Working group OMERACT >Hand OA (Marion Kortekaas/Ruth Wittoek), Hip and knee OA
Objective of the subgroups work:
Development of US scoring systems for OA for structural and inflammatory features
Investigation of reliability, and when reliable
Truth, Discrimination and feasibility
After obtaining step 1-3, try endorsement of instrument
What is the contribution of the subgroup work to the OMERACT work?
Hand OA Domain set (2014) includes the domain “structural damage” in the middle circle, “joint activity” for which synovitis scoring system could be an applicable instrument, is in the inner core of the domain set.
Description of the previous work
Development and reliability testing of the osteophyte US score. The scoring system has proven to be reliable.
Development and reliability testing of a cartilage US scoring system. The score was developed and tested and showed good reliability only for dichotomous scores. The definition was subsequently modified and simplified: SQ 0-2)
Development and reliability testing for knee OA
Reporting back of work done since ACR 2017
Abnormalities in foot OA developed and tested and proven reliable
Patient based reliability testing (Copenhagen 2017):
Modified cartilage scoring system no improvement of reliability: due to the difficulties of the scoring system, as well technical difficulties, RED FLAG
Synovitis scoring system: palmar site scoring is less reliable and should not be performed
Synovitis scoring system low reliability, possibly due to low prevalence of findings, additional analyses needed
Palmar site scoring was found to be less reliable compared to dorsal.
Collateral ligaments SLR: only 1 US paper, 6 MRI papers. All very small numbers.
Next steps and discussion points
Additional analyses synovitis scoring system
If this shows good reliability: proposal to proceed to discrimination/truth/feasibility
If reliability is not established: discussion on scoring system: Modification needed?
Osteophytes scoring system endorsed for further assessment of TDF
Scoring systems for foot OA reliable: proceed? (can we fit this in OMERACT work? (since the working groups for OA have limited the area of interest to hand/knee and hip oa; however, there is a tendency to make an overarching domain set for osteoarthritis in general, which would make sense) )