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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Over the past years&#44; nailfold capillaroscopy &#40;NFC&#41; has gained popularity and its use among rheumatologists has increased substantially&#46; Basically&#44; the microvascular damage has been defined as progressive alteration of the capillaries structure and morphology with progressive decrease in their density&#44; together with alternation of the blood flow&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> Consequently&#44; assessment of peripheral microcirculation has booked its place as an important tool for valuation of patients with Raynaud&#39;s phenomenon and for the early diagnosis of systemic sclerosis&#46; In addition&#44; there Is also some evidence indicating positive relation between changes in the nailfold capillaroscopic pattern and the affection of target organs&#46; The recognition of the capillaroscopic patterns characterizing the secondary Raynaud&#39;s phenomenon &#40;RP&#41; has been proposed as a prognostic marker for the early detection of the risk of visceral RP &#40;e&#46;g&#46; coronary heart disease&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The NFC reproducibility and credentials has attracted the attention&#44; as regular monitoring and assessment of nailfold capillaroscopy may soon be considered a tool for the analysis not only of the peripheral circulation in autoimmune rheumatic diseases but also the microvascular systemic organ affection&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">4&#44;5</span></a> However&#44; whilst nailfold capillaroscopy may represent the best method to analyze microvascular abnormalities in autoimmune rheumatic diseases&#44; uncertainty may arise when documentation and reporting of the findings of the procedure are not standardized&#46; Given the rapidly growing use of NFC by a variety of healthcare professionals in both the standard day to day practice as well as in research context to predict the disease progression and monitor treatment effects&#44; a barrier for further evaluation is the lack of consensus on how to document the demographics&#47;outcomes of the assessment&#46; Therefore&#44; standardization of the NFC reporting seems paramount&#46; To step forward to this need&#44; experts in the field of capillaroscopy&#47;microcirculation provide in this evidence-based consensus study their view on determining the core set domains for nailfold capillaroscopy &#40;NFC&#41; reporting&#44; for both clinical practice as well as clinical research&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Design</span><p id="par0015" class="elsevierStylePara elsevierViewall">The evidence-based consensus was developed adopting a multistep process strategy&#58; 1&#46; Formulation of the overarching principles of NFC reporting&#59; 2&#46; Identify the candidate core items and domains&#59; 3&#46; Literature search for core items and domains of NFC reporting&#59; 4&#46; Critical assessment and selection of the evidence&#59; 5&#46; Presentation of results&#44; and recommendations&#46; This work led to the development of a draft core set of domains &#40;and subdomains&#41; to be included in the NFC reporting&#46; The domains were stratified into those ones which were part of the inner core set &#40;essential to NFC reporting&#41;&#44; middle core set &#40;relevant but not essential to assess in NFC reporting&#41; or outer core &#40;should be part of a research agenda&#41;&#46; The study design was formulated based on the &#8220;Clinical&#44; Evidence-based&#44; Guidelines &#40;CEG&#41;&#8221; guideline development process protocol which involves a scientific evidence and consensus&#44; based on the existing scientific evidence and clinical experience&#46; The manuscript conformed to the preferred reporting items for systematic reviews and meta-analyses guidelines for reporting systematic reviews&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Development stages</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Core team</span><p id="par0020" class="elsevierStylePara elsevierViewall">This was composed of three experts who are all professionally involved in doing nailfold capillaroscopy &#40;NFC&#41;&#46; With recognized experience in NFC research&#46; The core team supervised&#44; coordinated and assisted with developing the scope of the project and the key clinical questions&#44; nominating the expert panel and drafting the manuscript&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Literature review team</span><p id="par0025" class="elsevierStylePara elsevierViewall">Led by an experienced literature review consultant and the assistance of an expert in methodology&#59; the literature review was conducted based on the specific research questions identified&#46; The team completed the literature search&#44; data abstraction as well as the quality of evidence rating&#46; The studies were categorized by grades of recommendation<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">7&#44;8</span></a> and strength of evidence according to Oxford Centre for Evidence-based Medicine &#40;CEBM&#41; system&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Expert panel</span><p id="par0030" class="elsevierStylePara elsevierViewall">The core leadership team nominated 11 participants&#46; The criteria for their selection included&#58; have professional knowledge and experience in the field of nailfold capillaroscopy as well as active participation in scientific research&#46; The expert panel assisted with developing the scope of the project and refining the key clinical questions&#46; The statements were sent to the expert panel for voting on the recommendations&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Data sources and search strategies</span><p id="par0035" class="elsevierStylePara elsevierViewall">Literature search strategies were developed for PubMed&#44; Embase&#44; and Cochrane Library databases to identify randomized clinical trials evaluating the nailfold capillaroscopy&#44; its standardization and reporting for the assessment of microcirculation&#46; The search strategies were designed to be broad to have high sensitivity for identifying relevant literature and included search terms for nailfold capillaroscopy&#44; standardization and reporting randomized clinical trials&#46; The literature searches were carried out on January 24&#44; 2022&#44; for PubMed and Cochrane Library databases&#44; and on January 31&#44; 2022&#44; for Embase&#46; Additional relevant studies were retrieved by reviewing the reference lists of studies identified with the database search strategies that met the pre-set inclusion criteria&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study selection</span><p id="par0040" class="elsevierStylePara elsevierViewall">Relevant studies were selected by applying inclusion and exclusion criteria to the literature retrieved with the search strategies&#46;</p><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Inclusion criteria</span><p id="par0045" class="elsevierStylePara elsevierViewall">Articles included were systematic reviews&#44; randomized controlled trials &#40;RCTs&#41;&#44; uncontrolled trials&#44; observational studies including cohort&#44; case&#8211;control and cross-sectional studies&#44; or those where economic evaluation was made&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Exclusion criteria</span><p id="par0050" class="elsevierStylePara elsevierViewall">Editorials&#44; commentaries&#44; conference abstracts and non-evidence-based narrative&#47;personal reviews&#44; manuscripts lacking English version&#44; were excluded&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Delphi process</span><p id="par0055" class="elsevierStylePara elsevierViewall">Delphi technique was adopted to develop core set domains for reporting nailfold capillaroscopy in both clinical practice as well as clinical research&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">9&#44;10</span></a> The Delphi process was conducted through online questionnaires&#46; Each Delphi round was followed by discussion&#44; amendments or