International spondyloarthritis interobserver reliability exercise - The INSPIRE study: II. Assessment of peripheral joints, enthesitis, and dactylitis

D D Gladman, R D Inman, R J Cook, W P Maksymowych, J Braun, J C Davis, R B M Landewe, P Mease, J Brandt, R B Vargas, V Chandran, P Helliwell, A Kavanaugh, F D O'Shea, M A Khan, N Pipitone, P Rahman, J D Reveille, M A Stone, W Taylor & 2 others D J Veale, D van der Heijde

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Abstract

Objective. To determine whether the assessments of peripheral joints and enthesitis were reproducible for both AS and PsA with axial disease, and whether dactylitis assessment is reproducible in patients with PsA. Methods. A group of 20 rheumatologists from 1 countries with expertise in spondyloarthritis (SpA) met for a combined physical examination exercise to assess 10 patients with PsA with axial involvement (9 men, 1 woman, mean age 52 yrs, disease duration 17 yrs) and 9 patients with AS (7 men, 2 women, mean age 38 yrs, disease duration 16 yrs). A modified Latin-square design that enabled assessment of patient, assessor, and order effect was used. Measures included were number of tender and swollen joints, presence of enthesitis using 6 different indices, and dactylitis score. Data were analyzed using intraclass correlation (ICC adjusted for order of measurements. Results. The majority of the variance was contributed by the patients. There was no order effect. The assessment of tender joints (ICC 0.69) was more reliable than the assessment of swollen joints (ICC 0.54). Moreover, there was better agreement in patients with PsA (ICC 0.78) than in patients with AS (ICC 0.62). There was excellent agreement on the number of active enthesitis sites (ICC 0.86). All the enthesitis indices provided substantial to excellent agreement among observers. Agreement for the dactylitis score was substantial (ICC 0.70). Conclusion. The assessment of peripheral joints is more reliable in patients with PsA. Enthesitis instruments can be used reliably in patients with AS and patients with PsA with spinal involvement. The Leeds dactylitis instrument functions well in PsA.
LanguageEnglish
Pages1740-1745
Number of pages6
JournalJournal of Rheumatology
Volume34
Issue number8
StatusPublished - 2007

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Joints
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Gladman, D. D., Inman, R. D., Cook, R. J., Maksymowych, W. P., Braun, J., Davis, J. C., ... van der Heijde, D. (2007). International spondyloarthritis interobserver reliability exercise - The INSPIRE study: II. Assessment of peripheral joints, enthesitis, and dactylitis.

International spondyloarthritis interobserver reliability exercise - The INSPIRE study: II. Assessment of peripheral joints, enthesitis, and dactylitis. / Gladman, D D; Inman, R D; Cook, R J; Maksymowych, W P; Braun, J; Davis, J C; Landewe, R B M; Mease, P; Brandt, J; Vargas, R B; Chandran, V; Helliwell, P; Kavanaugh, A; O'Shea, F D; Khan, M A; Pipitone, N; Rahman, P; Reveille, J D; Stone, M A; Taylor, W; Veale, D J; van der Heijde, D.

In: Journal of Rheumatology, Vol. 34, No. 8, 2007, p. 1740-1745.

Research output: Contribution to journalArticle

Gladman, DD, Inman, RD, Cook, RJ, Maksymowych, WP, Braun, J, Davis, JC, Landewe, RBM, Mease, P, Brandt, J, Vargas, RB, Chandran, V, Helliwell, P, Kavanaugh, A, O'Shea, FD, Khan, MA, Pipitone, N, Rahman, P, Reveille, JD, Stone, MA, Taylor, W, Veale, DJ & van der Heijde, D 2007, 'International spondyloarthritis interobserver reliability exercise - The INSPIRE study: II. Assessment of peripheral joints, enthesitis, and dactylitis' Journal of Rheumatology, vol. 34, no. 8, pp. 1740-1745.
Gladman, D D ; Inman, R D ; Cook, R J ; Maksymowych, W P ; Braun, J ; Davis, J C ; Landewe, R B M ; Mease, P ; Brandt, J ; Vargas, R B ; Chandran, V ; Helliwell, P ; Kavanaugh, A ; O'Shea, F D ; Khan, M A ; Pipitone, N ; Rahman, P ; Reveille, J D ; Stone, M A ; Taylor, W ; Veale, D J ; van der Heijde, D. / International spondyloarthritis interobserver reliability exercise - The INSPIRE study: II. Assessment of peripheral joints, enthesitis, and dactylitis. In: Journal of Rheumatology. 2007 ; Vol. 34, No. 8. pp. 1740-1745
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abstract = "Objective. To determine whether the assessments of peripheral joints and enthesitis were reproducible for both AS and PsA with axial disease, and whether dactylitis assessment is reproducible in patients with PsA. Methods. A group of 20 rheumatologists from 1 countries with expertise in spondyloarthritis (SpA) met for a combined physical examination exercise to assess 10 patients with PsA with axial involvement (9 men, 1 woman, mean age 52 yrs, disease duration 17 yrs) and 9 patients with AS (7 men, 2 women, mean age 38 yrs, disease duration 16 yrs). A modified Latin-square design that enabled assessment of patient, assessor, and order effect was used. Measures included were number of tender and swollen joints, presence of enthesitis using 6 different indices, and dactylitis score. Data were analyzed using intraclass correlation (ICC adjusted for order of measurements. Results. The majority of the variance was contributed by the patients. There was no order effect. The assessment of tender joints (ICC 0.69) was more reliable than the assessment of swollen joints (ICC 0.54). Moreover, there was better agreement in patients with PsA (ICC 0.78) than in patients with AS (ICC 0.62). There was excellent agreement on the number of active enthesitis sites (ICC 0.86). All the enthesitis indices provided substantial to excellent agreement among observers. Agreement for the dactylitis score was substantial (ICC 0.70). Conclusion. The assessment of peripheral joints is more reliable in patients with PsA. Enthesitis instruments can be used reliably in patients with AS and patients with PsA with spinal involvement. The Leeds dactylitis instrument functions well in PsA.",
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T1 - International spondyloarthritis interobserver reliability exercise - The INSPIRE study: II. Assessment of peripheral joints, enthesitis, and dactylitis

