Reporting of radiographic methods in randomized controlled trials assessing structural outcomes in rheumatoid arthritis

Gabriel Baron ^1*, Isabelle Boutron ¹, Bruno Giraudeau ² and Philippe Ravaud ¹

¹ Departement d’Epidemiologie - Hopital Bichat, France
² Centre d'Investigation Clinique Tours, France

^* To whom correspondence should be addressed. E-mail: gabriel.baron{at}bch.aphp.fr.

Accepted 2 December 2006

Abstract

Objective: Because an increasing number of clinical trials evaluating disease modifying anti- rheumatic drugs in rheumatoid arthritis (RA) emphasize radiographic outcomes as a primary outcome, using a reproducible radiographic measure should be placed at a premium. We aimed to evaluate the reporting of radiographic methods in randomized trials assessing radiographic outcomes in RA.

Methods: We searched MEDLINE for randomized controlled trials assessing radiographic outcomes published between January 1994 and December 2005 in general medical and specialty journals with a high impact factor. One reader extracted data (radiographic acquisition, assessment and reproducibility) using a standardized form.

Results: A total of 46 reports were included in the analysis. The mean (SD) methodological quality scores on the Jadad scale (range 0-5) and the Delphi list (0-9) were 2.9 (1.2) and 6.4 (1.3), respectively. Use of a standardized procedure for the acquisition of the radiographs was reported in 2 articles (4.3%). Two reports (4.3%) indicated that the quality of the radiographs was evaluated. In 65.2% of the reports, 2 or more radiographic scores were used. Reporting of radiographic assessment was well detailed for number of readers (91.3%), information on readers (71.7%), blinding (91.4%) and how films were viewed (74.0%). The reproducibility of the reading was reported in 39.1% of the articles.

Conclusion: Our results highlight that the reporting of results of randomized controlled trials of radiographic outcomes in RA shows great variability in radiographic scores used and that reporting of radiographic methods could be improved upon, especially the acquisition procedure and the reproducibility of the reading.

Keywords: radiographic acquisition, radiographic assessment, randomized controlled trials, reproducibility, rheumatoid arthritis

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