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Quantitative outcome measures for systemic sclerosis-related Microangiopathy – Reliability of image acquisition in Nailfold Capillaroscopy

Dinsdale, Graham; Moore, Tonia L; O'Leary, Neil; Berks, Michael; Roberts, Christopher; Manning, Joanne B; Allen, John LU ; Anderson, Marina; Cutolo, Maurizio and Hesselstrand, Roger LU , et al. (2017) In Microvascular Research 113. p.56-59
Abstract

Background Nailfold capillaroscopic parameters hold increasing promise as outcome measures for clinical trials in systemic sclerosis (SSc). Their inclusion as outcomes would often naturally require capillaroscopy images to be captured at several time points during any one study. Our objective was to assess repeatability of image acquisition (which has been little studied), as well as of measurement. Method 41 patients (26 with SSc, 15 with primary Raynaud's phenomenon) and 10 healthy controls returned for repeat high-magnification (300 ×) videocapillaroscopy mosaic imaging of 10 digits one week after initial imaging (as part of a larger study of reliability). Images were assessed in a random order by an expert blinded observer and 4... (More)

Background Nailfold capillaroscopic parameters hold increasing promise as outcome measures for clinical trials in systemic sclerosis (SSc). Their inclusion as outcomes would often naturally require capillaroscopy images to be captured at several time points during any one study. Our objective was to assess repeatability of image acquisition (which has been little studied), as well as of measurement. Method 41 patients (26 with SSc, 15 with primary Raynaud's phenomenon) and 10 healthy controls returned for repeat high-magnification (300 ×) videocapillaroscopy mosaic imaging of 10 digits one week after initial imaging (as part of a larger study of reliability). Images were assessed in a random order by an expert blinded observer and 4 outcome measures extracted: (1) overall image grade and then (where possible) distal vessel locations were marked, allowing (2) vessel density (across the whole nailfold) to be calculated (3) apex width measurement and (4) giant vessel count. Intra-rater, intra-visit and intra-rater inter-visit (baseline vs. 1 week) reliability were examined in 475 and 392 images respectively. A linear, mixed-effects model was used to estimate variance components, from which intra-class correlation coefficients (ICCs) were determined. Results Intra-visit and inter-visit reliability estimates (ICCs) were (respectively): overall image grade, 0.97 and 0.90; vessel density, 0.92 and 0.65; mean vessel width, 0.91 and 0.79; presence of giant capillary, 0.68 and 0.56. These estimates were conditional on each parameter being measurable. Conclusion Within-operator image analysis and acquisition are reproducible. Quantitative nailfold capillaroscopy, at least with a single observer, provides reliable outcome measures for clinical studies including randomised controlled trials.

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publication status
published
subject
keywords
Nailfold videocapillaroscopy, Raynaud's phenomenon, Reliability, Systemic sclerosis
in
Microvascular Research
volume
113
pages
56 - 59
publisher
Academic Press
external identifiers
  • scopus:85019416368
  • wos:000404692200008
ISSN
0026-2862
DOI
10.1016/j.mvr.2017.05.003
language
English
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yes
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708ad83b-e785-4939-a1e8-0a490cc2e94d
date added to LUP
2017-06-16 11:16:03
date last changed
2017-09-18 11:41:31
@article{708ad83b-e785-4939-a1e8-0a490cc2e94d,
  abstract     = {<p>Background Nailfold capillaroscopic parameters hold increasing promise as outcome measures for clinical trials in systemic sclerosis (SSc). Their inclusion as outcomes would often naturally require capillaroscopy images to be captured at several time points during any one study. Our objective was to assess repeatability of image acquisition (which has been little studied), as well as of measurement. Method 41 patients (26 with SSc, 15 with primary Raynaud's phenomenon) and 10 healthy controls returned for repeat high-magnification (300 ×) videocapillaroscopy mosaic imaging of 10 digits one week after initial imaging (as part of a larger study of reliability). Images were assessed in a random order by an expert blinded observer and 4 outcome measures extracted: (1) overall image grade and then (where possible) distal vessel locations were marked, allowing (2) vessel density (across the whole nailfold) to be calculated (3) apex width measurement and (4) giant vessel count. Intra-rater, intra-visit and intra-rater inter-visit (baseline vs. 1 week) reliability were examined in 475 and 392 images respectively. A linear, mixed-effects model was used to estimate variance components, from which intra-class correlation coefficients (ICCs) were determined. Results Intra-visit and inter-visit reliability estimates (ICCs) were (respectively): overall image grade, 0.97 and 0.90; vessel density, 0.92 and 0.65; mean vessel width, 0.91 and 0.79; presence of giant capillary, 0.68 and 0.56. These estimates were conditional on each parameter being measurable. Conclusion Within-operator image analysis and acquisition are reproducible. Quantitative nailfold capillaroscopy, at least with a single observer, provides reliable outcome measures for clinical studies including randomised controlled trials.</p>},
  author       = {Dinsdale, Graham and Moore, Tonia L and O'Leary, Neil and Berks, Michael and Roberts, Christopher and Manning, Joanne B and Allen, John and Anderson, Marina and Cutolo, Maurizio and Hesselstrand, Roger and Howell, Kevin and Pizzorni, Carmen and Smith, Vanessa and Sulli, Alberto and Wildt, Marie and Taylor, Christopher and Murray, Andrea and Herrick, Ariane L},
  issn         = {0026-2862},
  keyword      = {Nailfold videocapillaroscopy,Raynaud's phenomenon,Reliability,Systemic sclerosis},
  language     = {eng},
  month        = {09},
  pages        = {56--59},
  publisher    = {Academic Press},
  series       = {Microvascular Research},
  title        = {Quantitative outcome measures for systemic sclerosis-related Microangiopathy – Reliability of image acquisition in Nailfold Capillaroscopy},
  url          = {http://dx.doi.org/10.1016/j.mvr.2017.05.003},
  volume       = {113},
  year         = {2017},
}