Elsevier

Academic Radiology

Volume 16, Issue 6, June 2009, Pages 739-757
Academic Radiology

Review article
Juvenile Idiopathic Arthritis of Peripheral Joints: Quality of Reporting of Diagnostic Accuracy of Conventional MRI1

https://doi.org/10.1016/j.acra.2009.01.012Get rights and content

Rationale and Objectives

The aim of this study was to systematically review the quality of papers on the clinimetric properties of magnetic resonance imaging for the diagnosis of juvenile idiopathic arthritis in peripheral joints.

Materials and Methods

A review of Medline, EMBASE, the Database of Abstracts of Reviews of Effects, and the Cochrane Library was performed by using a systematic search strategy. Two independent reviewers evaluated selected articles by using Standards for Reporting of Diagnostic Accuracy (STARD) and Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tools. Items were reported independently for STARD and QUADAS.

Results

Eighteen studies (validity, n = 18; reliability, n = 3; responsiveness, n = 3) were included. Their overall quality of reporting of methods was fair. Methodological problems with the STARD system included a lack of reporting of exclusion criteria (n = 14), partial or no information on operators' expertise (n = 14) or blinding (n = 18), and deficient information on study time frames (n = 12), treatments (n = 10), or indeterminate results (n = 18). The distribution of QUADAS scores was heterogeneous, with overall scores ranging between 3.5 (poor) and 16.5 (excellent) (maximum score, 17.5).

Conclusions

The quality of reporting of methods in studies on the magnetic resonance imaging assessment of juvenile idiopathic arthritis is heterogeneous and fair overall. Further methodological refinement of research design should be sought in future studies to provide stronger evidence for the value of novel techniques in clinical settings.

Section snippets

Data Sources and Search

An electronic search of the literature was performed by three investigators (E.M., E.U., A.S.D.), who identified studies in which the authors reported the diagnostic accuracy of MRI for the assessment of JIA. Medline (January 1966 to June 2008), EMBASE (January 1980 to June 2008), the Database of Abstracts of Reviews of Effects of the National Health Service Center for Reviews and Dissemination, and the Cochrane Library were searched through OVID using a validated search strategy (8) that

Search and Selection

We retrieved 1,782 citations; 18 studies were found to be eligible for this systematic review (Fig 1). Reasons for the exclusion of papers included a lack of information on conversion criteria for MRI 15, 16, pictorial essays 17, 18, review articles (5), a lack of correlation with MRI 19, 20, and axially located joint disease 21, 22, 23, 24. Table 1 shows the demographic characteristic of patients and MRI clinimetric properties of the selected articles. Details on methodologic design according

Discussion

The results of this review indicate that diagnostic test standards were fairly fulfilled in studies of the validity, reliability, and responsiveness of MRI in JIA.

Ideally, more clarity in the description of research designs is desirable in upcoming studies. Suggestions to improve the methodologic report of studies include the use of the medical subject terms “sensitivity,” “specificity,” or “positive [or negative] likelihood [or predictive value]” and the use of ROC curves as a measure of

Glossary

QUADAS (Quality Assessment of Diagnostic Accuracy Studies)(12): A scoring system developed in an attempt to produce standards for reporting evaluations of diagnostic tests (55).

Reliability: Obtaining the same result when a phenomenon is measured by the same clinician or by different clinicians on the same occasion or on different occasions (56).

Responsiveness: The ability of a scale to detect change in outcomes when change is present (sensitivity to change) 57, 58.

STARD (Standards for Reporting

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