Auleley G R, Giraudeau B, Dougados M, Ravaud P
Faculté de Médecine Cochin Port-Royal and Clinique de Rhumatologie, Hôpital Cochin, AP-HP, Paris, France.
Ann Rheum Dis. 2000 Jun;59(6):422-7. doi: 10.1136/ard.59.6.422.
To compare radiographic reading procedures and evaluate their impact on sample size in hip osteoarthritis (OA) longitudinal studies.
Pelvic radiographs performed twice, three years apart, in 104 patients with hip OA were read by a single reader using the Kellgren and Lawrence system, joint space narrowing scale, and joint space width (JSW). Reading procedures were (a) films read as single radiographs, (b) films grouped by patient but read in random order, (c) films grouped by patient and chronologically ordered, all with landmarks for JSW measurements, (d) films read as single radiographs, without landmarks for JSW measurements. JSW was measured at the narrowest point with a 0.1 mm graduated magnifying glass.
More Kellgren and Lawrence or joint space narrowing grades were modified respectively with the single (42% and 37%) than with the paired (32% and 23%) or chronologically ordered (34% and 29%) reading procedures. Variability of JSW progression was principally related to mean progression (88.3%) and landmarks (almost 10%). Standardised response means were -0.71 with the paired reading procedure with landmarks, -0.68 with the single reading procedure with landmarks, -0.65 with the single reading procedure without landmarks. With landmarks, 10% more patients would be needed using single than paired reading. Using single reading, 10% more patients would be needed without landmarks than with landmarks.
Kellgren and Lawrence grading seems to be influenced by the reading procedure, as is joint space narrowing grading, for assessing hip OA. Paired reading procedure with landmarks for JSW should be recommended in longitudinal studies.
比较髋关节骨关节炎（OA）纵向研究中的影像学阅片程序，并评估其对样本量的影响。
对104例髋关节OA患者相隔三年进行的两次骨盆X线片，由一名阅片者使用凯尔格伦和劳伦斯系统、关节间隙狭窄量表和关节间隙宽度（JSW）进行阅片。阅片程序包括：（a）将X线片作为单张片子阅片；（b）按患者分组但随机顺序阅片；（c）按患者分组且按时间顺序阅片，所有片子均有用于JSW测量的标记；（d）将X线片作为单张片子阅片，无用于JSW测量的标记。使用0.1毫米刻度放大镜在最窄点测量JSW。
与配对阅片程序（32%和23%）或按时间顺序阅片程序（34%和29%）相比，单张片子阅片程序（42%和37%）分别使更多的凯尔格伦和劳伦斯分级或关节间隙狭窄分级得到修改。JSW进展的变异性主要与平均进展（88.3%）和标记（近10%）有关。有标记的配对阅片程序标准化反应均值为-0.71，有标记的单张片子阅片程序为-0.68，无标记的单张片子阅片程序为-0.65。有标记时，单张片子阅片比配对阅片需要多10%的患者。使用单张片子阅片时，无标记比有标记需要多10%的患者。
在评估髋关节OA时，凯尔格伦和劳伦斯分级似乎受阅片程序影响，关节间隙狭窄分级也是如此。在纵向研究中，应推荐使用有JSW标记的配对阅片程序。
