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SPINART study: validation of the extended magnetic resonance imaging scale for evaluation of joint status in adult patients with severe haemophilia A using baseline data
Author(s) -
Hong W.,
Raunig D.,
Lundin B.
Publication year - 2016
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/hae.13022
Subject(s) - medicine , haemophilia , intraclass correlation , magnetic resonance imaging , synovitis , cronbach's alpha , arthropathy , physical therapy , nuclear medicine , osteoarthritis , surgery , radiology , arthritis , pathology , psychometrics , clinical psychology , alternative medicine
Most previous joint imaging scales for haemophilia have focused on earlier disease stages observed in younger patients. Aim We sought to demonstrate that the 45‐item extended magnetic resonance imaging (eMRI) scale is a valid instrument for measuring joint status in adults with severe haemophilia A. Methods Six scale categories (effusion/haemarthrosis, synovial hypertrophy, hemosiderin, erosion, subchondral cysts and cartilage loss) in two domains (soft tissue [range = 0–9] and osteochondral [range = 0–36]) were evaluated for each joint. eMRI scores were derived using baseline data from a randomized, controlled, parallel‐group clinical trial (SPINART). Quantitative analysis of linearity included assessments of the relationship between scores derived from the eMRI scale vs. the 17‐point International Prophylaxis Study Group (IPSG) MRI scale and Colorado Adult Joint Assessment Scale (CAJAS). Results Patient eMRI scores correlated with age ( r = 0.58), consistent with the expectation of arthropathy progression and more severe joint changes in older patients. eMRI scores demonstrated excellent between‐reader agreement for overall patient score (intraclass correlation coefficient [ICC] = 0.88) and outstanding agreement for knee evaluations (ICC = 0.95). There was a strong linear relationship of the eMRI score with the CAJAS ( r = 0.7). Adding individual bone evaluations for each joint increased the sensitivity of the instrument to detect change at low scores. There was minimal ceiling effect (5% maximum scores for all evaluated joints) compared with the IPSG MRI scale (20%). Internal reliability was good (overall Cronbach's alpha = 0.75). Conclusions Overall, the eMRI scale represents a valid and reliable measure of joint status in adolescents and adults with severe haemophilia A.