Open AccessJournal Article
An EULAR Study Group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases
Vanessa Smith,Sam Beeckman,Ariane L. Herrick,Saskia Decuman,Ellen Deschepper,Filip De Keyser,Oliver Distler,Ivan Foeldvari,Francesca Ingegnoli,Ulf Müller-Ladner,Valeria Riccieri,Gabriela Riemekasten,Alberto Sulli,Alexandre E. Voskuyl,Maurizio Cutolo +14 more
TLDR
In this paper, simple definitions of hairpin, tortuous or crossing were proposed for describing morphology of capillaries by rheumatologists with varying levels of expertise, and inter-rater agreement was assessed by calculation of proportion of agreement and by kappa coefficients.Abstract:
OBJECTIVE\nTo propose simple capillaroscopic definitions for interpretation of capillaroscopic morphologies and to assess inter-rater reliability.\n\n\nMETHODS\nThe simple definitions proposed were: normal--hairpin, tortuous or crossing; abnormal--not hairpin, not tortuous and not crossing; not evaluable--whenever rater undecided between normal and abnormal. Based upon an aimed kappa of 0.80 and default prevalences of normal (0.4), abnormal (0.4) and not evaluable (0.2) capillaries, 90 single capillaries were presented to three groups of raters: experienced independent raters, n = 5; attendees of the sixth EULAR capillaroscopy course, n = 34; novices after a 1-h course, n = 11. Inter-rater agreement was assessed by calculation of proportion of agreement and by kappa coefficients.\n\n\nRESULTS\nMean kappa based on 90 capillaries was 0.47 (95% CI: 0.39, 0.54) for expert raters, 0.40 (95% CI: 0.36, 0.44) for attendees and 0.46 (95% CI: 0.41, 0.52) for novices, with overall agreements of 67% (95% CI: 63, 71), 63% (95% CI: 60, 65) and 67% (95% CI: 63, 70), respectively. Comparing only normal vs the combined groups of abnormal and not evaluable capillaries did increase the kappa: 0.51 (95% CI: 0.37 ,: 0.65), 0.53 (95% CI: 0.49, 0.58) and 0.55 (95% CI: 0.49, 0.62). On the condition that the capillaries were classifiable, the mean kappa was 0.62 (95% CI: 0.50, 0.74) for expert raters (n = 65), 0.76 (95% CI: 0.69, 0.83) for attendees (n = 20) and 0.81 (95% CI: 0.74, 0.89) for novices (n = 44).\n\n\nCONCLUSION\nThis multicentre, international study showed moderate reliability of simple capillaroscopic definitions for describing morphology of capillaries by rheumatologists with varying levels of expertise. Novices were capable of distinguishing normal from abnormal capillaries by means of a 1-h training session. In future studies, the class not evaluable may be obsolete.read more
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Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud's phenomenon and systemic sclerosis
Vanessa Smith,Vanessa Smith,Ariane L. Herrick,Francesca Ingegnoli,Nemanja Damjanov,Rossella De Angelis,Christopher P. Denton,Christopher P. Denton,Oliver Distler,Karinna Espejo,Ivan Foeldvari,Tracy M. Frech,Boris Garro,Marwin Gutierrez,Geneviève Gyger,Geneviève Gyger,Eric Hachulla,Roger Hesselstrand,Annamaria Iagnocco,Cristiane Kayser,Karin Melsens,Karin Melsens,Ulf Müller-Ladner,Sabrina Paolino,Carmen Pizzorni,Mislav Radić,Valeria Riccieri,Marcus H Snow,Wendy Stevens,Alberto Sulli,Jacob M van Laar,Madelon C. Vonk,Amber Vanhaecke,Amber Vanhaecke,Maurizio Cutolo +34 more
TL;DR: Experts in the field of capillaroscopy/microcirculation provide in this very consensus paper their view on image acquisition and analysis, different capillsaroscopic techniques, normal and abnormal capillARoscopic characteristics and their meaning, scoring systems and reliability of image acquisitionand interpretation.
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Nailfold capillaroscopy in systemic lupus erythematosus: A systematic review and critical appraisal.
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Fast track algorithm : How to differentiate a "scleroderma pattern" from a "non-scleroderma pattern"
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TL;DR: For the first time, a clinical expert based fast track decision algorithm has been developed to differentiate a "non-scleroderma" from a "sclerodma pattern" on capillaroscopy images, demonstrating excellent reliability when applied by capilaroscopists with varying levels of expertise versus the principal expert and corroborated with external validation.
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Sequential nailfold videocapillaroscopy examinations have responsiveness to detect organ progression in systemic sclerosis
Jérôme Avouac,Gemma Lepri,Gemma Lepri,Vanessa Smith,Elide Toniolo,Charlotte Hurabielle,Anaïs Vallet,Fazia Amrouche,André Kahan,Maurizio Cutolo,Yannick Allanore +10 more
TL;DR: Sequential NVC is confirmed of value to monitor SSc, as well as progressive loss of capillaries over time as a potential surrogate marker for disease progression.
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