Quéré Baptiste, Méneur Léonie, Foulquier Nathan, Pensec Hugo, Devauchelle-Pensec Valérie, Garrigues Florent, Saraux Alain
Department of Rheumatology, CHU Brest, France.
Université de Bretagne Occidentale (Univ Brest), France.
PLOS Digit Health. 2024 Oct 7;3(10):e0000616. doi: 10.1371/journal.pdig.0000616. eCollection 2024 Oct.
Reading hand and foot X-rays in rheumatoid arthritis patients is difficult and time-consuming. In research, physicians use the modified Sharp van der Heijde Sharp (mvdH) score by reading of hand and foot radiographs. The aim of this study was to create a new method of determining the mvdH via eye tracking and to study its concordance with the mvdH score. We created a new method of quantifying the mvdH score based on reading time of a reader monitored via eye tracking (Tobii Pro Lab software) after training with the aid of a metronome. Radiographs were read twice by the trained eye-tracking reader and once by an experienced reference radiologist. A total of 440 joints were selected; 416 could be interpreted for erosion, and 396 could be interpreted for joint space narrowing (JSN) when read by eye tracking (eye tracking could not measure the time spent when two pathological joints were too close together). The agreement between eye tracking mvdH Sharp score and classical mvdH Sharp score yes (at least one erosion or JSN) versus no (no erosion or no JSN) was excellent for both erosions (kappa 0.97; 95% CI: 0.96-0.99) and JSN (kappa: 0.95; 95% CI: 0.93-0.097). This agreement by class (0 to 10) remained excellent for both erosions (kappa 0.82; 95% CI: 0.79-0.0.85) and JSN (kappa: 0.68; 95% CI: 0.65-0.0.71). To conclude, eye-tracking reading correlates strongly with classical mvdH-Sharp and is useful for assessing severity, segmenting joints and establishing a rapid score for lesions.
阅读类风湿性关节炎患者的手足X光片既困难又耗时。在研究中，医生通过阅读手足X光片来使用改良的夏普·范德海伊德夏普（mvdH）评分。本研究的目的是创建一种通过眼动追踪确定mvdH的新方法，并研究其与mvdH评分的一致性。我们创建了一种基于眼动追踪（使用托比专业实验室软件）监测的读者阅读时间来量化mvdH评分的新方法，该读者在节拍器的辅助下进行训练。经过训练的眼动追踪读者对手足X光片阅读两次，经验丰富的参考放射科医生阅读一次。总共选择了440个关节；通过眼动追踪阅读时，416个关节可用于评估侵蚀情况，396个关节可用于评估关节间隙变窄（JSN）（当两个病理关节靠得太近时，眼动追踪无法测量所花费的时间）。对于侵蚀情况（kappa值为0.97；95%置信区间：0.96 - 0.99）和关节间隙变窄（kappa值为0.95；95%置信区间：0.93 - 0.97），眼动追踪mvdH夏普评分与经典mvdH夏普评分在“是”（至少有一处侵蚀或关节间隙变窄）与“否”（无侵蚀或无关节间隙变窄）之间的一致性都非常好。按等级（0至10）划分，对于侵蚀情况（kappa值为0.82；95%置信区间：0.79 - 0.85）和关节间隙变窄（kappa值为0.68；95%置信区间：0.65 - 0.71），这种一致性仍然非常好。总之，眼动追踪阅读与经典的mvdH - 夏普评分密切相关，可用于评估严重程度、划分关节以及快速确定病变评分。
