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Recommendation
EULAR recommendations for the reporting of ultrasound studies in rheumatic and musculoskeletal diseases (RMDs)
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  1. Félicie Costantino1,2,
  2. Loreto Carmona3,
  3. Maarten Boers4,
  4. Marina Backhaus5,
  5. Peter V Balint6,
  6. George A Bruyn7,8,
  7. Robin Christensen9,
  8. Philip G Conaghan10,
  9. Ricardo J O Ferreira11,12,
  10. Juan Luis Garrido-Castro13,
  11. Francis Guillemin14,
  12. Hilde Berner Hammer15,
  13. Désirée van der Heijde16,
  14. Annamaria Iagnocco17,
  15. Marion C Kortekaas16,
  16. Robert BM Landewé18,19,
  17. Peter Mandl20,
  18. Esperanza Naredo21,22,
  19. Wolfgang A Schmidt23,
  20. Lene Terslev24,
  21. Caroline B Terwee4,
  22. Ralf Thiele25,
  23. Maria-Antonietta D'Agostino1,2,26
  1. 1 UVSQ, Inserm U1173, Infection et inflammation, Laboratory of Excellence INFLAMEX, Université Paris-Saclay, Montigny-le-Bretonneux, France
  2. 2 Rheumatology Department, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, Île-de-France, France
  3. 3 Instituto de Salud Musculoesquelética (INMUSC), Madrid, Madrid, Spain
  4. 4 Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
  5. 5 Department of Internal Medicine—Rheumatology and Clinical Immunology, Park-Klinik Weissensee, Berlin, Berlin, Germany
  6. 6 3rd Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
  7. 7 Rheumatology Department, MC Group Hospitals, Lelystad, The Netherlands
  8. 8 Rheumatology Department, Reumakliniek Flevoland, Lelystad, The Netherlands
  9. 9 Department of Clinical Research, Odense University Hospital, Odense, Denmark
  10. 10 Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  11. 11 Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  12. 12 Health Sciences Research Unit: Nursing (UICiSA:E), Coimbra, Portugal
  13. 13 Spanish Federation of Spondyloarthritis Associations (CEADE), Madrid, Spain
  14. 14 Medecine, School of Public Health, Vandoeuvre, France
  15. 15 Rheumatology, Diakonhjemmet Sykehus, Oslo, Norway
  16. 16 Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  17. 17 Scienze Cliniche e Biologiche, Università degli Studi di Torino, Torino, Italy
  18. 18 Rheumatology Department, Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands
  19. 19 Rheumatology, Zuyderland MC, Heerlen, The Netherlands
  20. 20 Internal Medicine 3, Division of Rheumatology, Medical University Vienna, Vienna, Austria
  21. 21 Department of Rheumatology, Bone and Joint Research Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
  22. 22 IIS Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
  23. 23 Rheumatology Department, Medical Centre for Rheumatology Berlin Buch, Berlin, Germany
  24. 24 Center for Rheumatology and Spine Diseases, Rigshospitalet, Kobenhavn, Denmark
  25. 25 Department of Medicine, Division of Allergy, Immunology and Rheumatology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
  26. 26 Rheumatology Department, Università Cattolica del Sacro Cuore, Policlinico Universitario Agostino Gemelli IRCSS, Roma, Italy
  1. Correspondence to Professor Maria-Antonietta D'Agostino, Rheumatology Department, Università Cattolica del Sacro Cuore, Policlinico Universitario Agostino Gemelli IRCSS, 00187 Roma, Italy; mariaantonietta.dagostino{at}unicatt.it

Abstract

Objective To produce European League Against Rheumatism (EULAR) recommendations for the reporting of ultrasound studies in rheumatic and musculoskeletal diseases (RMDs).

Methods Based on the literature reviews and expert opinion (through Delphi surveys), a taskforce of 23 members (12 experts in ultrasound in RMDs, 9 in methodology and biostatistics together with a patient research partner and a health professional in rheumatology) developed a checklist of items to be reported in every RMD study using ultrasound. This checklist was further refined by involving a panel of 79 external experts (musculoskeletal imaging experts, methodologists, journal editors), who evaluated its comprehensibility, feasibility and comprehensiveness. Agreement on each proposed item was assessed with an 11-point Likert scale, grading from 0 (total disagreement) to 10 (full agreement).

Results Two face-to-face meetings, as well as two Delphi rounds of voting, resulted in a final checklist of 23 items, including a glossary of terminology. Twenty-one of these were considered ‘mandatory’ items to be reported in every study (such as blinding, development of scoring systems, definition of target pathologies) and 2 ‘optional’ to be reported only if applicable, such as possible confounding factors (ie, ambient conditions) or experience of the sonographers.

Conclusion An EULAR taskforce developed a checklist to ensure transparent and comprehensive reporting of aspects concerning research and procedures that need to be presented in studies using ultrasound in RMDs. This checklist, if widely adopted by authors and editors, will greatly improve the interpretability of study development and results, including the assessment of validity, generalisability and applicability.

  • ultrasonography
  • outcome and process assessment
  • healthcare
  • quality indicators

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/annrheumdis-2020-219816

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Handling editor Josef S Smolen

    • Twitter @carmona_loreto, @FerreiraRJO

    • MB, PVB, GAB, RC, PGC, RJOF, JLG-C, FG, HBH, DvdH, AI, MCK, RBL, PM, EN, WAS, LT, CBT and RT contributed equally.

    • Contributors Full-text review, data abstraction and Delphi assessments were performed by FC, supervised by MADA and independently double-checked by LC. MADA and LC supervised the methodology of the scoping literature review and FC prepared the evidence report. FC and MADA prepared the first draft of recommendations, and all authors participated in the discussion and formulation of recommendations. MADA supervised the project and FC, MADA, LC, MB and PGC drafted the manuscript. All authors reviewed the manuscript and approved its final version.

    • Funding This project was funded by the European League Against Rheumatism (EULAR). PGC is supported in part by the UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre. RC is supported by a core grant from the Oak Foundation (OCAY-18–774-OFIL).

    • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

    • Competing interests FC reports personal fees from Lilly and Novartis France. MB reports personal fees from Novartis, BMS and Pfizer. RC is a founding member of the Technical Advisory Group of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 12 companies. DvdH reports personal fees from AbbVie, Amgen, Astellas, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma and is Director of Imaging Rheumatology bv. AI reports grants from Abbvie, MSD, and Alfasigma and personal fees from AbbVie, Abiogen, Alfasigma, Biogen, BMS, Celgene, Eli-Lilly, Janssen, MSD, Novartis, Sanofi, Sanofi Genzyme. RBL reports personal fees from AbbVie, Galapagos, Gilead, Jansen, Eli-Lilly, Novartis, Pfizer, UCB. PM reports grants and personal fees from AbbVie, Novartis, Janssen, personal fees from Celgene, grants from Merck Sharp & Dohme, UCB, Roche. RT reports personal fees from Amgen, AbbVie, Novartis. MADA reports personal fees from Abbvie, BMS, Novartis, Celgene, Janssen and grants from Pfizer.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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