Maillefert Jean Francis, Sharp John T, Aho Ludwig Serge, Dougados Maxime
René Descartes University, Institute of Rheumatology, Paris, France.
J Rheumatol. 2002 Dec;29(12):2592-6.
To compare the intraobserver reliability and the sensitivity to change of 2 techniques evaluating the cartilage breakdown in hip osteoarthritis (OA).
3 year longitudinal study.
patients with painful hip OA.
coxofemoral joint space width (JSW) at baseline and at 3 year followup was measured on anteroposterior weight-bearing radiographs by 2 methods: a manual method to obtain JSW at the narrowest point (minimal JSW) using a 0.1 mm graduated magnifying glass and a computer based method to obtain minimal and average JSW.
Two assessments, at one month interval, of each pair of films; evaluation of the intraobserver reliability using the intraclass coefficient of correlation, and the Bland and Altman approach, obtaining the smallest detectable difference (SDD). For each technique, percentage of progressors was evaluated, i.e., the percentage of patients with change greater than the SDD. Evaluation of sensitivity to change was performed using the standardized response mean (SRM), with 95% CI calculated using the jackknife method.
Twenty-five pairs of films were evaluated. There were no statistically significant differences between the 3 analyses in the calculated intraclass coefficients of correlation, percentage of progressors, or SRM.
These results suggest that both techniques are reliable and sensitive enough to detect changes in a relevant percentage of patients with hip OA after a 3 year followup.
比较评估髋骨关节炎（OA）软骨破坏的两种技术的观察者内可靠性和对变化的敏感性。
为期3年的纵向研究。
有疼痛性髋OA的患者。
通过两种方法在前后位负重X线片上测量基线和3年随访时的股髋关节间隙宽度（JSW）：一种手动方法，使用0.1毫米刻度放大镜在最窄点获取JSW（最小JSW），以及一种基于计算机的方法来获取最小和平均JSW。
对每对胶片每隔1个月进行两次评估；使用组内相关系数、布兰德和奥特曼方法评估观察者内可靠性，得出最小可检测差异（SDD）。对于每种技术，评估进展者的百分比，即变化大于SDD的患者百分比。使用标准化反应均值（SRM）评估对变化的敏感性，使用刀切法计算95%置信区间。
评估了25对胶片。在计算的组内相关系数、进展者百分比或SRM方面，三种分析之间没有统计学上的显著差异。
这些结果表明，两种技术都足够可靠和敏感，能够在3年随访后检测出相当比例的髋OA患者的变化。
