{
  "abstract": "Objective To evaluate the inter-rater and intrarater reliability of consensus-based definitions of elementary ultrasound lesions in Takayasu arteritis (TAK) in live patient-based reliability exercises.Methods Two live exercises with two rounds each were conducted, each involving 12 vascular sonographers who independently examined five patients with TAK and one control subject. Bilateral common carotid, subclavian and axillary arteries and the abdominal aorta were investigated to identify key elementary ultrasound lesions in TAK: ‘macaroni sign’, stenosis and occlusion. Inter-rater and intrarater reliability were calculated using Fleiss’ and Cohen’s kappa (κ), respectively.Results Overall, inter-rater reliability across the two rounds of both exercises was moderate to good for the ‘macaroni sign’ (κ 0.51-0.74 across the two rounds of both exercises), fair for stenosis (0.24–0.38) and variable for occlusion (0.02–0.60). Intrarater reliability across the two exercises was good to excellent for the ‘macaroni sign’ (0.74–0.81) and moderate for stenosis (0.55–0.64) and occlusion (0.64–1.00; the latter based on a limited number of assessments). In both exercises, inter-rater reliability was good to excellent for the ‘macaroni sign’ in carotids but worse across other vessels and lesion types; intrarater reliability was good to excellent when analysed per single vessel and lesion though limited for occlusions and for the abdominal aorta.Conclusion Among the ultrasound elementary lesions for TAK, the ‘macaroni sign’ revealed moderate to good reliability, while the reproducibility of stenosis and occlusion was worse and more variable. These results provide the methodological basis to develop a new global Outcome Measures in Rheumatology (OMERACT) ultrasound score in TAK.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Rheumatology, Hospital of Brunico (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University Innsbruck, Bruneck, Italy",
    "Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy",
    "Rheumatology, Waldfriede Hospital, Berlin, Germany",
    "Rheumatology Department, ULS Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal",
    "Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal",
    "Division of Rheumatology, Medical University of Vienna, Vienna, Austria",
    "Department of Rheumatology, Hospital Lillebaelt, Vejle, Denmark",
    "Rheumatology Department, Hospital Universitario La Paz, Madrid, Spain",
    "Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway",
    "Department of Rheumatology, Institute of Rheumatology, Prague, Czech Republic",
    "Medical Faculty, University of Ljubljana, Ljubljana, Slovenia",
    "UMC Ljubljana, Ljubljana, Slovenia",
    "Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India",
    "IRCCS Istituto Auxologico Italiano, Milan, Italy",
    "Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi, Milan, Italy",
    "Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark",
    "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark",
    "Department of Medicine, The Regional Hospital Horsens, Horsens, Denmark",
    "Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy",
    "Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology and Clinical Immunology, University Hospital Bonn, Bonn, Germany",
    "Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland",
    "Department of Angiology, University Hospital Basel, Basel, Switzerland",
    "Advanced Imaging for Personalized Medicine, Experimental Imaging Centre, IRCCS San Raffaele Scientific Institute, Milan, Italy",
    "School of Medicine, Università Vita-Salute San Raffaele, Milan, Italy",
    "Department of Radiology, Medical University Innsbruck/Tirol Kliniken GmbH, Innsbruck, Austria",
    "Rheumatology Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy",
    "Università Cattolica del Sacro Cuore, Rome, Italy",
    "Department of Rheumatology, IRCCS Galeazzi—Sant'Ambrogio Hospital, Milan, Italy",
    "Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy",
    "Division of Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico",
    "Rheumatology, Clinical Division of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria",
    "Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 28,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Michele di Lernia"
    },
    {
      "affs": [
        1
      ],
      "name": "Alessandro Tomelleri",
