Video clip assessment of a salivary gland ultrasound scoring system in Sjögren’s syndrome using consensual definitions: an OMERACT ultrasound working group reliability exercise

Author:

Jousse-Joulin SandrineORCID,D'Agostino Maria Antonietta,Nicolas Celine,Naredo Esperanza,Ohrndorf Sarah,Backhaus Marina,Tamborrini Giorgio,Chary-Valckenaere Isabelle,Terslev Lene,Iagnocco Annamaria,Collado Paz,Hernández-Díaz Cristina,Gandjbakhch Frederique,Schmidt Wolfgang A,Filippou GeorgiosORCID,Dejaco ChristianORCID,Stradner Martin Helmut,Mortada Mohamed Atia,Hočevar Alojzija,Chrysidis Stavros,El Mardenly Ghada,de Agustín Juan José,Thiele Ralf,MacCarter Daryl K,Finzel Stephanie,Hanova Petra,Zabotti AlenORCID,Glaser Cornelia,Alavi Zarrin,Hammenfors Daniel Sten,Gatineau Florence,Bruyn George AW

Abstract

ObjectiveTo develop ultrasound (US) definitions and a US novel scoring system for major salivary gland (SG) lesions in patients with primary Sjögren’s syndrome (pSS) and to test their intrareader and inter-reader reliability using US video clips.MethodsTwenty-five rheumatologists were subjected to a three-round, web-based Delphi process in order to agree on (1) definitions and scanning procedure of salivary gland ultrasonography (SGUS): parotid, submandibular and sublingual glands (PG, SMG and SLG); (2) definitions for the elementary SGUS lesions in patients with Sjögren’s syndrome; (3) scoring system for grading changes. The experts rated the statements on a 1–5 Likert scale. In the second step, SGUS video clips of patients with pSS and non-pSS sicca cases were collected containing various spectrums of disease severity followed by an intrareader and inter-reader reliability exercise. Each video clip was evaluated according to the agreed definitions.ResultsConsensual definitions were developed after three Delphi rounds. Among the three selected SGs, US assessment of PGs and SMGs was agreed on. Agreement was reached to score only greyscale lesions and to focus on anechoic/hypoechoic foci in a semiquantitative matter or, if not possible on a qualitatively (present/absent) evaluation of fatty or fibrous lesions. Intrareader reliability for detecting and scoring these lesions was excellent (Cohen’s kappa 0.81) and inter-reader reliability was good (Light’s kappa 0.66).ConclusionNew definitions for developing a novel semiquantitative US score in patients with pSS were developed and tested on video clips. Inter-reader and intrareader reliabilities were good and excellent, respectively.

Publisher

BMJ

Subject

General Biochemistry, Genetics and Molecular Biology,Immunology,Immunology and Allergy,Rheumatology

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