, moderate, and severe (increments of 0.5 for synovitis, erosive damage, and BML). In the first exercise, most features showed good to very good ICC values (0.64-0.94), except synovitis (0.34). In the second exercise using the atlas, the ICC values were > 0.74 for all MRI features, and the PEA/PCA values were higher than in the first exercise.
Conclusion:
A preliminary HOAMRIS with good to very good interreader reliability was developed. Longitudinal studies are needed to assess its sensitivity to change.