addition of items&#44; then repeated anonymous voting&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Voting process</span><p id="par0060" class="elsevierStylePara elsevierViewall">Live online delivered voting was carried out in rounds that are strictly time limited&#46; All members of the task force were invited to participate and are pre-informed of the opening and closure times of each round of votes&#46; Unique access links were sent out&#44; and votes were gathered and processed&#46; After each voting&#44; domains were revised based on feedback from the expert group&#44; together with further critical review of the available literature&#46; Additional&#47;amended domains were added&#46; Only the members of the task force had the right to vote on the domains&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Rating</span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Round 1</span>&#58; Nine response categories are set per each item ranging between 1 and 9 with 1 indicative of &#8216;complete disagreement&#8217; and 9 indicating &#8216;complete agreement&#8217;&#46; Rankings of 7&#8211;9 indicate domains of critical importance&#44; rankings of 4&#8211;6 indicate domains that are important but not critical&#44; and rankings of 1&#8211;3 indicate domains of low importance&#46; In the first e-Delphi round&#44; it was open for the participants to propose additional domains&#46; <span class="elsevierStyleItalic">Round 2</span>&#58; three responses &#8220;in&#44; out or undecided&#8221;&#46; All domains were allowed for the entry of comments which were reviewed by the scientific committee&#46; In all the votes&#8217; rounds&#44; the members were urged to leave comments&#46; This enabled the panel to identify an instance of misinterpretation of the domain and invalidate the vote on that item&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Consensus process</span><p id="par0070" class="elsevierStylePara elsevierViewall">The structured Delphi approach ensures that the opinions of participants are equally considered&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> The first Delphi round included one item for each candidate domain with its subdomains&#46; Round 2&#44; aimed to reach preliminary consensus &#8220;in&#8221; or &#8220;out&#8221; for domains&#46; It included all items that were rated &#8220;of critical importance&#8221; &#40;rated in the range of 7&#8211;9&#41; by at least 80&#37; of the participants as well as any new domains proposed in round 1&#46; Three response categories per item&#58; &#8220;include&#8221;&#44; &#8220;undecided&#8221; or &#8220;do not include&#8221;&#46; Round 3 might be needed&#44; to reach preliminary consensus &#8220;in&#8221; or &#8220;out&#8221; for domains that did not reach preliminary consensus in round 2&#46; Three response categories per item &#8220;include&#8221;&#44; &#8220;undecided&#8221;&#44; &#8220;do not include&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> The definitions we used for the consensus of the core areas and domains were summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Definition of consensus</span><p id="par0075" class="elsevierStylePara elsevierViewall">Definition of consensus was established before initiating the online Delphi procedure and data analysis&#46; The core team reviewed and discussed the consensus criteria and the criteria for excluding domains from consideration in subsequent rounds&#46; Consensus definition were set as&#58; consensus &#8216;in&#8217;&#58; rated &#8216;do not include&#8217; by &#60;30&#37; of panellists&#44; consensus &#8216;out&#8217;&#58; rated &#8216;include&#8217; by &#60;30 of panellists&#44; no consensus&#58; rated &#8216;include&#8217; by at least 30&#37; and rated &#8216;exclude&#8217; by at least 30&#37;&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Chronogram of Delphi rounds</span><p id="par0080" class="elsevierStylePara elsevierViewall">The first round took place between 13th and 17th May 2022 &#40;5 days&#41;&#46; The first-round outcomes were revised in view of the comments and included in the second round&#46; The second round took place between 1st and 10th Jun 2022 &#40;11 days&#41;&#46; The third round deemed unnecessary as consensus was achieved by the end of the second round&#46;</p><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Ethics and consent</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study was performed in accordance with the Helsinki Declaration&#46; The &#8220;Clinical&#44; Evidence-based&#44; Guidelines &#40;CEG&#41;&#8221; initiative protocol was approved the local ethical committee&#58; ethical approval code&#58; 34842&#47;8&#47;21&#44; ethical board Tanta University&#46; All the participants were kept anonymous&#44; in compliance with data protection regulations&#46;</p></span></span></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Results</span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Content analysis of the literature</span><p id="par0090" class="elsevierStylePara elsevierViewall">The literature review included 331 studies that discussed report recommendations&#44; definitions&#44; standards&#44; and techniques for quantifying NFC results&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> depicts the systematic review research strategy adopted in this work&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Delphi rounds</span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">This was based on an online survey</span><p id="par0095" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0100" class="elsevierStylePara elsevierViewall">The first round of the electronic survey included core items identified in the literature review together with their candidate domains and subdomains&#46; The participants identified seven subdomains to be added&#58; two items under Raynaud&#39;s phenomenon core area &#40;number of attacks during the week&#44; number of finger ulcers&#41;&#44; 2-items under procedure &#40;number of fingers examined and date of the first examination&#41;&#44; 1-item under medical status &#40;comorbidities&#41;&#44; 1-item under medical status &#40;medications&#41;&#44; and 1-item under findings &#40;subpapillary plexus&#41;&#46; The final list of the core areas and domains&#47;subdomains are shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; The response rate in this round was 100&#37; &#40;11&#47;11&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the results of this round which revealed that on 81&#46;8&#37; of the topics&#44; there was agreement on the key NFC Core set domains &#40;i&#46;e&#46;&#44; 75&#37; of respondents strongly agreed or agreed&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0105" class="elsevierStylePara elsevierViewall">The second round was based on the first round&#39;s results and the response rate in this round was 100&#37; &#40;11&#47;11&#41;&#46; Outcomes revealed that a consensus has been achieved on the &#8220;in&#8221; or &#8220;out&#8221; core areas and domains&#46; 81&#46;8&#8211;100&#37; of respondents agreed the key NFC Core set domains to be included&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the results of this round outcomes&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></li></ul></p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0185">Expert panel characteristics</span><p id="par0110" class="elsevierStylePara elsevierViewall">The Delphi form was sent to expert panel &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41;&#44; who participated in the two rounds&#46; Respondents were five internationals&#44; with participation of two Italian &#40;18&#46;2&#37;&#41; and two German &#40;18&#46;2&#37;&#41; and one from UK &#40;9&#46;1&#37;&#41; experts&#44; whereas six national experts were gathered from different governorates and health centres across Egypt&#58; Cairo University &#40;9&#46;1&#37;&#41;&#44; Ain Shams University &#40;9&#46;1&#37;&#41;&#44; Tanta University &#40;9&#46;1&#37;&#41;&#44; Fayoum University &#40;9&#46;1&#37;&#41;&#44; Assiut University &#40;9&#46;1&#37;&#41;&#44; and National Research Centre &#40;9&#46;1&#37;&#41;&#46;</p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0190">Reporting template</span><p id="par0115" class="elsevierStylePara elsevierViewall">Based on the outcomes of this work&#44; a final reporting template of NFC for use in standard clinical practice and reached has been set up&#46; The reporting template is shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0195">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">The NFC outcomes not only have a diagnostic value&#44; but also have a positive predictive role for the development of specific spectrum disorders&#46; Therefore&#44; a detailed and analytical documentation of the nailfold capillaroscopy findings can be useful to ensure attaining a reproducibly quantitative as well as qualitative recording of the various NFC parameters&#46; So far there is no standard model for NFC reporting&#46; The current study aimed to bring objectivity and achieve consensus about outcome domains to be included in a model of nailfold capillaroscopy report&#46; Also&#44; to ensure that the level of the details included in the report meet the expected standards for both clinical practice as well as clinical research&#46; Online Delphi procedure was adopted with the help of international expert panel to reach a consensus about the core items&#44; domains as well as subdomains for NFC reporting&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Bearing in mind the fact that NFC is a highly operator-dependent imaging tool&#44; earlier attempts to set up standards for reporting the NFC findings highlighted the importance of the matter&#44; but the outcomes of these studies revealed that there is still work remain to be done&#46; Ingegnoli et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> carried out a study to propose a pragmatic reporting checklist for NFC&#46; The study produced a checklist on standardization of reporting capillaroscopy derived from an international consensus&#46; Three overarching areas for reporting NVC were identified&#46; These included patient preparation before NFC&#44; device description and examination details&#46; However&#44; the study concluded that the available evidence is insufficient to make definitive recommendations&#46; The study recommended a further step towards standardization and development of a future &#8216;NFC core set&#8217;&#46; In another study&#44; the Pan-American League of Associations for Rheumatology &#40;PANLAR&#41; capillaroscopy study group published a consensus for the format and content of the nailfold capillaroscopy report in rheumatology&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> Forty-six recommendations for the capillaroscopy report in rheumatology reached a consensus&#46; They were stratified over six sections&#58; patient&#39;s data&#44; Raynaud&#39;s phenomenon&#44; visibility&#44; NFC examination&#44; diagnosis&#44; suggestion&#44; and imaging&#46; However&#44; the study was based on a comparison of the expert&#39;s opinion&#44; in the absence of a strong background of evidence&#44; and it did not suggest a standard reporting format&#44; highlighting a gap in the literature that need to be addressed&#46; Results of this work identified 14 core areas &#40;included in details in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; This significant increase in the number of the core items reflects the main objective of this work that is development of NVC core set&#44; which was meant to provide a relevant step forward towards NFC reporting standardization&#46; The developed report template offers detailed specifications of the contents of the NFC report in clinical practice&#47;scientific research&#44; which should encompass specific information that is useful in describing the variable pathologic findings and provide reproducible and measurable information to the examining clinician&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Given its increasing use by a variety of physicians in different centres all over the world&#44; the technique standardization published by the EULAR Study Group on Microcirculation in Rheumatic Diseases&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> regarding image acquisition and analysis&#44; different techniques&#44; normal and abnormal capillaroscopic characteristics and their meaning&#44; scoring systems and reliability of image acquisition and interpretation&#44; has paved the way for producing the reporting standardization too&#46; Though these standards focussed on the technique and defining the capillaroscopic characteristics&#44; it facilitated the concept of having a similar approach for reporting standards&#46; Analysis of this study results revealed that the experts reached a consensus in both rounds on the core items to be reported in the format with some amendments&#46; This reflects the relevance and clarity of the items included in the suggest report core items&#46; In the meantime&#44; the level of consensus agreement&#44; is expected to help to harmonize and smooth NFC reporting and to overcome the personal preferences in documenting the NFC outcomes&#46; Previously published general commendations on the accurate reporting of imaging investigations determined that a &#8216;good&#8217; report of medical imaging should be designated by the eight Cs&#58; clarity&#44; correctness&#44; confidence&#44; concision&#44; completeness&#44; consistency&#44; communication and consultation&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> The domains identified in this study based on the available evidence derived from the systematic review as well as their terminology were set to meet these &#8216;good&#8217; report recommendationsIn conclusion&#44; the adoption of a shared form of reporting NFC findings could be a relevant step towards NFC standardization&#46; Considering that several factors may affect the NFC findings&#44; this would defer the calls that NFC report should focus on defining capillaroscopic characteristics to be evaluated &#40;density&#44; dimension&#44; abnormal shape and haemorrhages&#41;&#44; but also to include other demographic and methodological standardization applicable for both day to day practice and clinical research&#46; A Delphi survey was carried out including an international expert panel&#46; The majority of the domains identified in the literature and the draft core set were identified by the participants to be important and valid&#46; All domains met the 80&#37; voting threshold set in this work&#46; The work proposed an NFC recording template&#46;<elsevierMultimedia ident="tb0005"></elsevierMultimedia></p></span><span id="sec0150" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0220">Ethical approval</span><p id="par0150" class="elsevierStylePara elsevierViewall">This study was performed in accordance with the Helsinki Declaration&#46; The &#8220;Clinical&#44; Evidence-based&#44; Guidelines &#40;CEG&#41;&#8221; initiative protocol was approved the local ethical committee&#58; ethical approval code&#58; 34842&#47;8&#47;21&#44; ethical board Tanta University&#46; All the participants were kept anonymous&#44; in compliance with data protection regulations&#46;</p></span><span id="sec0155" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0225">Authors&#8217; contributions</span><p id="par0155" class="elsevierStylePara elsevierViewall">All authors contributed to the study methodology&#44; analysis&#44; and interpretation of the data and outcomes as well as the manuscript writing&#44; reading&#44; and approval of the final version&#46;</p></span><span id="sec0160" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0230">Funding</span><p id="par0160" class="elsevierStylePara elsevierViewall">The author&#40;s&#41; received no financial support for the research&#44; authorship&#44; and&#47;or publication of this article&#46;</p></span><span id="sec0165" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0235">Conflict of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">Nothing to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The peripheral microangiopathy may be well evaluated and studied by nailfold capillaroscopy &#40;NFC&#41; which is a safe