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Related Experiment Video

Updated: Aug 19, 2025

A Reproducible Computerized Method for Quantitation of Capillary Density using Nailfold Capillaroscopy
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Evaluation of Nailfold Capillaroscopy Online Training Using the Fast Track Algorithm.

Sue-Ann Ng1, Wen Hao Tan2, Seyed Ehsan Saffari3

  • 1S.A. Ng, MBBS, MCI, Department of Rheumatology and Immunology, Singapore General Hospital, and Duke-NUS Medical School, National University of Singapore; sue.ann.ng.p.l@singhealth.com.sg.

The Journal of Rheumatology
|December 1, 2022
PubMed
Summary

Online training for nailfold capillaroscopy (NFC) using the Fast Track algorithm demonstrated high agreement in identifying scleroderma patterns. This supports the effectiveness of standardized online workshops for NFC assessment.

Keywords:
Raynaud phenomenoneducationnailfold capillaroscopysclerodermasystemic sclerosis

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Area of Science:

  • Rheumatology
  • Dermatology
  • Medical Education

Background:

  • Nailfold capillaroscopy (NFC) is crucial for early identification of systemic sclerosis (SSc).
  • The European Alliance of Associations for Rheumatology developed a "Fast Track algorithm" for NFC pattern differentiation.
  • Standardized training is essential for accurate NFC interpretation.

Purpose of the Study:

  • To evaluate the effectiveness of online training for nailfold capillaroscopy (NFC) using the Fast Track algorithm.
  • To assess the agreement in identifying scleroderma vs. nonscleroderma patterns after online training.
  • To determine the feasibility of standardized online workshops for NFC interpretation.

Main Methods:

  • Participants completed an online training workshop on the Fast Track algorithm for NFC.
  • Trained participants independently evaluated 45 NFC images twice: immediately and 2-4 weeks later.
  • Inter- and intrarater Cohen's kappa agreement was calculated for pattern identification.

Main Results:

  • High inter- and intrarater agreement (kappa ≈ 0.86 and 0.83) were observed for scleroderma vs. nonscleroderma pattern identification.
  • Overall agreement for identifying scleroderma, normal nonscleroderma, and nonspecific nonscleroderma patterns was also substantial (kappa ≈ 0.71).
  • Agreement for differentiating normal from nonspecific nonscleroderma patterns was moderate (kappa ≈ 0.59).

Conclusions:

  • Online training utilizing the Fast Track algorithm for NFC demonstrates very good inter- and intrarater agreement.
  • This study supports the feasibility and effectiveness of standardized online training workshops for nailfold capillaroscopy.
  • Online training can enhance the consistent and accurate assessment of NFC patterns in clinical practice.