Self-reported diagnostic confidence predicts diagnostic accuracy in axial spondyloarthritis imaging

Sevtap Tugce Ulas*, Felix Radny, Katharina Ziegeler, Iris Eshed, Juliane Greese, Dominik Deppe, Carsten Stelbrink, Robert Biesen, Hildrun Haibel, Valeria Rios Rodriguez, Judith Rademacher, Mikhail Protopopov, Fabian Proft, Denis Poddubnyy, Torsten Diekhoff

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objectives: Reporting diagnostic confidence (DC) in axial spondyloarthritis (axSpA) imaging is recommended by the ASAS guidelines. Our aim was to investigate whether self-reported DC predicts diagnostic accuracy in axSpA imaging using X-ray (XR), computed tomography (CT) and magnetic resonance imaging (MRI). Methods: We performed a post hoc analysis including 163 patients with low back pain (89 axSpA and 56 non-axSpA). Nine blinded readers with different experience levels [inexperienced (<1 year), semi-experienced (3–8 years) and experienced (>12 years)] scored the sacroiliac joint images for compatibility with axSpA. DC was reported on a scale from 1 (not sure) to 10 (very sure). Mean DC scores and standard deviations were calculated for correct and incorrect responses using XR, CT, MRI, XRþMRI and CTþMRI. Differences in DC were assessed using the Mann–Whitney U test. Results: DC scores were higher for correct axSpA diagnoses and differed significantly between correct and incorrect responses for all modalities (P < 0.001), with a mean DC of 7.1 6 2.1 and 6.3 6 2.1 for XR, 8.3 6 1.8 and 6.7 6 2.0 for CT, 8.1 6 1.9 and 6.2 6 1.9 for MRI, 8.2 6 1.8 and 6.7 6 1.8 for XRþMRI and 8.4 6 1.8 and 6.8 6 1.8 for CTþMRI, respectively. This was also the case when looking at the results by experience group, except for XR in the inexperienced group. Conclusion: Providing self-reported DC in radiological reports is useful information to predict diagnostic reliability in axSpA imaging.

Original languageEnglish
Pages (from-to)2199-2204
Number of pages6
JournalRheumatology
Volume63
Issue number8
DOIs
StatePublished - 1 Aug 2024

Funding

FundersFunder number
Berlin Institute of Health

    Keywords

    • axial spondyloarthritis
    • computed tomography
    • magnetic resonance imaging

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