and non-invasive technique&#46; NFC has been reported to have both diagnostic and prognostic values in patients presenting with Raynaud&#39;s phenomenon&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The overarching objective of this work was to make a consensus on what domains should be included in a capillaroscopy report and that it can be used in daily clinical practice and clinical research in the area of rheumatology&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A Delphi questionnaire was developed regarding capillaroscopy report from a literature review and expert consensus&#46; The first Delphi round included 14 core areas&#44; its 18 domains with 50 subdomains&#44; derived from a systematic literature review&#46; The level of evidence was determined for each core set using the Oxford Centre for Evidence-based Medicine &#40;CEBM&#41; system&#46; Nine response categories have been set per each item ranging between 1 and 9&#46; Round 2&#44; aimed to reach preliminary consensus &#8220;in&#8221; or &#8220;out&#8221; for domains&#46; It included all items that were rated &#8220;critical&#8221; by at least 80&#37; of the participants as well as any new domains proposed in round 1&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The participants to the first&#44; and second round were 11 experts&#46; Fourteen domains were discussed in the two rounds&#46; At the end of the survey&#44; the final report template of NFC in rheumatology reached a consensus&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A nailfold capillaroscopy report template has been developed by this study&#44; based on outcomes of a Delphi process&#44; by international participants panel&#46; All domains met the 80&#37; voting threshold set in this work&#46; The reporting template can be used for both clinical research as well as day to day practice to provide guidance and standardize the NFC reporting&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La microangiopat&#237;a perif&#233;rica puede ser evaluada y estudiada adecuadamente mediante capilaroscopia ungueal &#40;NFC&#41;&#44; que es una t&#233;cnica segura y no invasiva&#46; Se ha informado que la NFC tiene valores tanto diagn&#243;sticos como pron&#243;sticos en pacientes que presentan el fen&#243;meno de Raynaud&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El objetivo general de este trabajo fue aportar de manera objetiva y lograr un consenso sobre los dominios que se incluir&#225;n en los resultados de un modelo de informe de la NFC y que pueda ser aplicable tanto para la pr&#225;ctica cl&#237;nica est&#225;ndar como para la investigaci&#243;n cl&#237;nica en reumatolog&#237;a&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se elabor&#243; un cuestionario Delphi sobre el informe de capilaroscopia a partir de una revisi&#243;n bibliogr&#225;fica y del consenso de expertos&#46; La primera ronda Delphi incluy&#243; 14 &#225;reas centrales&#44; sus 18 dominios con 50 subdominios&#44; derivados de una revisi&#243;n sistem&#225;tica de la literatura&#46; El nivel de evidencia se determin&#243; para cada conjunto b&#225;sico utilizando el sistema del Centro de Medicina basada en la Evidencia de Oxford&#46; Se han establecido 9 categor&#237;as de respuesta para cada &#237;tem&#44; que oscilan entre 1 y 9&#46; La ronda 2 ten&#237;a como objetivo llegar a un consenso preliminar &#171;dentro&#187; o &#171;fuera&#187; de los dominios&#46; Inclu&#237;a todos los elementos que fueron calificados como &#171;cr&#237;ticos&#187; por al menos el 80&#37; de los participantes&#44; as&#237; como cualquier dominio nuevo propuesto en la ronda 1&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">En la primera y segunda ronda participaron 11 expertos&#46; En las 2 rondas se discutieron 14 dominios&#46; Al final de la encuesta&#44; el modelo de informe final de la NFC en reumatolog&#237;a alcanz&#243; un consenso&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusi&#243;n</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Este estudio desarroll&#243; una plantilla de informe de capilaroscopia ungueal&#44; basada en los resultados de un proceso Delphi por un panel internacional de participantes&#46; Todos los dominios alcanzaron el umbral de votaci&#243;n del 80&#37; establecido en este trabajo&#46; La plantilla de informes se puede utilizar tanto para la investigaci&#243;n cl&#237;nica como para la pr&#225;ctica diaria&#44; para proporcionar orientaci&#243;n y estandarizar los informes de la NFC&#46;</p></span>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Core area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Definition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Capillary density&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Number of capillaries&#47;1<span class="elsevierStyleHsp" style=""></span>mm&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Capillary length&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Distance between the capillary apex and the point where the capillary loop is no longer visible&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Capillary diameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Width of the arterial &#40;afferent&#41;&#44; apical&#44; venous &#40;efferent&#41; loop &#40;especially apical loop&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Giant capillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A homogeneously &#40;very&#41; enlarged capillary&#44; with a diameter of &#62;50<span class="elsevierStyleHsp" style=""></span>mm&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morphology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The shape of each individual capillary&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blood flow&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regular erythrocytes column&#44; slowed down&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ghost capillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A capillary that slips in and out of the field of view &#40;during live imaging&#41; because it is only intermittently perfused&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Avascular area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Section of the nailfold where no capillaries can be seen&#46; It can sometimes be difficult to decide whether this is &#8216;true&#8217; avascularity or due to difficulties in visualizing &#40;sections of&#41; the distal row&#46; When using a contact probe&#44; a section of the nailfold can appear avascular if too much pressure is applied&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Haemorrhage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dark areas of hemosiderin on the nailfold capillary bed due to the capillary wall rupture&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Angiogenesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abnormal shapes &#40;other shapes than hairpin&#44; tortuous&#44; or crossing&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pericapillary oedema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pericapillary increase of interstitial fluid&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Domain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean rate<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37; of agreement&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Level of agreement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; patient&#39;s demographics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; examining health care professionals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; reason for referral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; Raynaud&#39;s phenomenon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; medical status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; medications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; lab results&#58; ANA&#47;ENA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; preparation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; device&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; the procedure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; image