An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases

on behalf of the EULAR study group on microcirculation

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Objective. To propose simple capillaroscopic definitions for interpretation of capillaroscopic morphologies and to assess inter-rater reliability. Methods. The simple definitions proposed were: normal-hairpin, tortuous or crossing; abnormal-not hairpin, not tortuous and not crossing; not evaluable-whenever rater undecided between normal and abnormal. Based upon an aimed kappa of 0.80 and default prevalences of normal (0.4), abnormal (0.4) and not evaluable (0.2) capillaries, 90 single capillaries were presented to three groups of raters: experienced independent raters, n = 5; attendees of the sixth EULAR capillaroscopy course, n = 34; novices after a 1-h course, n = 11. Inter-rater agreement was assessed by calculation of proportion of agreement and by kappa coefficients. Results. Mean kappa based on 90 capillaries was 0.47 (95% CI: 0.39, 0.54) for expert raters, 0.40 (95% CI: 0.36, 0.44) for attendees and 0.46 (95% CI: 0.41, 0.52) for novices, with overall agreements of 67% (95% CI: 63, 71), 63% (95% CI: 60, 65) and 67% (95% CI: 63, 70), respectively. Comparing only normal vs the combined groups of abnormal and not evaluable capillaries did increase the kappa: 0.51 (95% CI: 0.37, 0.65), 0.53 (95% CI: 0.49, 0.58) and 0.55 (95% CI: 0.49, 0.62). On the condition that the capillaries were classifiable, the mean kappa was 0.62 (95% CI: 0.50, 0.74) for expert raters (n = 65), 0.76 (95% CI: 0.69, 0.83) for attendees (n = 20) and 0.81 (95% CI: 0.74, 0.89) for novices (n = 44). Conclusion. This multicentre, international study showed moderate reliability of simple capillaroscopic definitions for describing morphology of capillaries by rheumatologists with varying levels of expertise. Novices were capable of distinguishing normal from abnormal capillaries by means of a 1-h training session. In future studies, the class not evaluable may be obsolete.

Original languageEnglish (US)
Pages (from-to)883-890
Number of pages8
JournalRheumatology (United Kingdom)
Volume55
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Rheumatic Diseases
Microscopic Angioscopy
Multicenter Studies

Keywords

  • Capillaroscopy
  • Definitions
  • EULAR study group on microcirculation
  • Experts
  • Morphology
  • Novices
  • Reliability
  • Trainees

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases. / on behalf of the EULAR study group on microcirculation.

In: Rheumatology (United Kingdom), Vol. 55, No. 5, 01.05.2016, p. 883-890.

