title: Inter & intra-observer reliability of grading ultrasound videoclips with hand pathology in rheumatoid arthritis by using non- sophisticated internet tools (LUMINA study).
abstract: OBJECTIVE
  To evaluate the inter- and intraobserver agreement of a group of European rheumatologist ultrasonographers in grading musculoskeletal ultrasound videoclips posted on the Internet by using a non-sophisticated electronic environment.
  
  
  METHODS
  Forty short movie clips (less than 30 secs) were made available over the Internet to all participants. Normal and pathological RA hand joints and tendons were included in the movie clips. In the first phase 30 investigators from European countries were invited to evaluate the clips and to interpret/grade them. No instruction session was held prior to the initiation of the study. For synovitis the requested scoring system included 0 to3 grades and for tenosynovitis a binary variable 0/1; separate evaluations were performed for gray scale (GS) and Power Doppler (PD) examinations. In the second phase the responders were asked to grade the same clips in a different order without having access to their first grading scale. Light's k and Cohen's k were used to analyse inter- and intraobserver reliability.
  
  
  RESULTS
  Twenty two European rheumatologists agreed to finalise both study phases. Mean Cohen's κ for intraobserver reliability was 0.614/0.689 for tenosynovitis GS/PD and 0.523/0.621 for synovitis GS/PD. Light's k for interobserver reliability was 0.503 for tenosynovitis evaluation and 0.455 for global (synovitis and tenosynovitis) evaluation. Mean global overall agreement was 84.95% (90.2% for global synovitis).
  
  
  CONCLUSIONS
  An over-the-net US evaluation and grading has shown moderate to good reliability. The results could be improved if a training session is added at the beginning of the study.
authors.affiliation: Clinical Hospital Sf. Maria, Bucharest, Romania, Email:vladvioleta1@gmail.com.
authors.forename: Violeta
authors.initials: V
authors.lastname: Vlad
authors.affiliation: UMF "Carol Davila" Bucharest, Romania.
authors.forename: Florin
authors.initials: F
authors.lastname: Berghea
authors.affiliation: Sapienza Universita di Roma, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Iagnocco
authors.affiliation: Rehabilitation Clinical Hospital, Cluj Napoca, Romania.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Micu
authors.affiliation: Institute of Rheumatology Belgrade, Serbia.
authors.forename: Nemanja
authors.initials: N
authors.lastname: Damjanov
authors.affiliation: Institute for Treatment and Rehabilitation Niskabanja, Serbia.
authors.forename: Vlado
authors.initials: V
authors.lastname: Skakic
authors.affiliation: Institute of Rheumatology Belgrade, Serbia.
authors.forename: Slavica
authors.initials: S
authors.lastname: Prodanovic
authors.affiliation: Institute of Rheumatology Belgrade, Serbia.
authors.forename: Goran
authors.initials: G
authors.lastname: Radunovic
authors.affiliation: University of Copenhagen, Hospital at Koge, Denmark.
authors.forename: Marcin
authors.initials: M
authors.lastname: Szkudlarek
authors.affiliation: Rheumatology Center "St. Irina" Sofia, Bulgaria.
authors.forename: Rodina
authors.initials: R
authors.lastname: Nestorova
authors.affiliation: Clinic of Rheumatology, Sofia, Bulgaria.
authors.forename: Tzvetanka
authors.initials: T
authors.lastname: Petranova
authors.affiliation: Private Rheumatology Practice, Katerini, Greece.
authors.forename: Jasna
authors.initials: J
authors.lastname: Kakavouli
authors.affiliation: University of Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Porta
authors.affiliation: Sapienza Universita di Roma, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Perricone
authors.affiliation: Interclyde Royal Hospital,Glasgow,UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Ciechomska
authors.affiliation: Instituto Poal de Reumatologia, Barcelona,Spain.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Moller
authors.affiliation: Center of Rheumatic Diseases "Ion Stoia" Bucharest, Romania.
authors.forename: Luminita
authors.initials: L
authors.lastname: Varzaru
authors.affiliation: Clinical Hospital Center Zagreb, Croatia.
authors.forename: Porin
authors.initials: P
authors.lastname: Peric
authors.affiliation: Medical University Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Dejaco
authors.affiliation: "Dr Ion Cantacuzino" Hospital, Bucharest, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Bojinca
authors.affiliation: UMF "Iuliu Hatieganu" Cluj Napoca, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Fodor
authors.affiliation: "Dr Ion Cantacuzino" Hospital, Bucharest, Romania.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Milicescu
authors.affiliation: Hospital General Universitario Gregorio Maranon, Madrid, Spain.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Naredo
mesh_terms: D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005060:Europe; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D020407:Internet; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D014463:Ultrasonography / Q000706:statistics & numerical data*; D014584:User-Computer Interface; D014741:Video Recording / Q000706:statistics & numerical data*