Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/48519
Title: Validity, reproducibility, and responsiveness of a twelve-joint simplified power Doppler ultrasonographic assessment of joint inflammation in rheumatoid arthritis
Authors: Naredo, Esperanza
Martín Rodríguez, Manuel María 
Campos, Cristina
Rodríguez-Heredia, José Manuel
Medina, Julio A.
Giner, Emilio
Martínez, Olga
Toyos, Francisco Javier
Ruíz, Teresa
Ros, Inmaculada
Pujol, Manuel
Miquel, Xavier
Aznar, Juan José
Chamizo, Eugenio
Páez, Manuel
García Morales, Pilar 
Rueda, Amalia
Tuneu, Roser
Corominas, Hector
De Agustín, Juan José
Moragues, Carmen
Mínguez, Dolores
Willisch, Alfredo
González Cruz, Isabel
Aragón, Angel 
Iglesias, Gerardo
Armas, Carlos
Valdazo, Juan Pablo
Vargas, Carmen
Calvo-Alén, Jaime
Juan-Mas, Antonio
Salvador, Georgina
Puigdollers, Angels
Galíndez, Eva
Garrido, Noemi
Salaberri, José
Raya, Enrique
Salles, Meritxell
Díaz, César
Cuadra, José Luis
Garrido, Jesús
UNESCO Clasification: 32 Ciencias médicas
Issue Date: 2008
Journal: Arthritis Care and Research 
Abstract: Objective To investigate the validity, reproducibility, and responsiveness of a simplified power Doppler ultrasound (PDUS) assessment of joint inflammation compared with a comprehensive 44-joint PDUS assessment in patients with rheumatoid arthritis (RA) who started therapy with a biologic agent. Methods A total of 160 patients with active RA who started a biologic agent were prospectively recruited in 18 Spanish centers. The patients underwent clinical and laboratory assessment and blinded PDUS examination at baseline and 6 months. A PDUS examination of 128 synovial sites in 44 joints was performed. US synovitis and PD signal were semiquantitatively graded from 1 to 3 in all synovial sites. US count and index for synovitis and PD signal were obtained. PDUS intraobserver and interobserver reliability were evaluated. A process of data reduction based on the frequency of involvement of synovial sites by both synovitis and PD signal was conducted. Construct and discriminant validity of a simplified PDUS assessment was investigated. Results A PDUS simplified assessment including 24 synovial sites from 12 joints detected 100% of patients with synovitis and 91% of patients with PD signal. There was a highly significant correlation between the 44-joint count and index for synovitis and PD signal and the 12-joint count and index for synovitis and PD signal at baseline and 6 months (r = 0.84–0.90, P < 0.0005). The smallest detectable difference was lower than the mean change in simplified PDUS variables. Conclusion A 12-joint PDUS assessment of RA joint inflammation may be a valid, feasible method for multicenter monitoring of therapeutic response to biologic agents.
URI: http://hdl.handle.net/10553/48519
ISSN: 2151-4658
DOI: 10.1002/art.23529
Source: Arthritis Care and Research [ISSN 2151-4658], v. 59 (4), p. 515-522, (Abril 2008)
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