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Research ArticleSystemic Sclerosis

Evaluation of Nailfold Capillaroscopy Online Training Using the Fast Track Algorithm

Sue-Ann Ng, Wen Hao Tan, Seyed Ehsan Saffari and Andrea H.L. Low
The Journal of Rheumatology March 2023, 50 (3) 368-372; DOI: https://doi.org/10.3899/jrheum.220794
Sue-Ann Ng
1S.A. Ng, MBBS, MCI, Department of Rheumatology and Immunology, Singapore General Hospital, and Duke-NUS Medical School, National University of Singapore;
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  • ORCID record for Sue-Ann Ng
  • For correspondence: sue.ann.ng.p.l@singhealth.com.sg
Wen Hao Tan
2W.H. Tan, MBBCh BAO, Department of Rheumatology and Immunology, Singapore General Hospital;
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Seyed Ehsan Saffari
3S.E. Saffari, PhD, Duke-NUS Medical School, National University of Singapore;
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Andrea H.L. Low
4A.H.L. Low, BMBS, FAMS (Rheum), MCI, Department of Rheumatology and Immunology, Singapore General Hospital, and Duke-NUS Medical School, National University of Singapore, Singapore.
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Abstract

Objective Nailfold capillaroscopy (NFC) is increasingly used in the early identification of systemic sclerosis (SSc)-related disorders. A consensus “Fast Track algorithm” was developed by the European Alliance of Associations for Rheumatology to aid differentiation of scleroderma from nonscleroderma pattern on NFC. Our objective was to evaluate the online training of NFC using the Fast Track algorithm in the assessment of scleroderma vs nonscleroderma NFC pattern.

Methods Participants attended the NFC online training workshop and were taught the Fast Track algorithm. Following the training, participants independently evaluated 45 NFC images in the same session, and then 2 to 4 weeks later, through the online platform. Participants had to differentiate between scleroderma vs nonscleroderma pattern, and additionally nonscleroderma pattern (normal) vs nonscleroderma pattern (nonspecific). The inter- and intrarater Cohen Embedded Image agreement was calculated.

Results Ninety-eight participants took part in the baseline evaluation, and 61 in the reevaluation session. For identification of scleroderma vs nonscleroderma pattern, the mean (95% CI) inter- and intrarater Embedded Image were 0.86 (0.83-0.88) and 0.83 (0.79-0.87), respectively. The overall inter- and intrarater Embedded Image in the identification of scleroderma, nonscleroderma (normal), and nonscleroderma (nonspecific) patterns were 0.71 (0.69-0.74) and 0.71 (0.67-0.75), respectively. For nonscleroderma (normal) vs nonscleroderma (nonspecific) pattern, the inter- and intrarater Embedded Image were 0.59 (0.55-0.63) and 0.59 (0.54-0.65), respectively.

Conclusion In this first study evaluating NFC online training using the Fast Track algorithm, we showed very good inter- and intrarater agreement for the identification of scleroderma and nonscleroderma NFC pattern, supporting the feasibility of online NFC standardized training workshops.

Key Indexing Terms:
  • education
  • nailfold capillaroscopy
  • Raynaud phenomenon
  • scleroderma
  • systemic sclerosis
  • Accepted for publication October 21, 2022.
  • Copyright © 2023 by the Journal of Rheumatology
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The Journal of Rheumatology
Vol. 50, Issue 3
1 Mar 2023
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Evaluation of Nailfold Capillaroscopy Online Training Using the Fast Track Algorithm
Sue-Ann Ng, Wen Hao Tan, Seyed Ehsan Saffari, Andrea H.L. Low
The Journal of Rheumatology Mar 2023, 50 (3) 368-372; DOI: 10.3899/jrheum.220794

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Evaluation of Nailfold Capillaroscopy Online Training Using the Fast Track Algorithm
Sue-Ann Ng, Wen Hao Tan, Seyed Ehsan Saffari, Andrea H.L. Low
The Journal of Rheumatology Mar 2023, 50 (3) 368-372; DOI: 10.3899/jrheum.220794
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Keywords

EDUCATION
nailfold capillaroscopy
RAYNAUD PHENOMENON
SCLERODERMA
SYSTEMIC SCLEROSIS

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Keywords

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  • nailfold capillaroscopy
  • Raynaud phenomenon
  • scleroderma
  • systemic sclerosis

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