{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:08:23Z","timestamp":1790291303394,"version":"4.1.0"},"reference-count":13,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"unspecified","delay-in-days":35,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100024075","name":"Region Syddanmark","doi-asserted-by":"publisher","award":["21\/17499"],"award-info":[{"award-number":["21\/17499"]}],"id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2025,7,10]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the agreement and repeatability of an automated robotic ultrasound system (ARTHUR V.2.0) combined with an AI model (DIANA V.2.0) in assessing synovial hypertrophy (SH) and Doppler activity in rheumatoid arthritis (RA) patients, using an expert rheumatologist\u2019s assessment as the reference standard.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>30 RA patients underwent two consecutive ARTHUR V.2.0 scans and rheumatologist assessment of 22 hand joints, with the rheumatologist blinded to the automated system\u2019s results. Images were scored for SH and Doppler by DIANA V.2.0 using the EULAR-OMERACT scale (0\u20133). The agreement was evaluated by weighted Cohen\u2019s kappa, percent exact agreement (PEA), percent close agreement (PCA) and binary outcomes using Global OMERACT-EULAR Synovitis Scoring (healthy \u22641\u2009vs diseased \u22652). Comparisons included intra-robot repeatability and agreement with the expert rheumatologist and a blinded independent assessor.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>ARTHUR successfully scanned 564 out of 660 joints, corresponding to an overall success rate of 85.5%. Intra-robot agreement for SH: PEA 63.0%, PCA 93.0%, binary 90.5% and for Doppler, PEA 74.8%, PCA 93.7%, binary 88.1% and kappa values of 0.54 and 0.49. Agreement between ARTHUR+DIANA\u2009and the rheumatologist: SH (PEA 57.9%, PCA 92.9%, binary 87.3%, kappa 0.38); Doppler (PEA 77.3%, PCA 94.2%, binary 91.2%, kappa 0.44) and with the independent assessor: SH (PEA 49.0%, PCA 91.2%, binary 80.0%, kappa 0.39); Doppler (PEA 62.6%, PCA 94.4%, binary 88.1%, kappa 0.48).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ARTHUR V.2.0 and DIANA V.2.0 demonstrated repeatability on par with intra-expert agreement reported in the literature and showed encouraging agreement with human assessors, though further refinement is needed to optimise performance across specific joints.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-005805","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T18:25:47Z","timestamp":1754418347000},"page":"e005805","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Automated ultrasound system ARTHUR V.2.0 with AI analysis DIANA V.2.0 matches expert rheumatologist in hand joint assessment of rheumatoid arthritis patients"],"prefix":"10.1136","volume":"11","author":[{"given":"Bill Aplin","family":"Frederiksen","sequence":"first","affiliation":[{"name":"Section of Rheumatology, Department of Medicine, Svendborg Hospital - Odense University Hospital, Svendborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7317-8991","authenticated-orcid":false,"given":"Hilde Berner","family":"Hammer","sequence":"additional","affiliation":[{"name":"Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene","family":"Terslev","sequence":"additional","affiliation":[{"name":"Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mads","family":"Ammitzb\u00f8ll-Danielsen","sequence":"additional","affiliation":[{"name":"Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiusius Rajeeth","family":"Savarimuthu","sequence":"additional","affiliation":[{"name":"The Maersk Mc-Kinney Moller Institute, Syddansk Universitet, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders Bossel Holst","family":"Weber","sequence":"additional","affiliation":[{"name":"ROPCA, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3946-5919","authenticated-orcid":false,"given":"S\u00f8ren Andreas","family":"Just","sequence":"additional","affiliation":[{"name":"Section of Rheumatology, Department of Medicine, Svendborg Hospital - Odense University Hospital, Svendborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"2025090312224806000_11.3.e005805.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13103"},{"key":"2025090312224806000_11.3.e005805.2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.berh.2017.09.002","article-title":"Role of ultrasound imaging in individuals at risk of RA","volume":"31","author":"Nam","year":"2017","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2025090312224806000_11.3.e005805.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210602"},{"key":"2025090312224806000_11.3.e005805.4","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2016-000428","article-title":"Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardised, consensus-based scoring system","volume":"3","author":"D\u2019Agostino","year":"2017","journal-title":"RMD Open"},{"key":"2025090312224806000_11.3.e005805.5","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2016-000427","article-title":"Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 2: reliability and application to multiple joints of a standardised consensus-based scoring system","volume":"3","author":"Terslev","year":"2017","journal-title":"RMD Open"},{"key":"2025090312224806000_11.3.e005805.6","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1002\/acr.23518","article-title":"2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015\u20132030","volume":"70","author":"Battafarano","year":"2018","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025090312224806000_11.3.e005805.7","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s42358-022-00263-2","article-title":"Ultrasound joint examination by an automated system versus by a rheumatologist: from a patient perspective","volume":"62","author":"Frederiksen","year":"2022","journal-title":"Adv Rheumatol"},{"key":"2025090312224806000_11.3.e005805.8","unstructured":"Aplin Frederiksen B , Berner Hammer H , Schultz Overgaard B , et al . Performance of an Artificial Intelligence Model Compared to Multiple Human Experts in Scoring Synovitis Severity and Osteophyte Severity on Joint Ultrasound Images [abstract]. Arthritis Rheumatol 2024;76."},{"key":"2025090312224806000_11.3.e005805.9","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1007\/s10067-017-3662-1","article-title":"Reliability of ultrasound grading traditional score and new global OMERACT-EULAR score system (GLOESS): results from an inter- and intra-reading exercise by rheumatologists","volume":"36","author":"Ventura-R\u00edos","year":"2017","journal-title":"Clin Rheumatol"},{"key":"2025090312224806000_11.3.e005805.10","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208103"},{"key":"2025090312224806000_11.3.e005805.11","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.009548"},{"key":"2025090312224806000_11.3.e005805.12","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1093\/rheumatology\/keu354","article-title":"Greyscale and power Doppler ultrasonographic evaluation of normal synovial joints: correlation with pro- and anti-inflammatory cytokines and angiogenic factors","volume":"54","author":"Kitchen","year":"2015","journal-title":"Rheumatology (Sunnyvale)"},{"key":"2025090312224806000_11.3.e005805.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.152926"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2025-005805","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:23:02Z","timestamp":1756927382000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2025-005805"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,8,5]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/rmdopen-2025-005805"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2025-005805","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}