Repeated teaching courses of the modified Rodnan skin score in systemic sclerosis

Abstract

Objectives: To evaluate the efficacy of a repeated teaching process of the modified Rodnan skin score (MRSS) in systemic sclerosis (SSc). The question is whether a repeated teaching course is required to maintain good results after a first, successful teaching process.

Methods: Two consecutive teaching courses were organised by two Romanian EUSTAR centres for the same rheumatologists, to evaluate and compare the inter-observer variability. Coefficients of variation, the intra-class correlation coefficients (ICC) and the within patient standard deviations were calculated.

Results: The ICC showed good agreement between 12 participants of both the first teaching course (0.639) and of the course seven months later (0.684).

Conclusions: For rheumatologists, a good ICC that is close to 0.7 can be achieved, and these results remain stable without the need for another, repeated teaching cycle. The high inter-rater variations seen in some patients demand that, in clinical studies, the same investigator should assess the same patient at each visit.