Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, 86. sokak, 9/16 Emek, Ankara, Turkey.
Clin Rheumatol. 2010 Jan;29(1):65-70. doi: 10.1007/s10067-009-1290-0. Epub 2009 Oct 8.
The objective of the present study was to compare two radiographic scoring methods (the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and the Bath Ankylosing Spondylitis Radiology Index-spine (BASRI-spine)) in terms of reliability, construct validity, and feasibility in Turkish ankylosing spondylitis (AS) patients. The study involved seventy-four patients. The patients were evaluated with 100-mm visual analog scale (VAS) for pain, global assessment of patient, and global assessment of doctor. The laboratory evaluations of patients comprised erythrocyte sedimentation rate and serum C-reactive protein. Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), and Bath AS Radiology Index (BASRI) were calculated. Bilateral cervical, lumbar spine, and anteroposterior pelvis radiographs of all patients were obtained and evaluated by two radiologists. Each radiograph was scored by two scoring methods, mSASSS and BASRI-spine, and these methods were tested according to the aspects of the Outcome Measures in Rheumatology Clinical Trials filter: reliability, construct validity, and feasibility. The BASRI-spine reached intra- and interobserver intraclass correlation coefficient (ICC) of 0.726 and 0.689, respectively. The mSASSS scores more reliable, with ICC of 0.831 and 0.840, respectively. The BASMI and BASFI correlated significantly with the two scoring systems, respectively (mSASSS r: 0.557, r: 0.319; BASRI-spine r: 0.605, r: 0.285). For the two methods, the magnitude of the correlation with disease duration was similar (mSASSS p < 0.01 and BASRI p < 0.01), but no significant correlation was observed when compared to the BASDAI. It is known that the BASRI-spine is a feasible method that reliably detects damage in patients with AS. However, the present authors believe that, in AS patients, mSASSS should be the radiological scoring method to choose because of less radiation exposure, along with excellent intra- and interobserver reliability.
本研究旨在比较两种影像学评分方法(改良 Stoke 强直性脊柱炎脊柱评分(mSASSS)和 Bath 强直性脊柱炎放射学指数-脊柱(BASRI-spine))在土耳其强直性脊柱炎(AS)患者中的可靠性、结构有效性和可行性。该研究共纳入 74 例患者。患者采用 100mm 视觉模拟量表(VAS)评估疼痛、患者总体评估和医生总体评估。实验室评估包括红细胞沉降率和血清 C 反应蛋白。计算 Bath AS 疾病活动指数(BASDAI)、Bath AS 功能指数(BASFI)、Bath AS 计量学指数(BASMI)和 Bath AS 放射学指数(BASRI)。所有患者均接受双侧颈椎、腰椎和前后骨盆的 X 线片检查,并由两位放射科医生进行评估。每位放射科医生分别采用 mSASSS 和 BASRI-spine 两种评分方法对每张 X 线片进行评分,并根据风湿病临床试验结果测量标准的方面对这些方法进行了可靠性、结构有效性和可行性测试。BASRI-spine 的观察者内和观察者间的组内相关系数(ICC)分别为 0.726 和 0.689。mSASSS 评分更可靠,ICC 分别为 0.831 和 0.840。BASMI 和 BASFI 与两种评分系统均显著相关(mSASSS r:0.557,r:0.319;BASRI-spine r:0.605,r:0.285)。对于两种方法,与疾病持续时间的相关性大小相似(mSASSS p < 0.01 和 BASRI p < 0.01),但与 BASDAI 无显著相关性。已知 BASRI-spine 是一种可靠的检测方法,可检测 AS 患者的损害。然而,作者认为,在 AS 患者中,mSASSS 应该是选择的影像学评分方法,因为其放射暴露量更少,同时具有极好的观察者内和观察者间可靠性。
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