Research output: Contribution to journalArticle

@article{7ba603c6f41d49329090c505d4b3f30f,
title = "An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases",
abstract = "Objective. To propose simple capillaroscopic definitions for interpretation of capillaroscopic morphologies and to assess inter-rater reliability. Methods. The simple definitions proposed were: normal-hairpin, tortuous or crossing; abnormal-not hairpin, not tortuous and not crossing; not evaluable-whenever rater undecided between normal and abnormal. Based upon an aimed kappa of 0.80 and default prevalences of normal (0.4), abnormal (0.4) and not evaluable (0.2) capillaries, 90 single capillaries were presented to three groups of raters: experienced independent raters, n = 5; attendees of the sixth EULAR capillaroscopy course, n = 34; novices after a 1-h course, n = 11. Inter-rater agreement was assessed by calculation of proportion of agreement and by kappa coefficients. Results. Mean kappa based on 90 capillaries was 0.47 (95{\%} CI: 0.39, 0.54) for expert raters, 0.40 (95{\%} CI: 0.36, 0.44) for attendees and 0.46 (95{\%} CI: 0.41, 0.52) for novices, with overall agreements of 67{\%} (95{\%} CI: 63, 71), 63{\%} (95{\%} CI: 60, 65) and 67{\%} (95{\%} CI: 63, 70), respectively. Comparing only normal vs the combined groups of abnormal and not evaluable capillaries did increase the kappa: 0.51 (95{\%} CI: 0.37, 0.65), 0.53 (95{\%} CI: 0.49, 0.58) and 0.55 (95{\%} CI: 0.49, 0.62). On the condition that the capillaries were classifiable, the mean kappa was 0.62 (95{\%} CI: 0.50, 0.74) for expert raters (n = 65), 0.76 (95{\%} CI: 0.69, 0.83) for attendees (n = 20) and 0.81 (95{\%} CI: 0.74, 0.89) for novices (n = 44). Conclusion. This multicentre, international study showed moderate reliability of simple capillaroscopic definitions for describing morphology of capillaries by rheumatologists with varying levels of expertise. Novices were capable of distinguishing normal from abnormal capillaries by means of a 1-h training session. In future studies, the class not evaluable may be obsolete.",
keywords = "Capillaroscopy, Definitions, EULAR study group on microcirculation, Experts, Morphology, Novices, Reliability, Trainees",
author = "{on behalf of the EULAR study group on microcirculation} and Vanessa Smith and Sam Beeckman and Herrick, {Ariane L.} and Saskia Decuman and Ellen Deschepper and {De Keyser}, Filip and Oliver Distler and Ivan Foeldvari and Francesca Ingegnoli and Ulf M{\"u}ller-Ladner and Valeria Riccieri and Gabriela Riemekasten and Alberto Sulli and Alexandre Voskuyl and Maurizio Cutolo and Amina Abdessemed and Alatri Adriano and Yannick Allanore and Laura Andreoli and Filipe Ara{\'u}jo and Zolt{\'a}n Barth and Brasseur, {Jean Pierre} and Corrado Campochiaro and Blan, {Rayma Castalia Pe{\~n}a} and Sandra Chartrand and Stefania Corvaglia and Cristina Cuciti and Nemanja Damjanov and {De Almeida Borges}, Fernando and {De Keyser}, Eline and {De Knop}, Kathleen and {De Kock}, Joris and Fernandez, {Maria Jose} and Matteo Filippini and Garcia, {Ana Cunha Luiza} and Kwan, {Carmen Ho Tze} and Walter Hermann and Pichardo, {Sonia Houston} and Claudia Ickinger and Alena Ikic and Magdalena Kopec-Medrek and Satoshi Kubo and Ashima Makol and Mariagrazia Marrazza and Mesa, {Miguel Antonio} and Małgorzata Michalska-Jakubus and Renata Miossi and Corina Mogosan and Giovanna Moretti and Yora Mostmans",
year = "2016",
month = "5",
day = "1",
doi = "10.1093/rheumatology/kev441",
language = "English (US)",
volume = "55",
pages = "883--890",
journal = "Rheumatology (United Kingdom)",
issn = "1462-0324",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases

AU - on behalf of the EULAR study group on microcirculation

AU - Smith, Vanessa

AU - Beeckman, Sam

AU - Herrick, Ariane L.

