Photo Credit: stockdevil
The following is a summary of “Effect of Online Training on the Reliability of Assessing Sacroiliac Joint Radiographs in Axial Spondyloarthritis: A Randomized, Controlled Study,” published in the September 2024 issue of Rheumatology by Hadsbjerg et al.
Radiographic assessment of sacroiliac joints using the modified New York criteria is key for classifying axial spondyloarthritis, but reader agreement is often inconsistent.
Researchers conducted a prospective study to evaluate the reliability improvements in scoring sacroiliac joint radiographs after implementing an online real-time iterative calibration module.
They randomized 19 readers into 2 groups (A or B) and completed 3 calibration steps: manuscript review, slideshow, and video review (with group A using the real-time iterative calibration [RETIC] module), and re-review of the slideshow and video (with group B using RETIC). The module provided instant feedback until predefined reliability targets (κ) for modified New York (NY) positivity/negativity were met. After each step, readers scored different batches of 25 radiographs, and agreement (κ) with an expert radiologist was assessed. Improvements from the training strategies were analyzed using linear mixed models.
The results showed that in exercises I, II, and III, modified New York (mNY) κ values were 0.61, 0.76, and 0.84 for group A, and 0.70, 0.68, and 0.86 for group B (increasing mainly after RETIC completion). Improvements were observed in grading both mNY positivity/negativity and individual pathologies, especially in inexperienced readers. The RETIC module, combined with the slideshow and video, resulted in a significant κ increase of 0.17 (95% CI 0.07-0.27; P=0.002) for mNY grading, while the slideshow and video alone showed no significant change (κ = 0.00, 95% CI –0.10 to 0.10; P=0.99).
The study concluded that adding an online real-time iterative calibration (RETIC) module significantly improved agreement in scoring radiographs per modified New York criteria.
Source: jrheum.org/content/early/2024/10/09/jrheum.2024-0075
