Objective To compare the reliability, sensitivity to change and feasibility of three radiographic scoring methods for hand osteoarthritis (OA).
Methods Baseline, 2-year and 6-year hand radiographs of 90 patients with hand OA were read in triplicate in chronological order by three readers from different European centres using the OARSI atlas (OARSI), Kellgren–Lawrence grading scale (KL) and Verbruggen–Veys anatomical phase score (VV). Reliability was determined using intraclass correlation coefficients and smallest detectable change (SDC). Sensitivity to change was assessed by the proportion of progression above the SDC. Feasibility was reflected by the mean performance time.
Results Intra- and inter-reader reliability was similar across methods. Inter-reader SDCs (% maximum score) for KL, OARSI and VV were 2.9 (3.2), 4.1 (2.9) and 2.7 (1.8) over 2 years and 3.8 (4.1), 4.6 (3.3) and 4.0 (2.5) over 6 years, respectively. KL detected a slightly higher proportion of progression. There were differences between readers, despite methods to enhance consistency. The mean performance time (SD, minutes) for KL, OARSI and VV was 4.3 (2.5), 9.3 (6.0) and 2.8 (1.5), respectively.
Conclusion Methods had comparable reliability and sensitivity to change. Global methods were fastest to perform. For multicentre trials use of a central reading centre and multiple readers may minimise inter-reader variation.
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Handling editor Johannes WJ Bijlsma
Funding The GARP study was financially supported by the Dutch Arthritis Association and Pfizer (Groton, Connecticut, USA).
Ethics approval This study was conducted with the approval of the Leiden University Medical Center.
Competing interests Hans Bijlsma was the handling editor for this article.
Provenance and peer review Not commissioned; externally peer reviewed.