title: Quantitative assessment of hand radiographs of rheumatoid arthritis: interobserver variation in a multicenter radiographic study.
abstract: We investigated interobserver variations in the Larsen radiographic scoring method on hand radiographs of rheumatoid arthritis (RA) patients in a multicenter trial and developed a new radiographic scoring method. Thirteen experienced rheumatologists scored 10 representative RA hand radiograms with the Larsen scoring method and clarified the precipitating factors of interobserver variation. Based on this study, it was proved that the ankylotic joint, overlapping joint, and more precise erosive joint are needed for optimal radiographic evaluation. Therefore, we modified the Larsen scoring method on the basis of these precipitating factors and developed a novel radiographic scoring method. Finally, to determine which scoring system was most reliable, the interobserver variation using three methods (original Larsen method, revised Larsen method, our scoring method) were compared by 13 experienced rheumatologists and 13 residents. Our scoring method proved to have simplicity, reliability, and ease of learning. These results suggest that our novel radiological quantitative assessment method has useful applications for clinical studies in patients with RA.
authors.affiliation: Department of Biomedical Engineering, Toin University of Yokohama, 1614 Kurogane, Aoba, Yokohama, 225-8502, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsuno
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yudoh
authors.forename: Tadamasa
authors.initials: T
authors.lastname: Hanyu
authors.forename: Syogo
authors.initials: S
authors.lastname: Kano
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Komatsubara
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Matsubara
authors.forename: Norikazu
authors.initials: N
authors.lastname: Murata
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Syoichi
authors.initials: S
authors.lastname: Ozaki
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Shimizu
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Takasugi
authors.forename: Makoto
authors.initials: M
authors.lastname: Goto
mesh_terms: D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D007396:Internship and Residency; D015588:Observer Variation; D011859:Radiography / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012107:Research Design / Q000706:statistics & numerical data; D012219:Rheumatology / Q000193:education / Q000379:methods; D012720:Severity of Illness Index