
Abstract Objectives EULAR supports the use of nailfold videocapillaroscopy (NVC) for identifying disease patterns (DPs) associated with SSc and RP. Recently, EULAR proposed an easy-to-manage procedure, a so-called Fast Track algorithm, for differentiating SSc patterns from non-SSc patterns in NVC specimens. However, subjectivity among capillaroscopists remains a limitation. Our aim was to perform a software-based analysis of NVC peculiarities in a cohort of samples from SSc and RP patients and, subsequently, build a Fast Track–inspired algorithm for identifying DPs without the constraint of interobserver variability. Methods NVCs were examined by 9 capillaroscopists. Those NVCs whose DPs were consensually agreed upon (by ≥2 out of 3 interobservers) were subsequently analysed using in-house–developed software. The results for each variable were grouped according to the consensually agreed-upon DPs in order to identify useful hallmarks for categorizing them. Results A total of 851 NVCs (21 957 images) whose DPs had been consensually agreed upon were software-analysed. Appropriate cut-offs set for capillary density and percentage of abnormal and giant capillaries, tortuosities and haemorrhages allowed DP categorization and the development of the CAPI-score algorithm. This consisted of four rules: Rule 1, SSc vs non-SSc, accuracy 0.88; Rules 2 and 3, SSc-early vs SSc-active vs SSc-late, accuracy 0.82; Rule 4, non-SSc normal vs non-SSc non-specific, accuracy 0.73. Accuracy improved when the analysis was limited to NVCs whose DPs had achieved full consensus between the interobservers. Conclusion The CAPI-score algorithm may become a tool that is useful in assigning DPs by overcoming the limitations of subjectivity.
Male, Adult, Programari, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::microscopía::microscopía intravital::angioscopia microscópica, Raynaud's Phenomenon, Video Recording, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Microscopy::Intravital Microscopy::Microscopic Angioscopy, Esclerosi sistemàtica progressiva - Imatgeria, Microscopic Angioscopy, CIENCIA DE LA INFORMACIÓN::Ciencias de la información::metodologías computacionales::soporte lógico (informática), ANATOMÍA::integumento común::uñas, 616, DISEASES::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Scleroderma, Systemic, Humans, Capil·laroscòpia, Aged, ANATOMÍA::sistema cardiovascular::vasos sanguíneos::microvasos::capilares, Observer Variation, Scleroderma, Systemic, Nailfold videocapillaroscopy, Capil·lars, Fast Track algorithm, Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen, Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging, INFORMATION SCIENCE::Information Science::Computing Methodologies::Software, Clinical Science, Middle Aged, Capillaries, ANATOMY::Cardiovascular System::Blood Vessels::Microvessels::Capillaries, Software-based algorithm, Nails, Ungles, ANATOMY::Integumentary System::Nails, Systemic sclerosis, Female, ENFERMEDADES::enfermedades de la piel y tejido conjuntivo::enfermedades del tejido conjuntivo::esclerodermia sistémica, Algorithms, Software, Quantitative
Male, Adult, Programari, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::microscopía::microscopía intravital::angioscopia microscópica, Raynaud's Phenomenon, Video Recording, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Microscopy::Intravital Microscopy::Microscopic Angioscopy, Esclerosi sistemàtica progressiva - Imatgeria, Microscopic Angioscopy, CIENCIA DE LA INFORMACIÓN::Ciencias de la información::metodologías computacionales::soporte lógico (informática), ANATOMÍA::integumento común::uñas, 616, DISEASES::Skin and Connective Tissue Diseases::Connective Tissue Diseases::Scleroderma, Systemic, Humans, Capil·laroscòpia, Aged, ANATOMÍA::sistema cardiovascular::vasos sanguíneos::microvasos::capilares, Observer Variation, Scleroderma, Systemic, Nailfold videocapillaroscopy, Capil·lars, Fast Track algorithm, Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen, Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging, INFORMATION SCIENCE::Information Science::Computing Methodologies::Software, Clinical Science, Middle Aged, Capillaries, ANATOMY::Cardiovascular System::Blood Vessels::Microvessels::Capillaries, Software-based algorithm, Nails, Ungles, ANATOMY::Integumentary System::Nails, Systemic sclerosis, Female, ENFERMEDADES::enfermedades de la piel y tejido conjuntivo::enfermedades del tejido conjuntivo::esclerodermia sistémica, Algorithms, Software, Quantitative
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