AUTHOR=Zabotti Alen , Zandonella Callegher Sara , Tullio Annarita , Vukicevic Arso , Hocevar Alojzija , Milic Vera , Cafaro Giacomo , Carotti Marina , Delli Konstantina , De Lucia Orazio , Ernst Diana , Ferro Francesco , Gattamelata Angelica , Germanò Giuseppe , Giovannini Ivan , Hammenfors Daniel , Jonsson Malin V. , Jousse-Joulin Sandrine , Macchioni Pierluigi , Parisi Simone , Perricone Carlo , Stradner Martin Helmut , Filipovic Nenad , Tzioufas Athanasios G. , Valent Francesca , De Vita Salvatore
TITLE=Salivary Gland Ultrasonography in Sjögren's Syndrome: A European Multicenter Reliability Exercise for the HarmonicSS Project
JOURNAL=Frontiers in Medicine
VOLUME=7
YEAR=2020
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.581248
DOI=10.3389/fmed.2020.581248
ISSN=2296-858X
ABSTRACT=Objectives: Salivary gland ultrasonography (SGUS) is increasingly applied for the management of primary Sjögren's syndrome (pSS). This study aims to: (i) compare the reliability between two SGUS scores; (ii) test the reliability among sonographers with different levels of experience.
Methods: In the reliability exercise, two four-grade semi-quantitative SGUS scoring systems, namely De Vita et al. and OMERACT, were tested. The sonographers involved in work-package 7 of the HarmonicSS project from nine countries in Europe were invited to participate. Different levels of sonographers were identified on the basis of their SGUS experience and of the knowledge of the tested scores. A dedicated atlas was used as support for SGUS scoring.
Results: Twenty sonographers participated in the two rounds of the reliability exercise. The intra-rater reliability for both scores was almost perfect, with a Light's kappa of 0.86 for the De Vita et al. score and 0.87 for the OMERACT score. The inter-rater reliability for the De Vita et al. and the OMERACT score was substantial with Light's Kappa of 0.75 and 0.77, respectively. Furthermore, no significant difference was noticed among sonographers with different levels of experience.
Conclusion: The two tested SGUS scores are reliable for the evaluation of major salivary glands in pSS, and even less-expert sonographers could be reliable if adequately instructed.