A Multicenter Study of the Validity and Reliability of Responses to Hand Cold Challenge as Measured by Laser Speckle Contrast Imaging and Thermography

outcome measures for systemic sclerosis-related Raynaud's phenomenon

Jack D Wilkinson, Sarah A Leggett, Elizabeth J Marjanovic, Tonia L Moore, John Allen, Marina E Anderson, Jason Britton, Maya H Buch, Francesco Del Galdo, Christopher P Denton, Graham Dinsdale, Bridgett Griffiths, Frances Hall, Kevin Howell, Audrey MacDonald, Neil J McHugh, Joanne B Manning, John D Pauling, Christopher Roberts, Jacqueline A Shipley & 2 others Ariane L Herrick, Andrea K Murray

Research output: Contribution to journalArticle

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Abstract

Objective: Reliable and objective outcome measures to facilitate clinical trials of novel treatments for systemic sclerosis (SSc)–related Raynaud's phenomenon (RP) are badly needed. Laser speckle contrast imaging (LSCI) and thermography are noninvasive measures of perfusion that have shown excellent potential. This multicenter study was undertaken to determine the reliability and validity of a hand cold challenge protocol using LSCI, standard thermography, and low-cost cell phone/mobile phone thermography (henceforth referred to as mobile thermography) in patients with SSc-related RP. Methods: Patients with RP secondary to SSc were recruited from 6 UK tertiary care centers. The patients underwent cold challenge on 2 consecutive days. Changes in cutaneous blood flow/skin temperature at each visit were imaged simultaneously using LSCI, standard thermography, and mobile thermography. Measurements included area under the curve (AUC) for reperfusion/rewarming and maximum blood flow rate/skin temperature after rewarming (MAX). Test–retest reliability was assessed using intraclass correlation coefficients (ICCs). Estimated latent correlations (estimated from multilevel models, taking values between −1 and 1; denoted as rho values) were used to assess the convergent validity of LSCI and thermography. Results: In total, 159 patients (77% with limited cutaneous SSc) were recruited (84% female, median age 63.3 years). LSCI and standard thermography both had substantial reliability, with ICCs for the reperfusion/rewarming AUC of 0.67 (95% confidence interval [95% CI] 0.54, 0.76) and 0.68 (95% CI 0.58, 0.80), respectively, and ICCs for the MAX of 0.64 (95% CI 0.52, 0.75) and 0.72 (95% CI 0.64, 0.81), respectively. Very high latent correlations were present for the AUCs of LSCI and thermography (ρ = 0.94; 95% CI 0.87, 1.00) and for the AUCs of standard and mobile thermography (ρ = 0.98; 95% CI 0.94, 1.00). Conclusion: This is the first multicenter study to examine the reliability and validity of cold challenge using LSCI and thermography in patients with SSc-related RP. LSCI and thermography both demonstrated good potential as outcome measures. LSCI, standard thermography, and mobile thermography had very high convergent validity.

Original languageEnglish
Pages (from-to)903-911
Number of pages9
JournalArthritis & Rheumatology
Volume70
Issue number6
Early online date18 Feb 2018
DOIs
Publication statusPublished - 1 Jun 2018

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Raynaud Disease
Systemic Scleroderma
Reproducibility of Results
Multicenter Studies
Lasers
Hand
Outcome Assessment (Health Care)
Cell Phones
Area Under Curve
Rewarming
Perfusion
Skin Temperature
Reperfusion
Clinical Trials

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

Cite this

A Multicenter Study of the Validity and Reliability of Responses to Hand Cold Challenge as Measured by Laser Speckle Contrast Imaging and Thermography : outcome measures for systemic sclerosis-related Raynaud's phenomenon. / Wilkinson, Jack D; Leggett, Sarah A; Marjanovic, Elizabeth J; Moore, Tonia L; Allen, John; Anderson, Marina E; Britton, Jason; Buch, Maya H; Galdo, Francesco Del; Denton, Christopher P; Dinsdale, Graham; Griffiths, Bridgett; Hall, Frances; Howell, Kevin; MacDonald, Audrey; McHugh, Neil J; Manning, Joanne B; Pauling, John D; Roberts, Christopher; Shipley, Jacqueline A; Herrick, Ariane L; Murray, Andrea K.

In: Arthritis & Rheumatology, Vol. 70, No. 6, 01.06.2018, p. 903-911.

