Assessing the Reliability of the OMERACT Juvenile Idiopathic Arthritis Magnetic Resonance Scoring System for Temporomandibular Joints (JAMRIS-TMJ)

Mirkamal Tolend; Andrea S Doria; Arthur B Meyers; Tore A Larheim; Shelly Abramowicz; Julien Aguet; Simone Appenzeller; Linda Z Arvidsson; Lauren W Averill; Brian M Feldman; Saurabh Guleria; Emilio J Inarejos Clemente; Jacob L Jaremko; Thitiporn Junhasavasdikul; Thekla von Kalle; Eva Kirkhus; Bernd Koos; Elka Miller; Rahim Moineddin; Jyoti Panwar; Zachary S Peacock; Cory M Resnick; Marion A van Rossum; Jennifer Stimec; George Tomlinson; Nikolay Tzaribachev; Christian J Kellenberger

doi:10.3390/jcm10184047

Assessing the Reliability of the OMERACT Juvenile Idiopathic Arthritis Magnetic Resonance Scoring System for Temporomandibular Joints (JAMRIS-TMJ)

J Clin Med. 2021 Sep 7;10(18):4047. doi: 10.3390/jcm10184047.

Authors

Mirkamal Tolend¹, Andrea S Doria^{1

2}, Arthur B Meyers³, Tore A Larheim⁴, Shelly Abramowicz^{5

6}, Julien Aguet², Simone Appenzeller⁷, Linda Z Arvidsson⁴, Lauren W Averill⁸, Brian M Feldman^{1

9}, Saurabh Guleria¹⁰, Emilio J Inarejos Clemente¹¹, Jacob L Jaremko¹², Thitiporn Junhasavasdikul¹³, Thekla von Kalle¹⁴, Eva Kirkhus¹⁵, Bernd Koos¹⁶, Elka Miller¹⁷, Rahim Moineddin¹⁸, Jyoti Panwar¹⁹, Zachary S Peacock²⁰, Cory M Resnick²¹, Marion A van Rossum^{22

23}, Jennifer Stimec², George Tomlinson²⁴, Nikolay Tzaribachev²⁵, Christian J Kellenberger²⁶

Affiliations

¹ Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada.
² Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
³ Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
⁴ Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, 0317 Oslo, Norway.
⁵ Division of Oral and Maxillofacial Surgery, Departments of Surgery and Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.
⁶ Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.
⁷ Department of Orthopedics, Rheumatology and Traumatology, School of Medical Science, University of Campinas, Campinas 13083-970, Brazil.
⁸ Department of Medical Imaging, Nemours Children's Health System, Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA.
⁹ Division of Rheumatology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
¹⁰ Austin Radiological Association, Austin, TX 78731, USA.
¹¹ Department of Diagnostic Imaging, Hospital Sant Joan de Deu, 08950 Barcelona, Spain.
¹² Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, AB T6G 2B7, Canada.
¹³ Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
¹⁴ Department of Pediatric Radiology, Radiologisches Institut, Olgahospital Klinikum Stuttgart, 70174 Stuttgart, Germany.
¹⁵ Department of Radiology, Oslo University Hospital, 0424 Oslo, Norway.
¹⁶ Department of Orthodontics, University Hospital Tübingen, 72076 Tübingen, Germany.
¹⁷ Department of Medical Imaging, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1, Canada.
¹⁸ Department of Family & Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada.
¹⁹ Department of Radiology, Christian Medical College and Hospital, Vellore 632004, Tamil Nadu, India.
²⁰ Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
²¹ Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA 02115, USA.
²² Department of Pediatrics, Emma Children's Hospital, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands.
²³ Amsterdam Rheumatology and Immunology Center, Reade, 1007 MB Amsterdam, The Netherlands.
²⁴ Department of Medicine, University Health Network, Toronto, ON M5G 2C4, Canada.
²⁵ Pediatric Rheumatology Research Institute, 24576 Bad Bramstedt, Germany.
²⁶ Department of Diagnostic Imaging, University Children's Hospital Zürich, 8032 Zürich, Switzerland.

Abstract

Contrast-enhanced magnetic resonance imaging (MRI) remains the most comprehensive modality to assess juvenile idiopathic arthritis (JIA)-related inflammation and osteochondral damage in the temporomandibular joints (TMJ). This study tested the reliability of a new JIA MRI scoring system for TMJ (JAMRIS-TMJ) and the impact of variations in calibration and reader specialty. Thirty-one MRI exams of bilateral TMJs were scored independently using the JAMRIS-TMJ by 20 readers consisting of radiologists and non-radiologist clinicians in three reading groups, with or without a calibrating atlas and/or tutorial. The inter-reader reliability in the multidisciplinary cohort assessed by the generalizability coefficient was 0.61-0.67 for the inflammatory and 0.66-0.74 for the damage domain. The atlas and tutorial did not improve agreement within radiologists, but improved the agreement between radiologist and non-radiologist groups. Agreements between different calibration levels were 0.02 to 0.08 lower by the generalizability coefficient compared to agreement within calibration levels; agreement between specialty groups was 0.04 to 0.10 lower than within specialty groups. Averaging two radiologists raised the reliability above 0.8 for both domains. Therefore, the reliability of JAMRIS-TMJ was moderate-to-good depending on the presence of specialty and calibration differences. The atlas and tutorial are necessary to improve reliability when the reader cohort consists of multiple specialties.

Keywords: generalizability theory; juvenile idiopathic arthritis; magnetic resonance imaging; outcome measure; reliability; temporomandibular joints.