Royal National Hospital for Rheumatic Diseases, Bath, UK.
Arthritis Care Res (Hoboken). 2014 Feb;66(2):311-7. doi: 10.1002/acr.22104.
We set out to assess the feasibility, reliability, and sensitivity to change of 4 radiographic scoring methods in psoriatic arthritis (PsA).
Hand and feet radiographs from 50 patients with PsA were scored at 2 time points by 2 assessors with each of the following methods: modified Steinbrocker score, modified Sharp score (MSS), modified Sharp/van der Heijde score (SHS), and the Ratingen score for PsA. The radiographs of 10 patients were scored by both assessors to assess reliability using intraclass correlation coefficients (ICCs). Sensitivity to change was estimated using a standardized response mean (SRM) and smallest detectable change (SDC).
The patients' mean ± SD age at baseline was 50 ± 12.1 years, the mean ± SD disease duration was 10 ± 8.4 years, and the mean ± SD followup period was 25 ± 9.6 months. Intrarater reliability was excellent for all methods (ICC >0.97). Interrater reliability was highest for the SHS (ICC 0.95-0.99). The percentage SDC for the Steinbrocker method, the Ratingen method, the MSS, and the SHS was 2.9%, 2.1%, 1.4%, and 1.2%, respectively, and the SRMs were 0.46, 0.44, 0.77, and 0.79, respectively. The mean time to score each of the Steinbrocker method, the Ratingen method, the MSS, and the SHS was 6.2, 10.5, 14.6, and 14.4 minutes, respectively.
The SHS method was the most reliable and sensitive to change but took longer to perform. The Steinbrocker method is the most feasible but lacks the sensitivity of the SHS. The SDC of the Ratingen method is close to that of the SHS and MSS, but is quicker to perform.
我们旨在评估 4 种影像学评分方法在银屑病关节炎（PsA）中的可行性、可靠性和变化敏感性。
50 例 PsA 患者的手部和足部 X 线片在 2 个时间点由 2 名评估者使用以下 4 种方法进行评分：改良 Steinbrocker 评分、改良 Sharp 评分（MSS）、改良 Sharp/van der Heijde 评分（SHS）和 Ratingen 评分。对 10 例患者的 X 线片由两位评估者进行评分，使用组内相关系数（ICC）评估可靠性。使用标准化反应均值（SRM）和最小可检测变化（SDC）评估变化敏感性。
患者的基线平均年龄±标准差为 50±12.1 岁，平均疾病病程±标准差为 10±8.4 年，平均随访期±标准差为 25±9.6 个月。所有方法的组内信度均极好（ICC＞0.97）。SHS 的组间信度最高（ICC 0.95-0.99）。Steinbrocker 法、Ratingen 法、MSS 和 SHS 的百分比 SDC 分别为 2.9%、2.1%、1.4%和 1.2%，SRM 分别为 0.46、0.44、0.77 和 0.79。Steinbrocker 法、Ratingen 法、MSS 和 SHS 的评分时间分别为 6.2、10.5、14.6 和 14.4 分钟。
SHS 方法最可靠且对变化最敏感，但耗时较长。Steinbrocker 方法最可行，但敏感性不如 SHS。Ratingen 方法的 SDC 接近 SHS 和 MSS，但评分速度更快。