AU - Gladman,D D

AU - Inman,R D

AU - Cook,R J

AU - Maksymowych,W P

AU - Braun,J

AU - Davis,J C

AU - Landewe,R B M

AU - Mease,P

AU - Brandt,J

AU - Vargas,R B

AU - Chandran,V

AU - Helliwell,P

AU - Kavanaugh,A

AU - O'Shea,F D

AU - Khan,M A

AU - Pipitone,N

AU - Rahman,P

AU - Reveille,J D

AU - Stone,M A

AU - Taylor,W

AU - Veale,D J

AU - van der Heijde,D

N1 - ID number: ISI:000248736200019

PY - 2007

Y1 - 2007

N2 - Objective. To determine whether the assessments of peripheral joints and enthesitis were reproducible for both AS and PsA with axial disease, and whether dactylitis assessment is reproducible in patients with PsA. Methods. A group of 20 rheumatologists from 1 countries with expertise in spondyloarthritis (SpA) met for a combined physical examination exercise to assess 10 patients with PsA with axial involvement (9 men, 1 woman, mean age 52 yrs, disease duration 17 yrs) and 9 patients with AS (7 men, 2 women, mean age 38 yrs, disease duration 16 yrs). A modified Latin-square design that enabled assessment of patient, assessor, and order effect was used. Measures included were number of tender and swollen joints, presence of enthesitis using 6 different indices, and dactylitis score. Data were analyzed using intraclass correlation (ICC adjusted for order of measurements. Results. The majority of the variance was contributed by the patients. There was no order effect. The assessment of tender joints (ICC 0.69) was more reliable than the assessment of swollen joints (ICC 0.54). Moreover, there was better agreement in patients with PsA (ICC 0.78) than in patients with AS (ICC 0.62). There was excellent agreement on the number of active enthesitis sites (ICC 0.86). All the enthesitis indices provided substantial to excellent agreement among observers. Agreement for the dactylitis score was substantial (ICC 0.70). Conclusion. The assessment of peripheral joints is more reliable in patients with PsA. Enthesitis instruments can be used reliably in patients with AS and patients with PsA with spinal involvement. The Leeds dactylitis instrument functions well in PsA.

AB - Objective. To determine whether the assessments of peripheral joints and enthesitis were reproducible for both AS and PsA with axial disease, and whether dactylitis assessment is reproducible in patients with PsA. Methods. A group of 20 rheumatologists from 1 countries with expertise in spondyloarthritis (SpA) met for a combined physical examination exercise to assess 10 patients with PsA with axial involvement (9 men, 1 woman, mean age 52 yrs, disease duration 17 yrs) and 9 patients with AS (7 men, 2 women, mean age 38 yrs, disease duration 16 yrs). A modified Latin-square design that enabled assessment of patient, assessor, and order effect was used. Measures included were number of tender and swollen joints, presence of enthesitis using 6 different indices, and dactylitis score. Data were analyzed using intraclass correlation (ICC adjusted for order of measurements. Results. The majority of the variance was contributed by the patients. There was no order effect. The assessment of tender joints (ICC 0.69) was more reliable than the assessment of swollen joints (ICC 0.54). Moreover, there was better agreement in patients with PsA (ICC 0.78) than in patients with AS (ICC 0.62). There was excellent agreement on the number of active enthesitis sites (ICC 0.86). All the enthesitis indices provided substantial to excellent agreement among observers. Agreement for the dactylitis score was substantial (ICC 0.70). Conclusion. The assessment of peripheral joints is more reliable in patients with PsA. Enthesitis instruments can be used reliably in patients with AS and patients with PsA with spinal involvement. The Leeds dactylitis instrument functions well in PsA.

M3 - Article

VL - 34

SP - 1740

EP - 1745

JO - The Journal of Rheumatology

T2 - The Journal of Rheumatology

JF - The Journal of Rheumatology

SN - 0315-162X

IS - 8

ER -