quality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; findings&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; interpretation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;72<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; recommendations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Domain&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Do not include&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Patient&#39;s demographics&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Examining HCP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Reason for referral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;81&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;18&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Raynaud&#39;s phenomenon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;90&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;9&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&#8226; Image quality&#58;visibility&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8226; Findings&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&#8226; Interpretation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&#8226; Recommendations&nbsp;\t\t\t\t\t\t\n
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        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Delphi round 2 results&#58; core domains set for nailfold capillaroscopy reporting&#46;</p>"
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      6 => array:5 [
        "identificador" => "tb0005"
        "tipo" => "MULTIMEDIATEXTO"
        "mostrarFloat" => false
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        "texto" => array:1 [
          "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0200">Key summary points</span><span id="sec0135" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0205">What is already known on this topic</span><p id="par0135" class="elsevierStylePara elsevierViewall">Standardization of nailfold capillaroscopy examination for the assessment of patients with Raynaud&#39;s phenomenon and systemic sclerosis has been recently published by the Study Group on Microcirculation in Rheumatic Diseases &#40;EULAR SG&#47;MC RD group&#41;&#46;</p></span><span id="sec0140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0210">What this study adds</span><p id="par0140" class="elsevierStylePara elsevierViewall">Building up the expert consensus from the EULAR SG MC group&#44; it was recognized that the available evidence is insufficient to make definitive recommendations for nailfold capillaroscopy reporting&#46; A further step is required towards standardization&#44; and development of core set areas and domains for a future Nailfold capillaroscopy report that is fit for use in both clinical practice as well as research&#46; This study fills this gap&#46;</p></span><span id="sec0145" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0215">How this study might affect research&#44; practice or policy</span><p id="par0145" class="elsevierStylePara elsevierViewall">The current study aimed to bring objectivity and achieve consensus about outcome domains to be included in a model of nailfold capillaroscopy report&#46; Also&#44; to ensure that the level of the details included in the report meet the expected standards for both clinical practice as well as clinical research&#46;</p></span></span></span>"
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                      "titulo" => "Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis"
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Cutolo"
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                        "paginaFinal" => "160"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10648032"
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                0 => array:2 [
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                      "titulo" => "Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Cutolo"
                            1 => "C&#46; Pizzorni"
                            2 => "M&#46; Tuccio"
                            3 => "A&#46; Burroni"
                            4 => "C&#46; Craviotto"
                            5 => "M&#46; Basso"
                          ]
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                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/keh156"
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                        "tituloSerie" => "Rheumatology"
                        "fecha" => "2004"
                        "volumen" => "43"
                        "paginaInicial" => "719"
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15026581"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nailfold capillaroscopy is useful for the diagnosis and follow-up of autoimmune rheumatic diseases&#46; A future tool for the analysis of microvascular heart involvement&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
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                            0 => "M&#46; Cutolo"
                            1 => "A&#46; Sulli"
                            2 => "M&#46;E&#46; Secchi"
                            3 => "S&#46; Paolino"
                            4 => "C&#46; Pizzorni"
                          ]
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                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/kel310"
                      "Revista" => array:7 [
                        "tituloSerie" => "Rheumatology"
                        "fecha" => "2006"
                        "volumen" => "45"
                        "numero" => "suppl&#95;4"
                        "paginaInicial" => "iv43"
                        "paginaFinal" => "iv46"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16980724"
                            "web" => "Medline"
                          ]
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Original Article
Development of a core domain set for nailfold capillaroscopy reporting
Desarrollo de un conjunto de dominios centrales para el reporte de la capilaroscopia ungueal
Yasser El Miedanya, Sherif Ismailb, Mary Wadiec, Ulf Müller-Ladnerud, Roberto Giacomellie, Vasiliki Liakoulif, Walter Hermanng, Nihal Fathyh, Maha El Gaafaryi, Nermin A. Fouadj, Sally Saberk, Mohamed Hassan Abu-Zaidl,
Autor para correspondencia
drmhassan113@yahoo.com

Corresponding author.
a Canterbury Christ Church University, England, UK
b National Research Center, Internal Medicine, Rheumatology and Rehabilitation, Egypt
c Cairo University, Internal Medicine, Egypt
d Department of Rheumatology and Clinical Immunology, Justus-Liebig University of Giessen, Campus Kerckhoff, Bad Nauheim, Germany
e Istituto di Clinica Medica, Università, L’Aquila Italy
f Unit of Rheumatology, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila Italy
g Abteilung für Rheumatologie und Klinische Immunologie, Kerckhoff-Klinik GmbH, Benekestr. 2-8, 61231 Bad Nauheim, Germany
h Rheumatology and Rehabilitation, Assiut University, Assiut, Egypt
i Community and Public Health, Ain Shams University, Cairo, Egypt
j Rheumatology and Rehabilitation, Fayoum University, Fayoum, Egypt
k Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
l Rheumatology and Rehabilitation, Tanta University, Tanta, Egypt
