Impact of EUSTAR standardized training on accuracy of modified Rodnan skin score in patients with systemic sclerosis

Jun Won Park, Ga Young Ahn, Ji Won Kim, Eun Seong Park, Ji Hyoun Kang, Sung Hae Chang, In Ah Choi, Su Jin Yoo, Jin Kyun Park, Kichul Shin, Yong Beom Park, Jae-Bum Jun, László Czirják, Yannick Allanore, Marco Matucci-Cerinic, Eun Bong Lee

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Abstract

Objectives: To investigate the impact of European Scleroderma Trials and Research (EUSTAR) standardized training on the accuracy of modified Rodnan skin score (mRSS) in patients with systemic sclerosis (SSc). Methods: Eight SSc patients (four diffuse, four limited) and 10 physicians (4 fellows, 6 professors) were included. Gold-standard mRSS was performed by a senior instructor. Training comprised a video presentation and a live demonstration. Each physician performed mRSS with no clinical information in all patients: (a) before training; (b) after video session; and (c) after live demonstration. Primary outcome was the change in scoring accuracy, which was defined as the difference from the gold-standard skin score, as analyzed using a linear mixed model. Results: Mean (standard deviation) difference from the gold-standard score in all measurements by participants before the training was 7.7 (9.5). Completion of training significantly enhanced mRSS accuracy (adjusted β = −7.61; 95% CI: −11.91 to −3.32). This was largely attributable to the video presentation (adjusted β = −5.47; −9.16 to −1.78), although the live demonstration was associated with numerical reduction in the difference from the gold-standard score (adjusted β = −2.15; −5.84 to 1.55). Effect of training was prominent in fellows whereas professors showed an increase in the difference from gold-standard score after training (P value for interaction <0.001). The intraclass correlation coefficient for physician skin scores was acceptable. However, no significant change was observed after training. Conclusion: New EUSTAR standardized mRSS training significantly enhanced mRSS accuracy, especially in participant with less previous experience in skin scoring.

Original languageEnglish
Pages (from-to)96-102
Number of pages7
JournalInternational Journal of Rheumatic Diseases
Volume22
Issue number1
DOIs
StatePublished - 2019 Jan 1

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Systemic Scleroderma
Skin
Gold
Research
Physicians
Linear Models

Keywords

  • disease activity score
  • education
  • scleroderma
  • systemic sclerosis

Cite this

Park, Jun Won ; Ahn, Ga Young ; Kim, Ji Won ; Park, Eun Seong ; Kang, Ji Hyoun ; Chang, Sung Hae ; Choi, In Ah ; Yoo, Su Jin ; Park, Jin Kyun ; Shin, Kichul ; Park, Yong Beom ; Jun, Jae-Bum ; Czirják, László ; Allanore, Yannick ; Matucci-Cerinic, Marco ; Lee, Eun Bong. / Impact of EUSTAR standardized training on accuracy of modified Rodnan skin score in patients with systemic sclerosis. In: International Journal of Rheumatic Diseases. 2019 ; Vol. 22, No. 1. pp. 96-102.
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title = "Impact of EUSTAR standardized training on accuracy of modified Rodnan skin score in patients with systemic sclerosis",
abstract = "Objectives: To investigate the impact of European Scleroderma Trials and Research (EUSTAR) standardized training on the accuracy of modified Rodnan skin score (mRSS) in patients with systemic sclerosis (SSc). Methods: Eight SSc patients (four diffuse, four limited) and 10 physicians (4 fellows, 6 professors) were included. Gold-standard mRSS was performed by a senior instructor. Training comprised a video presentation and a live demonstration. Each physician performed mRSS with no clinical information in all patients: (a) before training; (b) after video session; and (c) after live demonstration. Primary outcome was the change in scoring accuracy, which was defined as the difference from the gold-standard skin score, as analyzed using a linear mixed model. Results: Mean (standard deviation) difference from the gold-standard score in all measurements by participants before the training was 7.7 (9.5). Completion of training significantly enhanced mRSS accuracy (adjusted β = −7.61; 95{\%} CI: −11.91 to −3.32). This was largely attributable to the video presentation (adjusted β = −5.47; −9.16 to −1.78), although the live demonstration was associated with numerical reduction in the difference from the gold-standard score (adjusted β = −2.15; −5.84 to 1.55). Effect of training was prominent in fellows whereas professors showed an increase in the difference from gold-standard score after training (P value for interaction <0.001). The intraclass correlation coefficient for physician skin scores was acceptable. However, no significant change was observed after training. Conclusion: New EUSTAR standardized mRSS training significantly enhanced mRSS accuracy, especially in participant with less previous experience in skin scoring.",
keywords = "disease activity score, education, scleroderma, systemic sclerosis",
author = "Park, {Jun Won} and Ahn, {Ga Young} and Kim, {Ji Won} and Park, {Eun Seong} and Kang, {Ji Hyoun} and Chang, {Sung Hae} and Choi, {In Ah} and Yoo, {Su Jin} and Park, {Jin Kyun} and Kichul Shin and Park, {Yong Beom} and Jae-Bum Jun and L{\'a}szl{\'o} Czirj{\'a}k and Yannick Allanore and Marco Matucci-Cerinic and Lee, {Eun Bong}",
year = "2019",
month = "1",
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doi = "10.1111/1756-185X.13433",
language = "English",
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Park, JW, Ahn, GY, Kim, JW, Park, ES, Kang, JH, Chang, SH, Choi, IA, Yoo, SJ, Park, JK, Shin, K, Park, YB, Jun, J-B, Czirják, L, Allanore, Y, Matucci-Cerinic, M & Lee, EB 2019, 'Impact of EUSTAR standardized training on accuracy of modified Rodnan skin score in patients with systemic sclerosis', International Journal of Rheumatic Diseases, vol. 22, no. 1, pp. 96-102. https://doi.org/10.1111/1756-185X.13433

