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Imaging
Viewpoint
Percentage of progressors in imaging: can we ignore regressors?
  1. Alexandre Sepriano1,2,
  2. Sofia Ramiro1,3,
  3. Robert Landewé3,4,
  4. Maxime Dougados5 and
  5. Desirée van der Heijde1
  1. 1 Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
  3. 3 Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands
  4. 4 Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands
  5. 5 Hopital Cochin, Rheumatology, Université Paris Descartes, Paris, France
  1. Correspondence to Dr Alexandre Sepriano; alexsepriano{at}gmail.com

Abstract

Stopping or preventing structural progression is a goal common to all inflammatory rheumatic diseases. Imaging may capture structural progression across diseases, but is susceptible to measurement error. Progression can be analysed as a continuous change score over time (eg, mean change of the van der Heijde-modified Sharp score) or as a binary change score (eg, percentage of progressors according to the modified New York criteria). Here, we argue that the former takes measurement error into account while the latter ignores it, which may lead to spurious conclusions. We will argue that assumptions underlying commonly used binary definitions of progression are false and we propose a method that incorporates (inevitable) measurement error.

  • axial spondyloarthritis
  • imaging
  • statistics
  • Rheumatoid Arthritis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/rmdopen-2018-000848

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    Footnotes

    • Contributors All authors gave substantial contributions to the conception of the paper as well as drafting the paper and revising it critically for important intellectual content.

    • Funding DESIR is financially supported by an unrestricted grant from Pfizer. AS is supported by a doctoral grant from ‘Fundação para a Ciência e Tecnologia’ (SFRH/BD/108246/2015).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.