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Over the past years&#44; nailfold capillaroscopy &#40;NFC&#41; has gained popularity and its use among rheumatologists has increased substantially&#46; Basically&#44; the microvascular damage has been defined as progressive alteration of the capillaries structure and morphology with progressive decrease in their density&#44; together with alternation of the blood flow&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> Consequently&#44; assessment of peripheral microcirculation has booked its place as an important tool for valuation of patients with Raynaud&#39;s phenomenon and for the early diagnosis of systemic sclerosis&#46; In addition&#44; there Is also some evidence indicating positive relation between changes in the nailfold capillaroscopic pattern and the affection of target organs&#46; The recognition of the capillaroscopic patterns characterizing the secondary Raynaud&#39;s phenomenon &#40;RP&#41; has been proposed as a prognostic marker for the early detection of the risk of visceral RP &#40;e&#46;g&#46; coronary heart disease&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The NFC reproducibility and credentials has attracted the attention&#44; as regular monitoring and assessment of nailfold capillaroscopy may soon be considered a tool for the analysis not only of the peripheral circulation in autoimmune rheumatic diseases but also the microvascular systemic organ affection&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">4&#44;5</span></a> However&#44; whilst nailfold capillaroscopy may represent the best method to analyze microvascular abnormalities in autoimmune rheumatic diseases&#44; uncertainty may arise when documentation and reporting of the findings of the procedure are not standardized&#46; Given the rapidly growing use of NFC by a variety of healthcare professionals in both the standard day to day practice as well as in research context to predict the disease progression and monitor treatment effects&#44; a barrier for further evaluation is the lack of consensus on how to document the demographics&#47;outcomes of the assessment&#46; Therefore&#44; standardization of the NFC reporting seems paramount&#46; To step forward to this need&#44; experts in the field of capillaroscopy&#47;microcirculation provide in this evidence-based consensus study their view on determining the core set domains for nailfold capillaroscopy &#40;NFC&#41; reporting&#44; for both clinical practice as well as clinical research&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Design</span><p id="par0015" class="elsevierStylePara elsevierViewall">The evidence-based consensus was developed adopting a multistep process strategy&#58; 1&#46; Formulation of the overarching principles of NFC reporting&#59; 2&#46; Identify the candidate core items and domains&#59; 3&#46; Literature search for core items and domains of NFC reporting&#59; 4&#46; Critical assessment and selection of the evidence&#59; 5&#46; Presentation of results&#44; and recommendations&#46; This work led to the development of a draft core set of domains &#40;and subdomains&#41; to be included in the NFC reporting&#46; The domains were stratified into those ones which were part of the inner core set &#40;essential to NFC reporting&#41;&#44; middle core set &#40;relevant but not essential to assess in NFC reporting&#41; or outer core &#40;should be part of a research agenda&#41;&#46; The study design was formulated based on the &#8220;Clinical&#44; Evidence-based&#44; Guidelines &#40;CEG&#41;&#8221; guideline development process protocol which involves a scientific evidence and consensus&#44; based on the existing scientific evidence and clinical experience&#46; The manuscript conformed to the preferred reporting items for systematic reviews and meta-analyses guidelines for reporting systematic reviews&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Development stages</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Core team</span><p id="par0020" class="elsevierStylePara elsevierViewall">This was composed of three experts who are all professionally involved in doing nailfold capillaroscopy &#40;NFC&#41;&#46; With recognized experience in NFC research&#46; The core team supervised&#44; coordinated and assisted with developing the scope of the project and the key clinical questions&#44; nominating the expert panel and drafting the manuscript&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Literature review team</span><p id="par0025" class="elsevierStylePara elsevierViewall">Led by an experienced literature review consultant and the assistance of an expert in methodology&#59; the literature review was conducted based on the specific research questions identified&#46; The team completed the literature search&#44; data abstraction as well as the quality of evidence rating&#46; The studies were categorized by grades of recommendation<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">7&#44;8</span></a> and strength of evidence according to Oxford Centre for Evidence-based Medicine &#40;CEBM&#41; system&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Expert panel</span><p id="par0030" class="elsevierStylePara elsevierViewall">The core leadership team nominated 11 participants&#46; The criteria for their selection included&#58; have professional knowledge and experience in the field of nailfold capillaroscopy as well as active participation in scientific research&#46; The expert panel assisted with developing the scope of the project and refining the key clinical questions&#46; The statements were sent to the expert panel for voting on the recommendations&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Data sources and search strategies</span><p id="par0035" class="elsevierStylePara elsevierViewall">Literature search strategies were developed for PubMed&#44; Embase&#44; and Cochrane Library databases to identify randomized clinical trials evaluating the nailfold capillaroscopy&#44; its standardization and reporting for the assessment of microcirculation&#46; The search strategies were designed to be broad to have high sensitivity for identifying relevant literature and included search terms for nailfold capillaroscopy&#44; standardization and reporting randomized clinical trials&#46; The literature searches were carried out on January 24&#44; 2022&#44; for PubMed and Cochrane Library databases&#44; and on January 31&#44; 2022&#44; for Embase&#46; Additional relevant studies were retrieved by reviewing the reference lists of studies identified with the database search strategies that met the pre-set inclusion criteria&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study selection</span><p id="par0040" class="elsevierStylePara elsevierViewall">Relevant studies were selected by applying inclusion and exclusion criteria to the literature retrieved with the search strategies&#46;</p><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Inclusion criteria</span><p id="par0045" class="elsevierStylePara elsevierViewall">Articles included were systematic reviews&#44; randomized controlled trials &#40;RCTs&#41;&#44; uncontrolled trials&#44; observational studies including cohort&#44; case&#8211;control and cross-sectional studies&#44; or those where economic evaluation was made&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Exclusion criteria</span><p id="par0050" class="elsevierStylePara elsevierViewall">Editorials&#44; commentaries&#44; conference abstracts and non-evidence-based narrative&#47;personal reviews&#44; manuscripts lacking English version&#44; were excluded&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Delphi process</span><p id="par0055" class="elsevierStylePara elsevierViewall">Delphi technique was adopted to develop core set domains for reporting nailfold capillaroscopy in both clinical practice as well as clinical research&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">9&#44;10</span></a> The Delphi process was conducted through online questionnaires&#46; Each Delphi round was followed by discussion&#44; amendments or addition of items&#44; then repeated anonymous voting&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Voting process</span><p id="par0060" class="elsevierStylePara elsevierViewall">Live online delivered voting was carried out in rounds that are strictly time limited&#46; All members of the task force were invited to participate and are pre-informed of the opening and closure times of each round of votes&#46; Unique access links were sent out&#44; and votes were gathered and processed&#46; After each voting&#44; domains were revised based on feedback from the expert group&#44; together with further critical review of the available literature&#46; Additional&#47;amended domains were added&#46; Only the members of the task force had the right to vote on the domains&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Rating</span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Round 