The provisional OMERACT ultrasonography score for giant cell arteritis

Christian Dejaco*, Cristina Ponte, Sara Monti, Davide Rozza, Carlo Alberto Scirè, Lene Terslev, George A.W. Bruyn, Dennis Boumans, Wolfgang Hartung, Alojzija Hočevar, Marcin Milchert, Uffe Møller Døhn, Chetan B. Mukhtyar, Markus Aschwanden, Philipp Bosch, Dario Camellino, Stavros Chrysidis, Giovanni Ciancio, Maria Antonietta D'Agostino, Thomas DaikelerBhaskar Dasgupta, Eugenio De Miguel, Andreas P. Diamantopoulos, Christina Duftner, Ana Agueda, Ulrich Fredberg, Petra Hanova, Ib Tønder Hansen, Ellen Margrethe Hauge, Annamaria Iagnocco, Nevsun Inanc, Aaron Juche, Rositsa Karalilova, Toshio Kawamoto, Kresten Krarup Keller, Helen Isobel Keen, Tanaz A. Kermani, Minna J. Kohler, Matthew Koster, Raashid Ahmed Luqmani, Pierluigi MacChioni, Sarah Louise MacKie, Esperanza Naredo, Berit Dalsgaard Nielsen, Michihiro Ogasawara, Carlos Pineda, Valentin Sebastian Schäfer, Luca Seitz, Alessandro Tomelleri, Karina D. Torralba, Kornelis S.M. Van Der Geest, Kenneth J. Warrington, Wolfgang A. Schmidt

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Objectives: To develop an Outcome Measures in Rheumatology (OMERACT) ultrasonography score for monitoring disease activity in giant cell arteritis (GCA) and evaluate its metric properties. Methods: The OMERACT Instrument Selection Algorithm was followed. Forty-nine members of the OMERACT ultrasonography large vessel vasculitis working group were invited to seven Delphi rounds. An online reliability exercise was conducted using images of bilateral common temporal arteries, parietal and frontal branches as well as axillary arteries from 16 patients with GCA and 7 controls. Sensitivity to change and convergent construct validity were tested using data from a prospective cohort of patients with new GCA in which ultrasound-based intima-media thickness (IMT) measurements were conducted at weeks 1, 3, 6, 12 and 24. Results: Agreement was obtained (92.7%) for the OMERACT GCA Ultrasonography Score (OGUS), calculated as follows: sum of IMT measured in every segment divided by the rounded cut-off values of IMTs in each segment. The resulting value is then divided by the number of segments available. Thirty-five members conducted the reliability exercise, the interrater intraclass correlation coefficient (ICC) for the OGUS was 0.72-0.84 and the median intrareader ICC was 0.91. The prospective cohort consisted of 52 patients. Sensitivity to change between baseline and each follow-up visit up to week 24 yielded standardised mean differences from-1.19 to-2.16, corresponding to large and very large magnitudes of change, respectively. OGUS correlated moderately with erythrocyte sedimentation rate, C reactive protein and Birmingham Vasculitis Activity Score (corrcoeff 0.37-0.48). Conclusion: We developed a provisional OGUS for potential use in clinical trials.

Original languageEnglish
JournalAnnals of the Rheumatic Diseases
Issue number4
Pages (from-to)556-564
Publication statusPublished - 1. Apr 2023

Bibliographical note

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© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.


  • giant cell arteritis
  • outcome assessment, health care
  • systemic vasculitis
  • ultrasonography


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