Research output: Contribution to journalArticle

Wilkinson, JD, Leggett, SA, Marjanovic, EJ, Moore, TL, Allen, J, Anderson, ME, Britton, J, Buch, MH, Galdo, FD, Denton, CP, Dinsdale, G, Griffiths, B, Hall, F, Howell, K, MacDonald, A, McHugh, NJ, Manning, JB, Pauling, JD, Roberts, C, Shipley, JA, Herrick, AL & Murray, AK 2018, 'A Multicenter Study of the Validity and Reliability of Responses to Hand Cold Challenge as Measured by Laser Speckle Contrast Imaging and Thermography: outcome measures for systemic sclerosis-related Raynaud's phenomenon', Arthritis & Rheumatology, vol. 70, no. 6, pp. 903-911. https://doi.org/10.1002/art.40457
Wilkinson, Jack D ; Leggett, Sarah A ; Marjanovic, Elizabeth J ; Moore, Tonia L ; Allen, John ; Anderson, Marina E ; Britton, Jason ; Buch, Maya H ; Galdo, Francesco Del ; Denton, Christopher P ; Dinsdale, Graham ; Griffiths, Bridgett ; Hall, Frances ; Howell, Kevin ; MacDonald, Audrey ; McHugh, Neil J ; Manning, Joanne B ; Pauling, John D ; Roberts, Christopher ; Shipley, Jacqueline A ; Herrick, Ariane L ; Murray, Andrea K. / A Multicenter Study of the Validity and Reliability of Responses to Hand Cold Challenge as Measured by Laser Speckle Contrast Imaging and Thermography : outcome measures for systemic sclerosis-related Raynaud's phenomenon. In: Arthritis & Rheumatology. 2018 ; Vol. 70, No. 6. pp. 903-911.
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abstract = "Objective: Reliable and objective outcome measures to facilitate clinical trials of novel treatments for systemic sclerosis (SSc)–related Raynaud's phenomenon (RP) are badly needed. Laser speckle contrast imaging (LSCI) and thermography are noninvasive measures of perfusion that have shown excellent potential. This multicenter study was undertaken to determine the reliability and validity of a hand cold challenge protocol using LSCI, standard thermography, and low-cost cell phone/mobile phone thermography (henceforth referred to as mobile thermography) in patients with SSc-related RP. Methods: Patients with RP secondary to SSc were recruited from 6 UK tertiary care centers. The patients underwent cold challenge on 2 consecutive days. Changes in cutaneous blood flow/skin temperature at each visit were imaged simultaneously using LSCI, standard thermography, and mobile thermography. Measurements included area under the curve (AUC) for reperfusion/rewarming and maximum blood flow rate/skin temperature after rewarming (MAX). Test–retest reliability was assessed using intraclass correlation coefficients (ICCs). Estimated latent correlations (estimated from multilevel models, taking values between −1 and 1; denoted as rho values) were used to assess the convergent validity of LSCI and thermography. Results: In total, 159 patients (77{\%} with limited cutaneous SSc) were recruited (84{\%} female, median age 63.3 years). LSCI and standard thermography both had substantial reliability, with ICCs for the reperfusion/rewarming AUC of 0.67 (95{\%} confidence interval [95{\%} CI] 0.54, 0.76) and 0.68 (95{\%} CI 0.58, 0.80), respectively, and ICCs for the MAX of 0.64 (95{\%} CI 0.52, 0.75) and 0.72 (95{\%} CI 0.64, 0.81), respectively. Very high latent correlations were present for the AUCs of LSCI and thermography (ρ = 0.94; 95{\%} CI 0.87, 1.00) and for the AUCs of standard and mobile thermography (ρ = 0.98; 95{\%} CI 0.94, 1.00). Conclusion: This is the first multicenter study to examine the reliability and validity of cold challenge using LSCI and thermography in patients with SSc-related RP. LSCI and thermography both demonstrated good potential as outcome measures. LSCI, standard thermography, and mobile thermography had very high convergent validity.",
author = "Wilkinson, {Jack D} and Leggett, {Sarah A} and Marjanovic, {Elizabeth J} and Moore, {Tonia L} and John Allen and Anderson, {Marina E} and Jason Britton and Buch, {Maya H} and Galdo, {Francesco Del} and Denton, {Christopher P} and Graham Dinsdale and Bridgett Griffiths and Frances Hall and Kevin Howell and Audrey MacDonald and McHugh, {Neil J} and Manning, {Joanne B} and Pauling, {John D} and Christopher Roberts and Shipley, {Jacqueline A} and Herrick, {Ariane L} and Murray, {Andrea K}",
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T1 - A Multicenter Study of the Validity and Reliability of Responses to Hand Cold Challenge as Measured by Laser Speckle Contrast Imaging and Thermography

