Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS)

Ulf Sundin, Mikkel Østergaard, Daniel Glinatsi, Anna-Birgitte Aga, Kim Hørslev-Petersen, Merete L Hetland, Kristian Stengard-Pedersen, Peter Junker, Bo J Ejbjerg, Paul Bird, Philip G Conaghan, Siri Lillegraven, Espen A Haavardsholm

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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
Issue number9
Pages (from-to)1222-1227
ISSN0315-162X
DOIs
Publication statusPublished - Sep 2019

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Joints
Rheumatology
Outcome Assessment (Health Care)
Pathology
Weights and Measures

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Sundin, U., Østergaard, M., Glinatsi, D., Aga, A-B., Hørslev-Petersen, K., Hetland, M. L., ... Haavardsholm, E. A. (2019). Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS). Journal of Rheumatology, 46(9), 1222-1227. https://doi.org/10.3899/jrheum.181064
Sundin, Ulf ; Østergaard, Mikkel ; Glinatsi, Daniel ; Aga, Anna-Birgitte ; Hørslev-Petersen, Kim ; Hetland, Merete L ; Stengard-Pedersen, Kristian ; Junker, Peter ; Ejbjerg, Bo J ; Bird, Paul ; Conaghan, Philip G ; Lillegraven, Siri ; Haavardsholm, Espen A. / Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS). In: Journal of Rheumatology. 2019 ; Vol. 46, No. 9. pp. 1222-1227.
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title = "Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS)",
abstract = "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.",
author = "Ulf Sundin and Mikkel {\O}stergaard and Daniel Glinatsi and Anna-Birgitte Aga and Kim H{\o}rslev-Petersen and Hetland, {Merete L} and Kristian Stengard-Pedersen and Peter Junker and Ejbjerg, {Bo J} and Paul Bird and Conaghan, {Philip G} and Siri Lillegraven and Haavardsholm, {Espen A}",
year = "2019",
month = "9",
doi = "10.3899/jrheum.181064",
language = "English",
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Sundin, U, Østergaard, M, Glinatsi, D, Aga, A-B, Hørslev-Petersen, K, Hetland, ML, Stengard-Pedersen, K, Junker, P, Ejbjerg, BJ, Bird, P, Conaghan, PG, Lillegraven, S & Haavardsholm, EA 2019, 'Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS)', Journal of Rheumatology, vol. 46, no. 9, pp. 1222-1227. https://doi.org/10.3899/jrheum.181064

Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS). / Sundin, Ulf; Østergaard, Mikkel; Glinatsi, Daniel; Aga, Anna-Birgitte; Hørslev-Petersen, Kim; Hetland, Merete L; Stengard-Pedersen, Kristian; Junker, Peter; Ejbjerg, Bo J; Bird, Paul; Conaghan, Philip G; Lillegraven, Siri; Haavardsholm, Espen A.

In: Journal of Rheumatology, Vol. 46, No. 9, 09.2019, p. 1222-1227.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS)

AU - Sundin, Ulf

AU - Østergaard, Mikkel

AU - Glinatsi, Daniel

AU - Aga, Anna-Birgitte

AU - Hørslev-Petersen, Kim

AU - Hetland, Merete L

AU - Stengard-Pedersen, Kristian

AU - Junker, Peter

AU - Ejbjerg, Bo J

AU - Bird, Paul

AU - Conaghan, Philip G

AU - Lillegraven, Siri

AU - Haavardsholm, Espen A

PY - 2019/9

Y1 - 2019/9

N2 - 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.

AB - 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.

U2 - 10.3899/jrheum.181064

DO - 10.3899/jrheum.181064

M3 - Journal article

C2 - 30770509

VL - 46

SP - 1222

EP - 1227

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

IS - 9

ER -