Risk of Alzheimer's disease and duration of NSAID use

TLDR

The study aimed to assess whether a standardized training program with equipment adjustment improves the reliability of vascular ultrasound for diagnosing giant cell arteritis among experienced musculoskeletal ultrasonographers. In a prospective, non‑interventional cohort, suspected GCA patients were examined by five experienced rheumatologists trained with the program, and images were subsequently reviewed by a blinded external expert. Among 112 suspected GCA patients, 66 showed vasculitis (45 cranial only, 14 both cranial and large vessel, 7 isolated large vessel), and the training program yielded excellent inter‑observer agreement (95–96% agreement, kappa 0.88–0.92) for overall diagnosis and 0.86–1.00 for individual arteries, indicating its potential for clinical implementation.

Abstract

<h3>Objective</h3> To evaluate the impact of a standardised training programme including equipment adjustment for experienced musculoskeletal ultrasonographers without previous experience in vascular ultrasound (US) on the reliability of US in the diagnosis of giant cell arteritis (GCA). <h3>Methods</h3> In this prospective, non-interventional observational cohort study, patients suspected of GCA were evaluated by US by one of five rheumatologists with long-standing experience in musculoskeletal US (&gt;8&nbsp;years), trained using a standardised training programme including equipment adjustment. Images of cranial and large vessels were subsequently evaluated first by the performing ultrasonographer and thereafter by a blinded external expert (gold standard). <h3>Results</h3> In three Danish centres, 112 patients suspected of GCA were included. According to the external expert, vasculitis changes were seen in 66 patients, in 45 of them with only cranial involvement, in 14 with both cranial and large vessel involvement, while in seven patients isolated large vessel vasculitis was found. The reliability was excellent between the local ultrasonographer and the US expert for the overall GCA diagnosis regarding the diagnosis of cranial and for large vessel GCA, with an interobserver agreement of 95–96%, mean kappa values of 0.88–0.92 (95% CI 0.78 to 0.99). Excellent reliability (mean kappa 0.86–1.00) was also found for the US examination of the individual arteries (temporal, facial, common carotid and axillary). <h3>Conclusion</h3> The US training programme resulted in excellent agreement between trainees and an expert in patients suspected of GCA and may thus be applicable for implementation of vascular US in clinical practice.