Evidence map›Paper›PMID 37061228›Full record

ArticleThe Journal of rheumatology2023

Consensus-Driven Definition for Unequivocal Sacroiliitis on Radiographs in Juvenile Spondyloarthritis.

Pamela F Weiss, Timothy G Brandon, Robert G Lambert, David M Biko, Nancy A Chauvin, Michael L Francavilla, Nele Herregods, Alison M Hendry, Walter P Maksymowych

Open access · bronzeAbstract read
In one paragraph

Article in The Journal of rheumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Radiographs in Pediatric Rheumatology: Where Do We Stand?The Indian journal of radiology & imaging · 2025
    Article
  5. Article
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 4 countries.

Pamela F WeissP.F. Weiss, MD, MSCE, Department of Pediatrics, Division of Rheumatology and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; weisspa@chop.edu.ORCID 0000-0002-9724-0443
Timothy G BrandonT.G. Brandon, MPH, Department of Pediatrics, Division of Rheumatology and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-1305-4871
Robert G LambertR.G. Lambert, MB BCh, Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0003-0305-3290
David M BikoD.M. Biko, MD, Department of Radiology, Children's Hospital of Philadelphia, and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Nancy A ChauvinN.A. Chauvin, MD, Department of Radiology, Penn State Health Milton S. Hershey Children's Hospital, Hershey, Pennsylvania, USA.
Michael L FrancavillaM.L. Francavilla, MD, Department of Radiology, Whiddon College of Medicine, University of South Alabama, Mobile, Alabama USA.ORCID 0000-0003-1347-7097
Nele HerregodsN. Herregods, MD, Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium.ORCID 0000-0003-0244-0168
Alison M HendryA.M. Hendry, PGDipHealMgt, PGDipHSc, General Medicine and Rheumatology, Division of Medicine, Emergency and Integrated Care, Counties Manukau District Health Board, Auckland, New Zealand.
Walter P MaksymowychW.P. Maksymowych, MD, Department of Medicine, University of Alberta and CARE Arthritis, Edmonton, Alberta, Canada.ORCID 0000-0002-1291-1755
Children's Hospital of Philadelphia · USUniversity of Alberta · CACounties Manukau District Health Board · NZGhent University Hospital · BEPenn State Milton S. Hershey Medical Center · USUniversity of South Alabama · US

Funding

Refining entry criteria and outcome measures for children with axial disease and spondyloarthritis: preparation for clinical trialsR01AR074098 · NIAMS · CHILDREN'S HOSP OF PHILADELPHIA · PI WEISS, PAMELA FITCH · 2019 to 2021
$678k
NIAMS NIH HHS R01 AR074098
6 · The paper itself

Abstract

objectiveRadiography is still used worldwide for the detection of sacroiliitis in juvenile spondyloarthritis (JSpA), despite its low sensitivity and reliability. We aimed to define unequivocal evidence of sacroiliitis on pelvic radiography in skeletally immature youth for use in classification criteria when magnetic resonance imaging (MRI) is unavailable.

methodsSubjects were a retrospective cohort of juvenile patients with spondyloarthritis with a radiograph and MRI as part of a diagnostic evaluation for axial disease. Six musculoskeletal imaging experts underwent an iterative consensus process to define unequivocal sacroiliitis on radiography in skeletally immature youth. Radiographs were graded using the modified New York (mNY) criteria and the unequivocal sacroiliitis criteria. Interrater agreement was assessed with the Fleiss [Formula: see text] statistic. Specificity, area under the receiver operator characteristic curve (AUROC), and sensitivity of the 2 measures were tested using 2 MRI reference standards.

resultsA total of 112 subjects, with a median age of 14.9 (range 6.7-20.1) years, were included. The Fleiss [Formula: see text] was fair for the mNY criteria (0.54, 95% CI 0.42-0.67) and the unequivocal sacroiliitis criteria (0.58, 95% CI 0.46-0.69). The unequivocal sacroiliitis criteria achieved > 90% specificity using both MRI reference standards. Sensitivity (59.26 and 57.14 vs 44.83 and 43.33) and AUROC (0.76 and 0.76 vs 0.71 and 0.71) were higher, for both reference standards, for the unequivocal sacroiliitis in youth definition than for the mNY criteria, respectively.

conclusionIn this study, we propose the first consensus-derived definition to our knowledge of unequivocal sacroiliitis by radiography in skeletally immature youth. This definition achieved excellent specificity and had higher AUROC and sensitivity values than the mNY criteria using both MRI reference standards. This definition has applicability to the JSpA axial disease classification imaging criterion when MRI is unavailable.

Indexed as

Arthritis, JuvenileSacroiliitisSpondylarthritisSpondylitis, AnkylosingAdolescentAdultChildConsensus Statements as TopicHumansMagnetic Resonance ImagingRadiographyReproducibility of ResultsRetrospective StudiesSacroiliac JointYoung Adultradiographysacroiliitisspondyloarthropathy

Identifiers

PMID37061228
PMCPMC10524560
OpenAlexW4365997790

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.