title: Quantitative determination of the diagnostic accuracy of the synovitis score and its components.
abstract: OBJECTIVE
  To assess the diagnostic accuracy of a three-component synovitis score and to determine the relative contribution of each of its components to its overall discriminatory power.
  
  
  RESULTS
  The synovitis score was determined in 666 synovial specimens: normal synovium, n = 33; post-traumatic arthropathy (PtA), n = 29; osteoarthritis (OA), n = 221; psoriatic arthritis (PsA), n = 42; and rheumatoid arthritis (RA), n = 341. The discriminatory abilities of the score and its components were quantified with binary and multicategory receiver operating characteristic (ROC) analysis. The score differentiated all arthropathies accurately from normal tissue (area under the ROC curve, AUC: 0.87-0.98) and RA from OA or PtA (AUC: 0.85 for both), but could not distinguish well within pairs of inflammatory or degenerative arthropathies. AUCs of the intimal hyperplasia and stromal cellularity components correlated with the AUCs of the complete score markedly more strongly (r = 0.94 and 0.91, respectively) than the inflammatory infiltration component (r = 0.60). Multicategory ROC analysis ranked the score several-fold higher than any of its components, and the components in the order stromal cellularity>intimal hyperplasia>infiltration.
  
  
  CONCLUSIONS
  Combining three distinct histological parameters into a three-component score produces greatly increased overall diagnostic power. The discriminatory ability of the score stems more from measuring proliferative than infiltrative aspects of synovitis.
authors.affiliation: Medical Faculty 'Carl Gustav Carus', Technical University of Dresden, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Slansky
authors.forename: Jialiang
authors.initials: J
authors.lastname: Li
authors.forename: Thomas
authors.initials: T
authors.lastname: Häupl
authors.forename: Lars
authors.initials: L
authors.lastname: Morawietz
authors.forename: Veit
authors.initials: V
authors.lastname: Krenn
authors.forename: Frank
authors.initials: F
authors.lastname: Pessler
mesh_terms: D001172:Arthritis, Rheumatoid / Q000473:pathology; D049109:Cell Proliferation; D006801:Humans; D010003:Osteoarthritis / Q000473:pathology; D012372:ROC Curve; D013583:Synovial Membrane / Q000473:pathology*; D013585:Synovitis / Q000473:pathology*