Effect of Characteristic Inflammatory and Structural Pelvic Magnetic Resonance Imaging Lesions on Expert Assessment of Axial Juvenile Spondyloarthritis
Authors' conclusion
The addition of imaging data affected directionality and improved high confidence agreement of expert assessment of axial disease.
Study context
- Population
- Patients with juvenile spondyloarthritis (JSpA) with suspected axial disease3 experts per case
- Participants
- 303 patients
- Exposure
- Expert assessment with clinical data alone vs with clinical and magnetic resonance imaging (MRI) data
- Outcome
- Expert agreement (≥ 2/3 experts rating ≤ −1 or ≥ 1) on presence of axial disease
Methodological detailsmodified Poisson regression models
- Modified Poisson regression models
Main finding
As reported in the abstract
Expert agreement on axial disease
Clinical data
89.8%
272 events
- Adding imaging data affected agreement
- 38.9% (118/303)
- Adding imaging data affected directionality of agreement
- 23.4% (71/303)
- Agreement facilitated
- 26/31
- Agreement lost
- 21/272
- Directionality changed from axial disease absent to present
- 33
- Directionality changed from present to absent
- 38
Observational data: associations, not effects.
Further findings
Factors independently associated with expert agreement (final model area under the receiver-operating characteristic (AUROC) 0.93)
| RR (95% CI) | ||
|---|---|---|
| HLA-B27 | 1.41 (1.14–1.74) | |
| Pain improvement with activity | 1.27 (1.05–1.54) | |
| Bone marrow edema on MRI | 4.08 (2.91–5.73) | |
| 0.20.5125Relative risk (log scale) |
- Factors independently associated with expert agreement (final model AUROC 0.93) — Final model AUROC
- 0.93
Original publication
Effect of Characteristic Inflammatory and Structural Pelvic Magnetic Resonance Imaging Lesions on Expert Assessment of Axial Juvenile Spondyloarthritis. J Rheumatol. Published 15 January 2025. doi:10.
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