Validity and responsiveness of combined inflammation and combined joint damage scores based on the OMERACT rheumatoid arthritis MRI scoring system (RAMRIS)

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DOI

  • Ulf Sundin, Diakonhjemmet Hospital, Universitetet i Oslo
  • ,
  • Mikkel Østergaard, Rigshospitalet, Københavns Universitet
  • ,
  • Daniel Glinatsi, Rigshospitalet
  • ,
  • Anna Birgitte Aga, Diakonhjemmet Hospital
  • ,
  • Kim Hørslev-Petersen, King Christian 10th Hospital for Rheumatic Diseases, Syddansk Universitet
  • ,
  • Merete L. Hetland, Rigshospitalet, Københavns Universitet
  • ,
  • Kristian Stengaard-Pedersen
  • Peter Junker, Odense Universitetshospital, Syddansk Universitet
  • ,
  • Bo J. Ejbjerg, Zealand University Hospital
  • ,
  • Paul Bird, University of New South Wales (UNSW) Australia
  • ,
  • Philip G. Conaghan, Leeds University, NIHR Leeds Biomedical Research Centre
  • ,
  • Siri Lillegraven, Diakonhjemmet Hospital
  • ,
  • Espen A. Haavardsholm, Diakonhjemmet Hospital, Universitetet i Oslo

Objective. The RAMRIS [Outcome Measures in Rheumatology rheumatoid arthritis (RA) magnetic resonance imaging (MRI) Scoring system] is used in clinical RA trials. We have investigated methods to combine the RAMRIS features into valid and responsive scores for inflammation and joint damage. Methods. We used data from 3 large randomized early RA trials to assess 5 methods to develop a combined score for inflammation based on RAMRIS bone marrow edema, synovitis, and tenosynovitis scores, and a combined joint damage score based on erosions and joint space narrowing. Methods included unweighted summation, normalized summation, and 3 different variants of weighted summation of the RAMRIS features. We used a derivation cohort to calculate summation weights to maximize the responsiveness of the combined score. Construct validity of the combined scores was examined by assessing correlations to imaging, clinical, and biochemical measures. Responsiveness was tested by calculating the standardized response mean (SRM) and the relative efficiency of each score in a validation cohort. Results. Patient characteristics, as well as baseline and followup RAMRIS scores, were comparable between cohorts. All combined scores were significantly correlated to other imaging, clinical, and biochemical measures. Inflammation scores combined by normalized and weighted summation had significantly higher responsiveness in comparison to unweighted summation, with SRM (95% CI) for unweighted summation 0.62 (0.51-0.73), normalized summation 0.73 (0.63-0.83), and weighted summation 0.74 (0.64-0.84). For the damage score, there was a trend toward higher responsiveness for weighted summation. Conclusion. Combined MRI scores calculated by normalized or weighted summation of individual MRI pathologies were valid and responsive.

Original languageEnglish
JournalJournal of Rheumatology
Volume46
Issue9
Pages (from-to)1222-1227
Number of pages6
ISSN0315-162X
DOIs
Publication statusPublished - 2019

    Research areas

  • Clinical trials, Magnetic resonance imaging, Omeract, Outcome assessment, Rheumatoid arthritis

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