      "orcid": "0000-0002-5440-2078"
    },
    {
      "affs": [
        2
      ],
      "name": "Wolfgang A Schmidt",
      "orcid": "0000-0001-7831-8738"
    },
    {
      "affs": [
        0
      ],
      "name": "Milena Bond",
      "orcid": "0000-0002-5400-2955"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Cristina Ponte",
      "orcid": "0000-0002-3989-1192"
    },
    {
      "affs": [
        5
      ],
      "name": "Peter Mandl"
    },
    {
      "affs": [
        6
      ],
      "name": "Stavros Chrysidis",
      "orcid": "0000-0001-8583-6517"
    },
    {
      "affs": [
        7
      ],
      "name": "Eugenio De Miguel",
      "orcid": "0000-0001-5146-1964"
    },
    {
      "affs": [
        8
      ],
      "name": "Andreas P Diamantopoulos"
    },
    {
      "affs": [
        9
      ],
      "name": "Petra Hanova"
    },
    {
      "affs": [
        10,
        11
      ],
      "name": "Alojzija Hocevar",
      "orcid": "0000-0002-7361-6549"
    },
    {
      "affs": [
        12
      ],
      "name": "Durga Prasanna Misra",
      "orcid": "0000-0002-5035-7396"
    },
    {
      "affs": [
        13,
        14
      ],
      "name": "Sara Monti",
      "orcid": "0000-0002-1800-6772"
    },
    {
      "affs": [
        15,
        16,
        17
      ],
      "name": "Berit Dalsgaard Nielsen"
    },
    {
      "affs": [
        18
      ],
      "name": "Niccolò Possemato"
    },
    {
      "affs": [
        19
      ],
      "name": "Valentin Sebastian Schäfer"
    },
    {
      "affs": [
        20
      ],
      "name": "Luca Seitz",
      "orcid": "0000-0002-5051-1445"
    },
    {
      "affs": [
        20
      ],
      "name": "Pascal Seitz"
    },
    {
      "affs": [
        21
      ],
      "name": "Markus Aschwanden"
    },
    {
      "affs": [
        22,
        23
      ],
      "name": "Davide Vignale"
    },
    {
      "affs": [
        22,
        23
      ],
      "name": "Antonio Esposito"
    },
    {
      "affs": [
        24
      ],
      "name": "Gerlig Widmann"
    },
    {
      "affs": [
        25,
        26
      ],
      "name": "Maria-Antonietta D’Agostino"
    },
    {
      "affs": [
        27,
        28
      ],
      "name": "Georgios Filippou"
    },
    {
      "affs": [
        29
      ],
      "name": "Carlos Pineda"
    },
    {
      "affs": [
        30
      ],
      "name": "Christina Duftner",
      "orcid": "0000-0003-3137-8834"
    },
    {
      "affs": [
        0,
        31
      ],
      "name": "Christian Dejaco",
      "orcid": "0000-0002-0173-0668"
    },
    {
      "name": "on behalf of the Large-Vessel Vasculitis-Ultrasound Subgroup of the OMERACT Ultrasound Working Group"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fr4rcjty4t7dk.bib",
  "cited_by": 0,
  "doi": "10.1136/rmdopen-2026-006884",
  "fulltext_url": "https://rmdopen.bmj.com/content/12/4/e006884.full",
  "id": "fr4rcjty4t7dk",
  "issns": [
    "2056-5933"
  ],
  "landing_url": "https://doi.org/10.1136/rmdopen-2026-006884",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "1506"
    ],
    [
      "heading",
      "Original Research"
    ],
    [
      "heading",
      "Vasculitis"
    ],
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2740|Vasculitis and related conditions"
    ]
  ],
  "openalex": "W7224946522",
  "pdf_url": null,
  "pmcid": "PMC13723918",
  "pmid": "42963057",
  "published": "2026-10-30",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/fr4rcjty4t7dk.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:22:50Z",
      "native_id": "0a5a78e7024942759c4ec19d665dfc67",
      "source": "doaj",
      "url": "https://doi.org/10.1136/rmdopen-2026-006884"
    },
    {
      "first_seen": "2026-11-04T12:22:28Z",
      "native_id": "PMC13723918",
      "source": "pmc",
      "url": "https://doi.org/10.1136/rmdopen-2026-006884"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Vasculitis and related conditions",
      "subfield": "general"
    }
  ],
  "title": "Assessing vasculitis in Takayasu arteritis by ultrasound: results of OMERACT patient-based reliability exercises",
  "title_text": "Assessing vasculitis in Takayasu arteritis by ultrasound: results of OMERACT patient-based reliability exercises",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:39Z",
  "url": "https://research.draconitic.com/paper/fr4rcjty4t7dk",
  "venue": "RMD Open",
  "versions": []
}