title: Development and Preliminary Validation of a Digital Overlay-based Learning Module for Semiquantitative Evaluation of Magnetic Resonance Imaging Lesions in Osteoarthritis of the Hip.
abstract: OBJECTIVE
  To develop and validate a knowledge transfer (KT) module aimed at enhancing feasibility and reliability of semiquantitative assessment of bone marrow lesions (BML) and synovitis-effusion using the Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS).
  
  
  METHODS
  Three radiologists naive to the HIMRISS method reviewed the manuscript describing the method and then scored MRI scans from 16 patients with hip OA obtained at baseline and 8 weeks after intraarticular injection of corticosteroid. Readers then reviewed a KT module comprising an instructional presentation and 8 reference DICOM (digital imaging and communications in medicine) cases scored by 3 readers with expertise in the HIMRISS method, and then used electronic overlay software to score scans from 23 patients with OA. The same format was followed with a second group of 3 readers naive to HIMRISS using a KT module revised to incorporate the overlay with a Web-based DICOM viewer to enhance feasibility. Interobserver reliability was assessed with the intraclass correlation coefficient (ICC).
  
  
  RESULTS
  In both exercises, reliability for baseline scores was excellent for femoral BML, very good for acetabular BML, and good for synovitis-effusion (overall ICC = 0.91, 0.89, 0.62, respectively) even without prior calibration using the KT module. However, reliability for detecting change was substantially worse than for expert readers, especially for acetabular BML and synovitis-effusion (overall ICC = 0.59 vs 0.19, and 0.42 vs 0.25, respectively). Reliability improved for detection of change in these lesions, especially after reader calibration with the revised KT module.
  
  
  CONCLUSIONS
  Development and validation of a systematic method for KT may enhance external validation of certain imaging instruments.
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta. walter.maksymowych@ualberta.ca.
authors.forename: Walter P
authors.initials: WP
authors.lastname: Maksymowych
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: Meaghan
authors.initials: M
authors.lastname: Pitts
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budak
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: David
authors.initials: D
authors.lastname: Gracey
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Lambert
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: David
authors.initials: D
authors.lastname: McDougall
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: Marcus
authors.initials: M
authors.lastname: Pianta
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: Winston J
authors.initials: WJ
authors.lastname: Rennie
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Wichuk
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: Naomi
authors.initials: N
authors.lastname: Winn
authors.affiliation: From the Departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada; Craigavon Area Hospital, Southern Health and Social Care Trust, Craigavon, UK; St. Vincent's Hospital, Victoria, Australia; University Hospitals of Leicester, Leicester; University of Manchester, Manchester, UK.W.P. Maksymowych, FRCPC, Professor, Department of Medicine, University of Alberta; M. Pitts, FRCPC, Fellow, Department of Radiology, University of Alberta; M.J. Budak, FRCPC, Fellow, Department of Radiology, University of Alberta; D. Gracey, FRCR, Consultant Radiologist, Craigavon Area Hospital, Southern Health and Social Care Trust; R.G. Lambert, FRCPC, Professor, Department of Radiology, University of Alberta; D. McDougall, FRCPC, Fellow, Department of Radiology, University of Alberta; M. Pianta, FRCR, Consultant Radiologist, St. Vincent's Hospital, Victoria, Australia; W.J. Rennie, FRCR, Consultant Radiologist, University Hospitals of Leicester; S. Wichuk, BSc, Research Associate, Department of Medicine, University of Alberta; N. Winn, FRCR, Consultant Radiologist, University of Manchester; J.L. Jaremko, FRCPC, Assistant Professor, Department of Radiology, University of Alberta.
authors.forename: Jacob L
authors.initials: JL
authors.lastname: Jaremko
mesh_terms: D000368:Aged; D004501:Education, Medical / Q000379:methods; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000473:pathology*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
keywords: INFLAMMATION; INSTRUMENT; KNOWLEDGE TRANSFER; MAGNETIC RESONANCE IMAGING; OSTEOARTHRITIS; VALIDATION