Systemic lupus international collaborating clinics renal activity/response exercise: comparison of agreement in rating renal response

2.50
Hdl Handle:
http://hdl.handle.net/2336/66933
Title:
Systemic lupus international collaborating clinics renal activity/response exercise: comparison of agreement in rating renal response
Authors:
Petri, Michelle; Kasitanon, Nuntana; Singh, Sukminder; Link, Kimberly; Magder, Laurence; Bae, Sang-Cheol; Hanly, John G; Nived, Ola; Sturfelt, Gunnar; van Vollenhoven, Ronald; Wallace, Daniel J; Alarcón, Graciela S; Adu, Dwomoa; Avila-Casado, Carmen; Bernatsky, Sasha R; Bruce, Ian N; Clarke, Ann E; Contreras, Gabriel; Fine, Derek M; Gladman, Dafna D; Gordon, Caroline; Kalunian, Kenneth C; Madaio, Michael P; Rovin, Brad H; Sanchez-Guerrero, Jorge; Steinsson, Kristjan; Aranow, Cynthia; Balow, James E; Buyon, Jill P; Ginzler, Ellen M; Khamashta, Munther A; Urowitz, Murray B; Dooley, Mary Anne; Merrill, Joan T; Ramsey-Goldman, Rosalind; Font, Josef; Tumlin, James; Stoll, Thomas; Zoma, Asad
Citation:
Arthritis Rheum. 2008, 58(6):1789-95
Issue Date:
1-Jun-2008
Abstract:
OBJECTIVE: To assess the degree to which physicians agree with each other and with ratings obtained with 3 existing responder indices, in rating the response to treatment of lupus nephritis. METHODS: Lupus nephritis patient medical records from 125 pairs of visits (6 months apart) were used to create renal response scenarios. Seven nephrologists and 22 rheumatologists rated each scenario as demonstrating complete response, partial response, same, or worsening. The plurality (most frequent) rating of renal response by the physicians was compared with the calculated score from the renal component of the British Isles Lupus Assessment Group (BILAG) index (original and updated [2004] version) and of the Responder Index for Lupus Erythematosus (RIFLE). The degree of agreement among the physicians was assessed by calculating intraclass correlation coefficients (ICCs). The degree of agreement between the plurality physician rating and ratings obtained with the established response indices was assessed using the kappa statistic. RESULTS: The ICC among all physicians was 0.64 (0.62 for nephrologists and 0.67 for rheumatologists). The chance-adjusted measure of agreement (kappa coefficient) between the plurality physician rating and the calculated score obtained using established indexes was 0.50 (95% confidence interval [95% CI] 0.38-0.61) for the RIFLE, 0.14 (95% CI 0.03-0.25) for the original BILAG, and 0.23 (95% CI 0.21-0.44) for the BILAG 2004. CONCLUSION: These findings indicate that rheumatologists as a group and nephrologists as a group have equal agreement in their rating of renal response. There was moderate agreement between plurality physician ratings and ratings obtained using the renal component of the RIFLE. Ratings of response using an index based on the original BILAG did not have good agreement with the plurality physician rating.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://dx.doi.org/10.1002/art.23802