AU - Decuman, Saskia

AU - Deschepper, Ellen

AU - De Keyser, Filip

AU - Distler, Oliver

AU - Foeldvari, Ivan

AU - Ingegnoli, Francesca

AU - Müller-Ladner, Ulf

AU - Riccieri, Valeria

AU - Riemekasten, Gabriela

AU - Sulli, Alberto

AU - Voskuyl, Alexandre

AU - Cutolo, Maurizio

AU - Abdessemed, Amina

AU - Adriano, Alatri

AU - Allanore, Yannick

AU - Andreoli, Laura

AU - Araújo, Filipe

AU - Barth, Zoltán

AU - Brasseur, Jean Pierre

AU - Campochiaro, Corrado

AU - Blan, Rayma Castalia Peña

AU - Chartrand, Sandra

AU - Corvaglia, Stefania

AU - Cuciti, Cristina

AU - Damjanov, Nemanja

AU - De Almeida Borges, Fernando

AU - De Keyser, Eline

AU - De Knop, Kathleen

AU - De Kock, Joris

AU - Fernandez, Maria Jose

AU - Filippini, Matteo

AU - Garcia, Ana Cunha Luiza

AU - Kwan, Carmen Ho Tze

AU - Hermann, Walter

AU - Pichardo, Sonia Houston

AU - Ickinger, Claudia

AU - Ikic, Alena

AU - Kopec-Medrek, Magdalena

AU - Kubo, Satoshi

AU - Makol, Ashima

AU - Marrazza, Mariagrazia

AU - Mesa, Miguel Antonio

AU - Michalska-Jakubus, Małgorzata

AU - Miossi, Renata

AU - Mogosan, Corina

AU - Moretti, Giovanna

AU - Mostmans, Yora

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Objective. To propose simple capillaroscopic definitions for interpretation of capillaroscopic morphologies and to assess inter-rater reliability. Methods. The simple definitions proposed were: normal-hairpin, tortuous or crossing; abnormal-not hairpin, not tortuous and not crossing; not evaluable-whenever rater undecided between normal and abnormal. Based upon an aimed kappa of 0.80 and default prevalences of normal (0.4), abnormal (0.4) and not evaluable (0.2) capillaries, 90 single capillaries were presented to three groups of raters: experienced independent raters, n = 5; attendees of the sixth EULAR capillaroscopy course, n = 34; novices after a 1-h course, n = 11. Inter-rater agreement was assessed by calculation of proportion of agreement and by kappa coefficients. Results. Mean kappa based on 90 capillaries was 0.47 (95% CI: 0.39, 0.54) for expert raters, 0.40 (95% CI: 0.36, 0.44) for attendees and 0.46 (95% CI: 0.41, 0.52) for novices, with overall agreements of 67% (95% CI: 63, 71), 63% (95% CI: 60, 65) and 67% (95% CI: 63, 70), respectively. Comparing only normal vs the combined groups of abnormal and not evaluable capillaries did increase the kappa: 0.51 (95% CI: 0.37, 0.65), 0.53 (95% CI: 0.49, 0.58) and 0.55 (95% CI: 0.49, 0.62). On the condition that the capillaries were classifiable, the mean kappa was 0.62 (95% CI: 0.50, 0.74) for expert raters (n = 65), 0.76 (95% CI: 0.69, 0.83) for attendees (n = 20) and 0.81 (95% CI: 0.74, 0.89) for novices (n = 44). Conclusion. This multicentre, international study showed moderate reliability of simple capillaroscopic definitions for describing morphology of capillaries by rheumatologists with varying levels of expertise. Novices were capable of distinguishing normal from abnormal capillaries by means of a 1-h training session. In future studies, the class not evaluable may be obsolete.

AB - Objective. To propose simple capillaroscopic definitions for interpretation of capillaroscopic morphologies and to assess inter-rater reliability. Methods. The simple definitions proposed were: normal-hairpin, tortuous or crossing; abnormal-not hairpin, not tortuous and not crossing; not evaluable-whenever rater undecided between normal and abnormal. Based upon an aimed kappa of 0.80 and default prevalences of normal (0.4), abnormal (0.4) and not evaluable (0.2) capillaries, 90 single capillaries were presented to three groups of raters: experienced independent raters, n = 5; attendees of the sixth EULAR capillaroscopy course, n = 34; novices after a 1-h course, n = 11. Inter-rater agreement was assessed by calculation of proportion of agreement and by kappa coefficients. Results. Mean kappa based on 90 capillaries was 0.47 (95% CI: 0.39, 0.54) for expert raters, 0.40 (95% CI: 0.36, 0.44) for attendees and 0.46 (95% CI: 0.41, 0.52) for novices, with overall agreements of 67% (95% CI: 63, 71), 63% (95% CI: 60, 65) and 67% (95% CI: 63, 70), respectively. Comparing only normal vs the combined groups of abnormal and not evaluable capillaries did increase the kappa: 0.51 (95% CI: 0.37, 0.65), 0.53 (95% CI: 0.49, 0.58) and 0.55 (95% CI: 0.49, 0.62). On the condition that the capillaries were classifiable, the mean kappa was 0.62 (95% CI: 0.50, 0.74) for expert raters (n = 65), 0.76 (95% CI: 0.69, 0.83) for attendees (n = 20) and 0.81 (95% CI: 0.74, 0.89) for novices (n = 44). Conclusion. This multicentre, international study showed moderate reliability of simple capillaroscopic definitions for describing morphology of capillaries by rheumatologists with varying levels of expertise. Novices were capable of distinguishing normal from abnormal capillaries by means of a 1-h training session. In future studies, the class not evaluable may be obsolete.

KW - Capillaroscopy

KW - Definitions

KW - EULAR study group on microcirculation

KW - Experts

KW - Morphology

KW - Novices

KW - Reliability

KW - Trainees

UR - http://www.scopus.com/inward/record.url?scp=84965076035&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84965076035&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/kev441

DO - 10.1093/rheumatology/kev441

M3 - Article

VL - 55

SP - 883

EP - 890

JO - Rheumatology (United Kingdom)

JF - Rheumatology (United Kingdom)

SN - 1462-0324

IS - 5

ER -