1</span>&#58; Nine response categories are set per each item ranging between 1 and 9 with 1 indicative of &#8216;complete disagreement&#8217; and 9 indicating &#8216;complete agreement&#8217;&#46; Rankings of 7&#8211;9 indicate domains of critical importance&#44; rankings of 4&#8211;6 indicate domains that are important but not critical&#44; and rankings of 1&#8211;3 indicate domains of low importance&#46; In the first e-Delphi round&#44; it was open for the participants to propose additional domains&#46; <span class="elsevierStyleItalic">Round 2</span>&#58; three responses &#8220;in&#44; out or undecided&#8221;&#46; All domains were allowed for the entry of comments which were reviewed by the scientific committee&#46; In all the votes&#8217; rounds&#44; the members were urged to leave comments&#46; This enabled the panel to identify an instance of misinterpretation of the domain and invalidate the vote on that item&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Consensus process</span><p id="par0070" class="elsevierStylePara elsevierViewall">The structured Delphi approach ensures that the opinions of participants are equally considered&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> The first Delphi round included one item for each candidate domain with its subdomains&#46; Round 2&#44; aimed to reach preliminary consensus &#8220;in&#8221; or &#8220;out&#8221; for domains&#46; It included all items that were rated &#8220;of critical importance&#8221; &#40;rated in the range of 7&#8211;9&#41; by at least 80&#37; of the participants as well as any new domains proposed in round 1&#46; Three response categories per item&#58; &#8220;include&#8221;&#44; &#8220;undecided&#8221; or &#8220;do not include&#8221;&#46; Round 3 might be needed&#44; to reach preliminary consensus &#8220;in&#8221; or &#8220;out&#8221; for domains that did not reach preliminary consensus in round 2&#46; Three response categories per item &#8220;include&#8221;&#44; &#8220;undecided&#8221;&#44; &#8220;do not include&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> The definitions we used for the consensus of the core areas and domains were summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Definition of consensus</span><p id="par0075" class="elsevierStylePara elsevierViewall">Definition of consensus was established before initiating the online Delphi procedure and data analysis&#46; The core team reviewed and discussed the consensus criteria and the criteria for excluding domains from consideration in subsequent rounds&#46; Consensus definition were set as&#58; consensus &#8216;in&#8217;&#58; rated &#8216;do not include&#8217; by &#60;30&#37; of panellists&#44; consensus &#8216;out&#8217;&#58; rated &#8216;include&#8217; by &#60;30 of panellists&#44; no consensus&#58; rated &#8216;include&#8217; by at least 30&#37; and rated &#8216;exclude&#8217; by at least 30&#37;&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Chronogram of Delphi rounds</span><p id="par0080" class="elsevierStylePara elsevierViewall">The first round took place between 13th and 17th May 2022 &#40;5 days&#41;&#46; The first-round outcomes were revised in view of the comments and included in the second round&#46; The second round took place between 1st and 10th Jun 2022 &#40;11 days&#41;&#46; The third round deemed unnecessary as consensus was achieved by the end of the second round&#46;</p><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Ethics and consent</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study was performed in accordance with the Helsinki Declaration&#46; The &#8220;Clinical&#44; Evidence-based&#44; Guidelines &#40;CEG&#41;&#8221; initiative protocol was approved the local ethical committee&#58; ethical approval code&#58; 34842&#47;8&#47;21&#44; ethical board Tanta University&#46; All the participants were kept anonymous&#44; in compliance with data protection regulations&#46;</p></span></span></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Results</span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Content analysis of the literature</span><p id="par0090" class="elsevierStylePara elsevierViewall">The literature review included 331 studies that discussed report recommendations&#44; definitions&#44; standards&#44; and techniques for quantifying NFC results&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> depicts the systematic review research strategy adopted in this work&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Delphi rounds</span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">This was based on an online survey</span><p id="par0095" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0100" class="elsevierStylePara elsevierViewall">The first round of the electronic survey included core items identified in the literature review together with their candidate domains and subdomains&#46; The participants identified seven subdomains to be added&#58; two items under Raynaud&#39;s phenomenon core area &#40;number of attacks during the week&#44; number of finger ulcers&#41;&#44; 2-items under procedure &#40;number of fingers examined and date of the first examination&#41;&#44; 1-item under medical status &#40;comorbidities&#41;&#44; 1-item under medical status &#40;medications&#41;&#44; and 1-item under findings &#40;subpapillary plexus&#41;&#46; The final list of the core areas and domains&#47;subdomains are shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; The response rate in this round was 100&#37; &#40;11&#47;11&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the results of this round which revealed that on 81&#46;8&#37; of the topics&#44; there was agreement on the key NFC Core set domains &#40;i&#46;e&#46;&#44; 75&#37; of respondents strongly agreed or agreed&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0105" class="elsevierStylePara elsevierViewall">The second round was based on the first round&#39;s results and the response rate in this round was 100&#37; &#40;11&#47;11&#41;&#46; Outcomes revealed that a consensus has been achieved on the &#8220;in&#8221; or &#8220;out&#8221; core areas and domains&#46; 81&#46;8&#8211;100&#37; of respondents agreed the key NFC Core set domains to be included&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the results of this round outcomes&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></li></ul></p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0185">Expert panel characteristics</span><p id="par0110" class="elsevierStylePara elsevierViewall">The Delphi form was sent to expert panel &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41;&#44; who participated in the two rounds&#46; Respondents were five internationals&#44; with participation of two Italian &#40;18&#46;2&#37;&#41; and two German &#40;18&#46;2&#37;&#41; and one from UK &#40;9&#46;1&#37;&#41; experts&#44; whereas six national experts were gathered from different governorates and health centres across Egypt&#58; Cairo University &#40;9&#46;1&#37;&#41;&#44; Ain Shams University &#40;9&#46;1&#37;&#41;&#44; Tanta University &#40;9&#46;1&#37;&#41;&#44; Fayoum University &#40;9&#46;1&#37;&#41;&#44; Assiut University &#40;9&#46;1&#37;&#41;&#44; and National Research Centre &#40;9&#46;1&#37;&#41;&#46;</p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0190">Reporting template</span><p id="par0115" class="elsevierStylePara elsevierViewall">Based on the outcomes of this work&#44; a final reporting template of NFC for use in standard clinical practice and reached has been set up&#46; The reporting template is shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0195">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">The NFC outcomes not only have a diagnostic value&#44; but also have a positive predictive role for the development of specific spectrum disorders&#46; Therefore&#44; a detailed and analytical documentation of the nailfold capillaroscopy findings can be useful to ensure attaining a reproducibly quantitative as well as qualitative recording of the various NFC parameters&#46; So far there is no standard model for NFC reporting&#46; The