RT Journal Article
SR Electronic
T1 AB0644 RESULTS OF A TRAINING COURSE FOR CALCULATION OF THE MODIFIED RODNAN SKIN SCORE IN SCLERODERMA
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1783
OP 1784
DO 10.1136/annrheumdis-2019-eular.6609
VO 78
IS Suppl 2
A1 Can, Gerçek
A1 Avşar, Aydan Köken
A1 Kocaer, Sinem Burcu
A1 Kenar, Gökçe
A1 Solmaz, Dilek
A1 Yarkan-Tuğsal, Handan
A1 Karadağ, Duygu Temiz
A1 Gökçen, Neslihan
A1 Yolbaş, Servet
A1 Babaoglu, Hakan
A1 Yıldırım, Alper
A1 Yayla, Müçteba Enes
A1 Okatan, İlyas Ercan
A1 Sarı, Alper
A1 Taş, Didem arslan
A1 Onen, Fatos
A1 Koca, Süleyman Serdar
A1 Akdoğan, Ali
A1 Birlik, Merih
YR 2019
UL http://ard.bmj.com/content/78/Suppl_2/1783.2.abstract
AB Background: Scleroderma is a connective tissue disease that is characterized by fibrosis of the skin.The modified Rodnan Skin Score (mRSS) is a measure generally used to assess the skin thickness in patients with scleroderma.Data on the effectiveness of the mRSS training courses differ in the literature.Objectives: The objective of our study was to evaluate the effectiveness of the mRSS training course in rheumatology fellows in the rheumatology departments.Methods: The study included 6 fellows from the departments of rheumatology.Participants were given a 1-hour-long theoretical training, including dermal involvement, and mRSS assessment by 3 rheumatology experts experienced in scleroderma, which was followed by an applied training on 4 patients for one-hour.Participants scored two patients before and after training on a form, which included 17 domains with a total score-range between “0” and “51”. Then using the SPSS15 software program, inter-rater reliability was assessed with intraclass correlation(ICC) analysis for both pre- and post-training mRSS.Fleiss’ kappa was used to measure the degree of agreement according to 12 Rodnan score areas before and after the training.Results: The ICC value for pre-training and post-training total Rodnan scores was 0.867 (95% CI-0.625-1.00, P=0.05), and 0.905(95% CI 0.045-1.00, P=0.02), respectively. Individual analysis of score areas showed that after the training there was an increase in degree of agreement in some of these areas, while there was no difference in one area, and it decreased in others (Table 1).Conclusion: Several studies have demonstrated the applicability, reliability, and validity of mRSS, a measure of dermal involvement, and that evaluation of the score requires experience, and an attentive learning process.In the literature, the inter-rater ICC values during previous training courses are reported to range between 0.378 and 0.92(1). These studies show differences in terms of the number and experience of participants, number of patients, course-length, and repeated courses. Similar to the observation by Ionescu et al(2), the pre-training inter-observer ICC value was very high(0.867), and it increased to 0.905 after the training. Presence of an increase in some areas, and reduction in some others in individual analysis of areas after the training may suggests the need for repeated training. Our limitations were low number of participants and patients. We obtained very good inter-rater ICC values in the mRSS training course given to rheumatology fellows; however we may benefit from new studies for optimization of these conclusions by increasing the numbers of trainees, patients, and the lenght of courses.References [1] Czirjak, L., et al., the EUSTAR model for teaching and implementing the modified Rodnan skin score in systemic sclerosis. Ann Rheum Dis, 2007.[2] Ionescu, R., et al., Repeated teaching courses of the modified Rodnan skin score in systemic sclerosis. Clin Exp Rheumatol, 2010.Disclosure of interests: None declared