@article{BasAlcolea:111355,
      author        = "Bas Alcolea, Paula and Gracia Tello, Borja del Carmelo",
      title         = "{Reproducibilidad de un nuevo sistema automático
                       (CAPILLARY.IO) en el análisis de imágenes
                       capilaroscópicas}",
      year          = "2020",
      note          = "INTRODUCTION: Nailfold Capillaroscopy is a simple,
                       inexpensive and non-invasive technique that allows
                       microvascular damage to be observed, gaining recent
                       importance in the diagnosis, monitoring and prognosis of
                       many diseases with microangiopathy. However, the
                       variability in the results interpretation has led to the
                       development of new computerized systems that allow the
                       automatic analysis of capillaroscopic images. OBJECTIVES:
                       to compare the degree of agreement between the automatic
                       system Capillary.io and a gold standard obtained from the
                       agreement of 9 expert capillaroscopists and to know the
                       degree of the interobserver reliability. To demonstrate the
                       validity of the system to detect normal and enlarged
                       capillaries, hemorrhages, megacapillaries, ramifications
                       and tortuosities. METHODS: a cross-sectional study was
                       performed in which 300 random and anonymous nailfold
                       capillaroscopic images (1165 capillaries) were analyzed by
                       9 experienced observers. The degree of interobserver
                       agreement was calculated from the 5 users. Likewise, the
                       system performed an automatic assessment of the images and
                       their agreement with the gold standard was calculated
                       (interobserver agreement greater than 5, 6, 7, 8 and 9
                       successively). The validity of the program for each
                       variable was also analyzed using sensitivity and
                       specificity, positive and negative predictive values, and
                       likelihood ratios, as well as their degree of agreement
                       using the weighted kappa statistic (95% CI, p <0.05). The
                       programs used for statistical calculations were SPSS 22.0
                       and EPIDAT 3.0. RESULTS: the degree of interobserver
                       agreement was 76.5% for the agreement of 5 or more
                       observers, progressively decreasing to 15.4% for the 9
                       observers. Capillary.io obtained higher levels of
                       agreement, reaching 97.7% for the 9 observers.
                       Statistically significant results were obtained in the
                       automated detection of all the morphological alterations
                       analyzed. CONCLUSIONS: Capillary.io demonstrated a high
                       degree of agreement with the gold standard, stronger with
                       greater consensus among observers. He was able to detect
                       with great sensitivity and specificity hemorrhages and
                       megacapillaries, very relevant alterations in
                       microangiopathies. More studies will be necessary to
                       analyze its functionality to detect dilatations,
                       tortuosities and ramifications, although the results have
                       been promising.",
}