Performance of an automated computer-based scoring method to assess joint space narrowing in rheumatoid arthritis: A longitudinal study
Article first published online: 27 APR 2006
Copyright © 2006 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 54, Issue 5, pages 1444–1450, May 2006
How to Cite
Finckh, A., de Pablo, P., Katz, J. N., Neumann, G., Lu, Y., Wolfe, F. and Duryea, J. (2006), Performance of an automated computer-based scoring method to assess joint space narrowing in rheumatoid arthritis: A longitudinal study. Arthritis & Rheumatism, 54: 1444–1450. doi: 10.1002/art.21802
- Issue published online: 27 APR 2006
- Article first published online: 27 APR 2006
- Manuscript Accepted: 31 JAN 2006
- Manuscript Received: 27 JUL 2005
- NIH. Grant Numbers: R03-AR-047605, P60-AR-47782, K24-AR-02123
- Centocor Health Outcomes in Rheumatic Diseases (CHORD)
- Kirkland Scholars Fellowship
- Arthritis Foundation Postdoctoral Fellowship
To compare the diagnostic performance of a computer-based method for measuring joint space width with the Sharp joint space narrowing (JSN) scoring method in patients with rheumatoid arthritis (RA).
A random sample of patients with early RA, for whom sequential hand radiographs and Sharp scores were available, was selected from the National Data Bank for Rheumatic Diseases. Hand joint space width was measured using an automated, computer-based method in random order and with blinding for clinical information. We constructed a receiver operating characteristic curve and compared the diagnostic performance of the computer-based and Sharp methods based on the areas under the curve.
One hundred twenty-nine patients with early RA who underwent serial radiography were included. Changes in the computer-based and Sharp methods were highly correlated (r = 0.75, P < 0.001). The computer-based method was significantly more discriminant than the Sharp JSN subscale. The area under the curve of the computer-based method was 0.96 (95% confidence interval [95% CI] 0.94, 0.99) compared with 0.93 (95% CI 0.89, 0.96) for the Sharp subscale (P = 0.024). At the most discriminant cutoff, specificity of the computer-based method was 88.4% compared with 81.4% for the Sharp subscale (P = 0.11); sensitivity was 87.6% for the computer-based method compared with 82.2% for Sharp subscale (P = 0.19). The signal-to-noise ratio for the computer-based method was 83% compared with 70% for the Sharp subscale (P = 0.013).
The computer-based method for measuring joint space width is more discriminant than the semiquantitative Sharp JSN subscale.