T2 - outcome measures for systemic sclerosis-related Raynaud's phenomenon

AU - Wilkinson, Jack D

AU - Leggett, Sarah A

AU - Marjanovic, Elizabeth J

AU - Moore, Tonia L

AU - Allen, John

AU - Anderson, Marina E

AU - Britton, Jason

AU - Buch, Maya H

AU - Galdo, Francesco Del

AU - Denton, Christopher P

AU - Dinsdale, Graham

AU - Griffiths, Bridgett

AU - Hall, Frances

AU - Howell, Kevin

AU - MacDonald, Audrey

AU - McHugh, Neil J

AU - Manning, Joanne B

AU - Pauling, John D

AU - Roberts, Christopher

AU - Shipley, Jacqueline A

AU - Herrick, Ariane L

AU - Murray, Andrea K

N1 - © 2018 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Objective: Reliable and objective outcome measures to facilitate clinical trials of novel treatments for systemic sclerosis (SSc)–related Raynaud's phenomenon (RP) are badly needed. Laser speckle contrast imaging (LSCI) and thermography are noninvasive measures of perfusion that have shown excellent potential. This multicenter study was undertaken to determine the reliability and validity of a hand cold challenge protocol using LSCI, standard thermography, and low-cost cell phone/mobile phone thermography (henceforth referred to as mobile thermography) in patients with SSc-related RP. Methods: Patients with RP secondary to SSc were recruited from 6 UK tertiary care centers. The patients underwent cold challenge on 2 consecutive days. Changes in cutaneous blood flow/skin temperature at each visit were imaged simultaneously using LSCI, standard thermography, and mobile thermography. Measurements included area under the curve (AUC) for reperfusion/rewarming and maximum blood flow rate/skin temperature after rewarming (MAX). Test–retest reliability was assessed using intraclass correlation coefficients (ICCs). Estimated latent correlations (estimated from multilevel models, taking values between −1 and 1; denoted as rho values) were used to assess the convergent validity of LSCI and thermography. Results: In total, 159 patients (77% with limited cutaneous SSc) were recruited (84% female, median age 63.3 years). LSCI and standard thermography both had substantial reliability, with ICCs for the reperfusion/rewarming AUC of 0.67 (95% confidence interval [95% CI] 0.54, 0.76) and 0.68 (95% CI 0.58, 0.80), respectively, and ICCs for the MAX of 0.64 (95% CI 0.52, 0.75) and 0.72 (95% CI 0.64, 0.81), respectively. Very high latent correlations were present for the AUCs of LSCI and thermography (ρ = 0.94; 95% CI 0.87, 1.00) and for the AUCs of standard and mobile thermography (ρ = 0.98; 95% CI 0.94, 1.00). Conclusion: This is the first multicenter study to examine the reliability and validity of cold challenge using LSCI and thermography in patients with SSc-related RP. LSCI and thermography both demonstrated good potential as outcome measures. LSCI, standard thermography, and mobile thermography had very high convergent validity.

AB - Objective: Reliable and objective outcome measures to facilitate clinical trials of novel treatments for systemic sclerosis (SSc)–related Raynaud's phenomenon (RP) are badly needed. Laser speckle contrast imaging (LSCI) and thermography are noninvasive measures of perfusion that have shown excellent potential. This multicenter study was undertaken to determine the reliability and validity of a hand cold challenge protocol using LSCI, standard thermography, and low-cost cell phone/mobile phone thermography (henceforth referred to as mobile thermography) in patients with SSc-related RP. Methods: Patients with RP secondary to SSc were recruited from 6 UK tertiary care centers. The patients underwent cold challenge on 2 consecutive days. Changes in cutaneous blood flow/skin temperature at each visit were imaged simultaneously using LSCI, standard thermography, and mobile thermography. Measurements included area under the curve (AUC) for reperfusion/rewarming and maximum blood flow rate/skin temperature after rewarming (MAX). Test–retest reliability was assessed using intraclass correlation coefficients (ICCs). Estimated latent correlations (estimated from multilevel models, taking values between −1 and 1; denoted as rho values) were used to assess the convergent validity of LSCI and thermography. Results: In total, 159 patients (77% with limited cutaneous SSc) were recruited (84% female, median age 63.3 years). LSCI and standard thermography both had substantial reliability, with ICCs for the reperfusion/rewarming AUC of 0.67 (95% confidence interval [95% CI] 0.54, 0.76) and 0.68 (95% CI 0.58, 0.80), respectively, and ICCs for the MAX of 0.64 (95% CI 0.52, 0.75) and 0.72 (95% CI 0.64, 0.81), respectively. Very high latent correlations were present for the AUCs of LSCI and thermography (ρ = 0.94; 95% CI 0.87, 1.00) and for the AUCs of standard and mobile thermography (ρ = 0.98; 95% CI 0.94, 1.00). Conclusion: This is the first multicenter study to examine the reliability and validity of cold challenge using LSCI and thermography in patients with SSc-related RP. LSCI and thermography both demonstrated good potential as outcome measures. LSCI, standard thermography, and mobile thermography had very high convergent validity.

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