eprintid: 10082087 rev_number: 18 eprint_status: archive userid: 608 dir: disk0/10/08/20/87 datestamp: 2019-09-24 10:55:36 lastmod: 2021-09-26 23:12:29 status_changed: 2019-09-24 10:55:36 type: article metadata_visibility: show creators_name: Smith, V creators_name: Vanhaecke, A creators_name: Herrick, AL creators_name: Distler, O creators_name: Guerra, MG creators_name: Denton, CP creators_name: Deschepper, E creators_name: Foeldvari, I creators_name: Gutierrez, M creators_name: Hachulla, E creators_name: Ingegnoli, F creators_name: Kubo, S creators_name: Müller-Ladner, U creators_name: Riccieri, V creators_name: Sulli, A creators_name: van Laar, JM creators_name: Vonk, MC creators_name: Walker, UA creators_name: Cutolo, M creators_name: EULAR Study Group on Microcirculation in Rheumatic Diseases, title: Fast track algorithm: How to differentiate a "scleroderma pattern" from a "non-scleroderma pattern" ispublished: inpress subjects: RFH divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G90 keywords: Algorithm, Capillaroscopy, EULAR Study Group on Microcirculation in Rheumatic Diseases, Experts, Novices, Reliability, “Scleroderma patterns” note: This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/ abstract: OBJECTIVES: This study was designed to propose a simple "Fast Track algorithm" for capillaroscopists of any level of experience to differentiate "scleroderma patterns" from "non-scleroderma patterns" on capillaroscopy and to assess its inter-rater reliability. METHODS: Based on existing definitions to categorise capillaroscopic images as "scleroderma patterns" and taking into account the real life variability of capillaroscopic images described standardly according to the European League Against Rheumatism (EULAR) Study Group on Microcirculation in Rheumatic Diseases, a fast track decision tree, the "Fast Track algorithm" was created by the principal expert (VS) to facilitate swift categorisation of an image as "non-scleroderma pattern (category 1)" or "scleroderma pattern (category 2)". Mean inter-rater reliability between all raters (experts/attendees) of the 8th EULAR course on capillaroscopy in Rheumatic Diseases (Genoa, 2018) and, as external validation, of the 8th European Scleroderma Trials and Research group (EUSTAR) course on systemic sclerosis (SSc) (Nijmegen, 2019) versus the principal expert, as well as reliability between the rater pairs themselves was assessed by mean Cohen's and Light's kappa coefficients. RESULTS: Mean Cohen's kappa was 1/0.96 (95% CI 0.95-0.98) for the 6 experts/135 attendees of the 8th EULAR capillaroscopy course and 1/0.94 (95% CI 0.92-0.96) for the 3 experts/85 attendees of the 8th EUSTAR SSc course. Light's kappa was 1/0.92 at the 8th EULAR capillaroscopy course, and 1/0.87 at the 8th EUSTAR SSc course. CONCLUSION: For the first time, a clinical expert based fast track decision algorithm has been developed to differentiate a "non-scleroderma" from a "scleroderma pattern" on capillaroscopic images, demonstrating excellent reliability when applied by capillaroscopists with varying levels of expertise versus the principal expert and corroborated with external validation. date: 2019 date_type: published official_url: https://doi.org/10.1016/j.autrev.2019.102394 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green article_type_text: Journal Article verified: verified_manual elements_id: 1696381 doi: 10.1016/j.autrev.2019.102394 pii: S1568-9972(19)30201-0 lyricists_name: Denton, Christopher lyricists_id: CPDEN87 actors_name: Denton, Christopher actors_id: CPDEN87 actors_role: owner full_text_status: public publication: Autoimmunity Reviews article_number: 102394 event_location: Netherlands issn: 1873-0183 citation: Smith, V; Vanhaecke, A; Herrick, AL; Distler, O; Guerra, MG; Denton, CP; Deschepper, E; ... EULAR Study Group on Microcirculation in Rheumatic Diseases; + view all <#> Smith, V; Vanhaecke, A; Herrick, AL; Distler, O; Guerra, MG; Denton, CP; Deschepper, E; Foeldvari, I; Gutierrez, M; Hachulla, E; Ingegnoli, F; Kubo, S; Müller-Ladner, U; Riccieri, V; Sulli, A; van Laar, JM; Vonk, MC; Walker, UA; Cutolo, M; EULAR Study Group on Microcirculation in Rheumatic Diseases; - view fewer <#> (2019) Fast track algorithm: How to differentiate a "scleroderma pattern" from a "non-scleroderma pattern". Autoimmunity Reviews , Article 102394. 10.1016/j.autrev.2019.102394 <https://doi.org/10.1016/j.autrev.2019.102394>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10082087/1/Manuscript%20FastTrack_Final.pdf