GLORIA

GEOMAR Library Ocean Research Information Access

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 81, No. 2 ( 2022-02), p. 237-242
    Abstract: To assess the diagnostic accuracy of radiography (X-ray, XR), CT and MRI of the sacroiliac joints for diagnosis of axial spondyloarthritis (axSpA). Methods 163 patients (89 with axSpA; 74 with degenerative conditions) underwent XR, CT and MR. Three blinded experts categorised the imaging findings into axSpA, other diseases or normal in five separate reading rounds (XR, CT, MR, XR +MR, CT +MR). The clinical diagnosis served as reference standard. Sensitivity and specificity for axSpA and inter-rater reliability were compared. Results XR showed lower sensitivity (66.3%) than MR (82.0%) and CT (76.4%) and also an inferior specificity of 67.6% vs 86.5% (MR) and 97.3% (CT). XR +MR was similar to MR alone (sensitivity 77.5 %/specificity 87.8%) while CT+MR was superior (75.3 %/97.3%). CT had the best inter-rater reliability (kappa=0.875), followed by MR (0.665) and XR (0.517). XR +MR was similar (0.662) and CT+MR (0.732) superior to MR alone. Conclusions XR had inferior diagnostic accuracy and inter-rater reliability compared with cross-sectional imaging. MR alone was similar in diagnostic performance to XR+MR. CT had the best accuracy, strengthening the importance of structural lesions for the differential diagnosis in axSpA.
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    RVK:
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 2
    In: BMJ Open, BMJ, Vol. 10, No. 2 ( 2020-02), p. e030088-
    Abstract: Q fever is a zoonosis caused by the bacterium Coxiella burnetii . It is recognised as an occupational hazard for individuals who are in regular contact with animal birth products. Data from the literature are not comparable because different serological assays perform very differently in detecting past infections. It is therefore essential to choose the right assay for obtaining reliable data of seroprevalence. Obstetricians are another profession potentially at risk of Q fever. They can be infected from birth products of women with Q fever during pregnancy. There is little data, however, for Q fever in this occupational group. Our study therefore had two purposes. The first was to obtain reliable seroprevalence data for occupational groups in regular contact with animal birth products by using an assay with proven excellent sensitivity and specificity for detecting past infections. The second purpose was to obtain primary data for obstetricians. Design We carried out a cross-sectional study. Setting The study included shepherds, cattle farmers, veterinarians and obstetricians from Thuringia. Participants 77 shepherds, 74 veterinarians, 14 cattle farmers, 17 office employees and 68 obstetricians participated. The control group consisted of 92 blood donors. Primary outcome measure The primary outcome measure was C. burnetii phase II specific IgG. The assay used was evaluated for this purpose in a previous study. Results Of the 250 blood samples we analysed, the very highest seroprevalences (64%–77%) occurred in individuals with frequent animal contact. There were no significant differences between shepherds, cattle farmers and veterinarians. The seroprevalence in people working in administration was lower but still significantly greater than the control. No obstetricians or midwives tested positive. Conclusions Shepherds, cattle farmers and veterinarians have a high risk of C. burnetii infection. However, our study clearly proves that there was no increased risk for people working in an obstetric department.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    In: RMD Open, BMJ, Vol. 8, No. 1 ( 2022-01), p. e001939-
    Abstract: To propose a data-driven definition for structural changes of sacroiliac (SI) joints in the context of axial spondyloarthritis (axSpA) imaging on a large collective of CT datasets. Methods 546 individuals (102 axSpA, 80 non-axSpA low back pain and 364 controls without back pain) with SI joint CTs were evaluated for erosions, sclerosis and ankylosis using a structured scoring system. Lesion frequencies and spatial distribution were compared between groups. Diagnostic performance (sensitivity (SE), specificity (SP), positive predictive values, negative predictive values and positive and negative likelihood ratios) was calculated for different combinations of imaging findings. Clinical diagnosis served as standard of reference. Results Ankylosis and/or erosions of the middle and dorsal joint portions yielded the best diagnostic performance with SE 67.6% and SP 96.3%. Inclusion of ventral erosions and sclerosis resulted in lower diagnostic performance with SE 71.2%/SP 92.5% and SE 70.6%/SP 90.0%, respectively. Conclusions Sclerosis and ventrally located erosions of SI joints have lower specificity on CT of the SI joint in the context of axSpA imaging. Ankylosis and/or erosions of the middle and dorsal joint portions show a strong diagnostic performance and are appropriate markers of a positive SI joint by CT.
    Type of Medium: Online Resource
    ISSN: 2056-5933
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2812592-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 4
    In: RMD Open, BMJ, Vol. 10, No. 1 ( 2024-03), p. e003944-
    Abstract: Reliable interpretation of imaging findings is essential for the diagnosis of axial spondyloarthritis (axSpA) and requires a high level of experience. We investigated experience-dependent differences in diagnostic accuracies using X-ray (XR), MRI and CT. Methods This post hoc analysis included 163 subjects with low back pain. Eighty-nine patients had axSpA, and 74 patients had other conditions (mechanical, degenerative or non-specific low back pain). Final diagnoses were established by an experienced rheumatologist before the reading sessions. Nine blinded readers (divided into three groups with different levels of experience) scored the XR, CT and MRI of the sacroiliac joints for the presence versus absence of axSpA. Parameters for diagnostic performance were calculated using contingency tables. Differences in diagnostic performance between the reader groups were assessed using the McNemar test. Inter-rater reliability was assessed using Fleiss kappa. Results Diagnostic performance was highest for the most experienced reader group, except for XR. In the inexperienced and semi-experienced group, diagnostic performance was highest for CT & MRI (78.5% and 85.3%, respectively). In the experienced group, MRI showed the highest performance (85.9%). The greatest difference in diagnostic performance was found for MRI between the inexperienced and experienced group (76.1% vs 85.9%, p=0.001). Inter-rater agreement was best for CT in the experienced group with κ=0.87. Conclusion Differences exist in the learnability of the imaging modalities for axSpA diagnosis. MRI requires more experience, while CT is more suitable for inexperienced radiologists. However, diagnosis relies on both clinical and imaging information.
    Type of Medium: Online Resource
    ISSN: 2056-5933
    Language: English
    Publisher: BMJ
    Publication Date: 2024
    detail.hit.zdb_id: 2812592-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...