Spondyloarthritis & psoriatic arthritis
Radiographic progression in psoriatic arthritis: head-to-head comparison of the Ratingen score and the Sharp–van der Heijde method
Authors' conclusion
SVDH and PARS showed broadly comparable psychometric performance for PsA damage assessment. Both methods were robust for cross-sectional scoring but showed important limitations in reliably detecting cumulative change in this low-progression cohort. Neither method demonstrated clear superiority.
Study context
- Population
- Belgian Psoriatic Arthritis (BePas) cohort; hand and foot radiographs at baseline T0 and follow-ups T1, T2
- Exposure
- Psoriatic Arthritis Ratingen Score (PARS) vs modified Sharp-van der Heijde (SVDH) scoring of radiographic progression
- Outcome
- Psychometric properties: inter-rater reliability (ICC), agreement (Bland-Altman), responsiveness (standardized response mean (SRM)) and measurement error (SDC)
Methodological detailscohort, head-to-head comparison, two blinded readers, BePas cohort, Radiographs independently scored by two blinded readers
- Cohort
- Head-to-head comparison
- Two blinded readers
- BePas cohort
- Radiographs independently scored by two blinded readers
Main finding
As reported in the abstract
Inter-rater reliability, baseline absolute scores (ICC)
PARS
0.906
Intraclass correlation coefficient (ICC)
SVDH
0.888
ICC
Observational data: associations, not effects.
Further findings
| Outcome | PARS | SVDH |
|---|---|---|
| Inter-rater reliability, cumulative change scores (ΔT2-T0) (ICC) · T2-T0Low and very similar for both methods | 0.485 | 0.483 |
| Responsiveness over cumulative interval (two-reader average SRM)Moderate responsiveness | 0.571 | 0.531 |
| SDC (% of maximum score); mean cumulative change smaller than SDC for both methods and readers | SDC 2.8-3.7% % of maximum score | SDC 2.8-4.1% % of maximum score |
- Smallest detectable change (SDC) (% of maximum score); mean cumulative change smaller than SDC for both methods and readers: average progression below threshold of reliable individual-level detection
Bland-Altman limits of agreement
- Slightly narrower absolute limits for PARS in selected comparisons; narrower relative limits for SVDH after normalization to maximum score
Mean change
- Both methods detected positive mean change, primarily between T0 and T1
Original publication
Radiographic progression in psoriatic arthritis: head-to-head comparison of the Ratingen score and the Sharp–van der Heijde method. Rheumatology (Oxford). Published 27 July 2026. doi:10.
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