Full metadata record

DC FieldValue Language
dc.contributor.authorPetri, Michelle-
dc.contributor.authorKasitanon, Nuntana-
dc.contributor.authorSingh, Sukminder-
dc.contributor.authorLink, Kimberly-
dc.contributor.authorMagder, Laurence-
dc.contributor.authorBae, Sang-Cheol-
dc.contributor.authorHanly, John G-
dc.contributor.authorNived, Ola-
dc.contributor.authorSturfelt, Gunnar-
dc.contributor.authorvan Vollenhoven, Ronald-
dc.contributor.authorWallace, Daniel J-
dc.contributor.authorAlarcón, Graciela S-
dc.contributor.authorAdu, Dwomoa-
dc.contributor.authorAvila-Casado, Carmen-
dc.contributor.authorBernatsky, Sasha R-
dc.contributor.authorBruce, Ian N-
dc.contributor.authorClarke, Ann E-
dc.contributor.authorContreras, Gabriel-
dc.contributor.authorFine, Derek M-
dc.contributor.authorGladman, Dafna D-
dc.contributor.authorGordon, Caroline-
dc.contributor.authorKalunian, Kenneth C-
dc.contributor.authorMadaio, Michael P-
dc.contributor.authorRovin, Brad H-
dc.contributor.authorSanchez-Guerrero, Jorge-
dc.contributor.authorSteinsson, Kristjan-
dc.contributor.authorAranow, Cynthia-
dc.contributor.authorBalow, James E-
dc.contributor.authorBuyon, Jill P-
dc.contributor.authorGinzler, Ellen M-
dc.contributor.authorKhamashta, Munther A-
dc.contributor.authorUrowitz, Murray B-
dc.contributor.authorDooley, Mary Anne-
dc.contributor.authorMerrill, Joan T-
dc.contributor.authorRamsey-Goldman, Rosalind-
dc.contributor.authorFont, Josef-
dc.contributor.authorTumlin, James-
dc.contributor.authorStoll, Thomas-
dc.contributor.authorZoma, Asad-
dc.date.accessioned2009-05-04T09:44:08Z-
dc.date.available2009-05-04T09:44:08Z-
dc.date.issued2008-06-01-
dc.date.submitted2009-05-04-
dc.identifier.citationArthritis Rheum. 2008, 58(6):1789-95en
dc.identifier.issn0004-3591-
dc.identifier.pmid18512814-
dc.identifier.doi10.1002/art.23802-
dc.identifier.urihttp://hdl.handle.net/2336/66933-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: To assess the degree to which physicians agree with each other and with ratings obtained with 3 existing responder indices, in rating the response to treatment of lupus nephritis. METHODS: Lupus nephritis patient medical records from 125 pairs of visits (6 months apart) were used to create renal response scenarios. Seven nephrologists and 22 rheumatologists rated each scenario as demonstrating complete response, partial response, same, or worsening. The plurality (most frequent) rating of renal response by the physicians was compared with the calculated score from the renal component of the British Isles Lupus Assessment Group (BILAG) index (original and updated [2004] version) and of the Responder Index for Lupus Erythematosus (RIFLE). The degree of agreement among the physicians was assessed by calculating intraclass correlation coefficients (ICCs). The degree of agreement between the plurality physician rating and ratings obtained with the established response indices was assessed using the kappa statistic. RESULTS: The ICC among all physicians was 0.64 (0.62 for nephrologists and 0.67 for rheumatologists). The chance-adjusted measure of agreement (kappa coefficient) between the plurality physician rating and the calculated score obtained using established indexes was 0.50 (95% confidence interval [95% CI] 0.38-0.61) for the RIFLE, 0.14 (95% CI 0.03-0.25) for the original BILAG, and 0.23 (95% CI 0.21-0.44) for the BILAG 2004. CONCLUSION: These findings indicate that rheumatologists as a group and nephrologists as a group have equal agreement in their rating of renal response. There was moderate agreement between plurality physician ratings and ratings obtained using the renal component of the RIFLE. Ratings of response using an index based on the original BILAG did not have good agreement with the plurality physician rating.en
dc.language.isoenen
dc.publisherWiley-Liss, Inc.en
dc.relation.urlhttp://dx.doi.org/10.1002/art.23802en
dc.subject.meshHumansen
dc.titleSystemic lupus international collaborating clinics renal activity/response exercise: comparison of agreement in rating renal responseen
dc.typeArticleen
dc.contributor.departmentDepartment of Rheumatology, Johns Hopkins University, Baltimore, Maryland 21205, USA. mpetri@jhmi.eduen
dc.identifier.journalArthritis and rheumatismen

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