TY - JOUR
T1 - Systemic lupus international collaborating clinics renal activity/response exercise
T2 - Comparison of agreement in rating renal response
AU - Petri, Michelle
AU - Kasitanon, Nuntana
AU - Singh, Sukminder
AU - Link, Kimberly
AU - Magder, Laurence
AU - Bae, Sang Cheol
AU - Hanly, John G.
AU - Nived, Ola
AU - Sturfelt, Gunnar
AU - Van Vollenhoven, Ronald
AU - Wallace, Daniel J.
AU - Alarcón, Graciela S.
AU - Adu, Dwomoa
AU - Avila-Casado, Carmen
AU - Bernatsky, Sasha R.
AU - Bruce, Ian N.
AU - Clarke, Ann E.
AU - Contreras, Gabriel
AU - Fine, Derek M.
AU - Gladman, Dafna D.
AU - Gordon, Caroline
AU - Kalunian, Kenneth C.
AU - Madaio, Michael P.
AU - Rovin, Brad H.
AU - Sanchez-Guerrero, Jorge
AU - Steinsson, Kristjan
AU - Aranow, Cynthia
AU - Balow, James E.
AU - Buyon, Jill P.
AU - Ginzler, Ellen M.
AU - Khamashta, Munther A.
AU - Urowitz, Murray B.
AU - Dooley, Mary Anne
AU - Merrill, Joan T.
AU - Ramsey-Goldman, Rosalind
AU - Font, Josef
AU - Tumlin, James
AU - Stoll, Thomas
AU - Zoma, Asad
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/6
Y1 - 2008/6
N2 - 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.
AB - 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.
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U2 - 10.1002/art.23802
DO - 10.1002/art.23802
M3 - Article
C2 - 18512814
AN - SCOPUS:45349106761
VL - 58
SP - 1789
EP - 1795
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
SN - 2326-5191
IS - 6
ER -