Impact of EUSTAR standardized training on accuracy of modified Rodnan skin score in patients with systemic sclerosis. / Park, Jun Won; Ahn, Ga Young; Kim, Ji Won; Park, Eun Seong; Kang, Ji Hyoun; Chang, Sung Hae; Choi, In Ah; Yoo, Su Jin; Park, Jin Kyun; Shin, Kichul; Park, Yong Beom; Jun, Jae-Bum; Czirják, László; Allanore, Yannick; Matucci-Cerinic, Marco; Lee, Eun Bong.

In: International Journal of Rheumatic Diseases, Vol. 22, No. 1, 01.01.2019, p. 96-102.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Impact of EUSTAR standardized training on accuracy of modified Rodnan skin score in patients with systemic sclerosis

AU - Park, Jun Won

AU - Ahn, Ga Young

AU - Kim, Ji Won

AU - Park, Eun Seong

AU - Kang, Ji Hyoun

AU - Chang, Sung Hae

AU - Choi, In Ah

AU - Yoo, Su Jin

AU - Park, Jin Kyun

AU - Shin, Kichul

AU - Park, Yong Beom

AU - Jun, Jae-Bum

AU - Czirják, László

AU - Allanore, Yannick

AU - Matucci-Cerinic, Marco

AU - Lee, Eun Bong

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: To investigate the impact of European Scleroderma Trials and Research (EUSTAR) standardized training on the accuracy of modified Rodnan skin score (mRSS) in patients with systemic sclerosis (SSc). Methods: Eight SSc patients (four diffuse, four limited) and 10 physicians (4 fellows, 6 professors) were included. Gold-standard mRSS was performed by a senior instructor. Training comprised a video presentation and a live demonstration. Each physician performed mRSS with no clinical information in all patients: (a) before training; (b) after video session; and (c) after live demonstration. Primary outcome was the change in scoring accuracy, which was defined as the difference from the gold-standard skin score, as analyzed using a linear mixed model. Results: Mean (standard deviation) difference from the gold-standard score in all measurements by participants before the training was 7.7 (9.5). Completion of training significantly enhanced mRSS accuracy (adjusted β = −7.61; 95% CI: −11.91 to −3.32). This was largely attributable to the video presentation (adjusted β = −5.47; −9.16 to −1.78), although the live demonstration was associated with numerical reduction in the difference from the gold-standard score (adjusted β = −2.15; −5.84 to 1.55). Effect of training was prominent in fellows whereas professors showed an increase in the difference from gold-standard score after training (P value for interaction <0.001). The intraclass correlation coefficient for physician skin scores was acceptable. However, no significant change was observed after training. Conclusion: New EUSTAR standardized mRSS training significantly enhanced mRSS accuracy, especially in participant with less previous experience in skin scoring.

AB - Objectives: To investigate the impact of European Scleroderma Trials and Research (EUSTAR) standardized training on the accuracy of modified Rodnan skin score (mRSS) in patients with systemic sclerosis (SSc). Methods: Eight SSc patients (four diffuse, four limited) and 10 physicians (4 fellows, 6 professors) were included. Gold-standard mRSS was performed by a senior instructor. Training comprised a video presentation and a live demonstration. Each physician performed mRSS with no clinical information in all patients: (a) before training; (b) after video session; and (c) after live demonstration. Primary outcome was the change in scoring accuracy, which was defined as the difference from the gold-standard skin score, as analyzed using a linear mixed model. Results: Mean (standard deviation) difference from the gold-standard score in all measurements by participants before the training was 7.7 (9.5). Completion of training significantly enhanced mRSS accuracy (adjusted β = −7.61; 95% CI: −11.91 to −3.32). This was largely attributable to the video presentation (adjusted β = −5.47; −9.16 to −1.78), although the live demonstration was associated with numerical reduction in the difference from the gold-standard score (adjusted β = −2.15; −5.84 to 1.55). Effect of training was prominent in fellows whereas professors showed an increase in the difference from gold-standard score after training (P value for interaction <0.001). The intraclass correlation coefficient for physician skin scores was acceptable. However, no significant change was observed after training. Conclusion: New EUSTAR standardized mRSS training significantly enhanced mRSS accuracy, especially in participant with less previous experience in skin scoring.

KW - disease activity score

KW - education

KW - scleroderma

KW - systemic sclerosis

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U2 - 10.1111/1756-185X.13433

DO - 10.1111/1756-185X.13433

M3 - Article

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EP - 102

JO - International journal of rheumatic diseases

JF - International journal of rheumatic diseases

SN - 1756-1841

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