doi:10.1093/rheumatology/keae197engGracia Tello, Borja del CarmeloSáez Comet, LuisLledó, GemaFreire Dapena, MaykaMesa, Miguel AntonioMartín-Cascón, MiguelGuillén del Castillo, AlfredoMartínez Robles, ElenaSimeón-Aznar, Carmen PilarTodolí Parra, Jose AntonioVarela, Diana CristinaMaldonado Vélez, GenessisMarín Ballvé, AdelaAramburu Llorente, JimenaPérez Abad, LauraRamos Ibáñez, EduardoCapi-score: a quantitative algorithm for identifying disease patterns in nailfold videocapillaroscopyART-2024-138689Objectives EULAR supports the use of nailfold videocapillaroscopy (NVC) for identifying disease patterns (DPs) associated with SSc and RP. Recently, EULAR proposed an easy-to-manage procedure, a so-called Fast Track algorithm, for differentiating SSc patterns from non-SSc patterns in NVC specimens. However, subjectivity among capillaroscopists remains a limitation. Our aim was to perform a software-based analysis of NVC peculiarities in a cohort of samples from SSc and RP patients and, subsequently, build a Fast Track–inspired algorithm for identifying DPs without the constraint of interobserver variability. Methods NVCs were examined by 9 capillaroscopists. Those NVCs whose DPs were consensually agreed upon (by ≥2 out of 3 interobservers) were subsequently analysed using in-house–developed software. The results for each variable were grouped according to the consensually agreed-upon DPs in order to identify useful hallmarks for categorizing them. Results A total of 851 NVCs (21 957 images) whose DPs had been consensually agreed upon were software-analysed. Appropriate cut-offs set for capillary density and percentage of abnormal and giant capillaries, tortuosities and haemorrhages allowed DP categorization and the development of the CAPI-score algorithm. This consisted of four rules: Rule 1, SSc vs non-SSc, accuracy 0.88; Rules 2 and 3, SSc-early vs SSc-active vs SSc-late, accuracy 0.82; Rule 4, non-SSc normal vs non-SSc non-specific, accuracy 0.73. Accuracy improved when the analysis was limited to NVCs whose DPs had achieved full consensus between the interobservers. Conclusion The CAPI-score algorithm may become a tool that is useful in assigning DPs by overcoming the limitations of subjectivity.2024http://zaguan.unizar.es/record/13560310.1093/rheumatology/keae197http://zaguan.unizar.es/record/135603oai:zaguan.unizar.es:135603Rheumatology (Oxford) 63, 12 (2024), 3315–3321byhttps://creativecommons.org/licenses/by/4.0/deed.esinfo:eu-repo/semantics/openAccess