current study aimed to bring objectivity and achieve consensus about outcome domains to be included in a model of nailfold capillaroscopy report&#46; Also&#44; to ensure that the level of the details included in the report meet the expected standards for both clinical practice as well as clinical research&#46; Online Delphi procedure was adopted with the help of international expert panel to reach a consensus about the core items&#44; domains as well as subdomains for NFC reporting&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Bearing in mind the fact that NFC is a highly operator-dependent imaging tool&#44; earlier attempts to set up standards for reporting the NFC findings highlighted the importance of the matter&#44; but the outcomes of these studies revealed that there is still work remain to be done&#46; Ingegnoli et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> carried out a study to propose a pragmatic reporting checklist for NFC&#46; The study produced a checklist on standardization of reporting capillaroscopy derived from an international consensus&#46; Three overarching areas for reporting NVC were identified&#46; These included patient preparation before NFC&#44; device description and examination details&#46; However&#44; the study concluded that the available evidence is insufficient to make definitive recommendations&#46; The study recommended a further step towards standardization and development of a future &#8216;NFC core set&#8217;&#46; In another study&#44; the Pan-American League of Associations for Rheumatology &#40;PANLAR&#41; capillaroscopy study group published a consensus for the format and content of the nailfold capillaroscopy report in rheumatology&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> Forty-six recommendations for the capillaroscopy report in rheumatology reached a consensus&#46; They were stratified over six sections&#58; patient&#39;s data&#44; Raynaud&#39;s phenomenon&#44; visibility&#44; NFC examination&#44; diagnosis&#44; suggestion&#44; and imaging&#46; However&#44; the study was based on a comparison of the expert&#39;s opinion&#44; in the absence of a strong background of evidence&#44; and it did not suggest a standard reporting format&#44; highlighting a gap in the literature that need to be addressed&#46; Results of this work identified 14 core areas &#40;included in details in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; This significant increase in the number of the core items reflects the main objective of this work that is development of NVC core set&#44; which was meant to provide a relevant step forward towards NFC reporting standardization&#46; The developed report template offers detailed specifications of the contents of the NFC report in clinical practice&#47;scientific research&#44; which should encompass specific information that is useful in describing the variable pathologic findings and provide reproducible and measurable information to the examining clinician&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Given its increasing use by a variety of physicians in different centres all over the world&#44; the technique standardization published by the EULAR Study Group on Microcirculation in Rheumatic Diseases&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> regarding image acquisition and analysis&#44; different techniques&#44; normal and abnormal capillaroscopic characteristics and their meaning&#44; scoring systems and reliability of image acquisition and interpretation&#44; has paved the way for producing the reporting standardization too&#46; Though these standards focussed on the technique and defining the capillaroscopic characteristics&#44; it facilitated the concept of having a similar approach for reporting standards&#46; Analysis of this study results revealed that the experts reached a consensus in both rounds on the core items to be reported in the format with some amendments&#46; This reflects the relevance and clarity of the items included in the suggest report core items&#46; In the meantime&#44; the level of consensus agreement&#44; is expected to help to harmonize and smooth NFC reporting and to overcome the personal preferences in documenting the NFC outcomes&#46; Previously published general commendations on the accurate reporting of imaging investigations determined that a &#8216;good&#8217; report of medical imaging should be designated by the eight Cs&#58; clarity&#44; correctness&#44; confidence&#44; concision&#44; completeness&#44; consistency&#44; communication and consultation&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> The domains identified in this study based on the available evidence derived from the systematic review as well as their terminology were set to meet these &#8216;good&#8217; report recommendationsIn conclusion&#44; the adoption of a shared form of reporting NFC findings could be a relevant step towards NFC standardization&#46; Considering that several factors may affect the NFC findings&#44; this would defer the calls that NFC report should focus on defining capillaroscopic characteristics to be evaluated &#40;density&#44; dimension&#44; abnormal shape and haemorrhages&#41;&#44; but also to include other demographic and methodological standardization applicable for both day to day practice and clinical research&#46; A Delphi survey was carried out including an international expert panel&#46; The majority of the domains identified in the literature and the draft core set were identified by the participants to be important and valid&#46; All domains met the 80&#37; voting threshold set in this work&#46; The work proposed an NFC recording template&#46;<elsevierMultimedia ident="tb0005"></elsevierMultimedia></p></span><span id="sec0150" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0220">Ethical approval</span><p id="par0150" class="elsevierStylePara elsevierViewall">This study was performed in accordance with the Helsinki Declaration&#46; The &#8220;Clinical&#44; Evidence-based&#44; Guidelines &#40;CEG&#41;&#8221; initiative protocol was approved the local ethical committee&#58; ethical approval code&#58; 34842&#47;8&#47;21&#44; ethical board Tanta University&#46; All the participants were kept anonymous&#44; in compliance with data protection regulations&#46;</p></span><span id="sec0155" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0225">Authors&#8217; contributions</span><p id="par0155" class="elsevierStylePara elsevierViewall">All authors contributed to the study methodology&#44; analysis&#44; and interpretation of the data and outcomes as well as the manuscript writing&#44; reading&#44; and approval of the final version&#46;</p></span><span id="sec0160" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0230">Funding</span><p id="par0160" class="elsevierStylePara elsevierViewall">The author&#40;s&#41; received no financial support for the research&#44; authorship&#44; and&#47;or publication of this article&#46;</p></span><span id="sec0165" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0235">Conflict of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">Nothing to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The peripheral microangiopathy may be well evaluated and studied by nailfold capillaroscopy &#40;NFC&#41; which is a safe and non-invasive technique&#46; NFC has been reported to have both diagnostic and prognostic values in patients presenting with Raynaud&#39;s phenomenon&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The overarching objective of this work was to make a consensus on what domains should be included in a capillaroscopy report and that it can be used in daily clinical practice and clinical research in the area of rheumatology&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A Delphi questionnaire was developed regarding capillaroscopy report from a literature review and expert consensus&#46; The first Delphi round included 14 core areas&#44; its 18 domains with 50 subdomains&#44; derived from a systematic literature review&#46; The level of evidence was determined for each core set using the Oxford Centre for Evidence-based Medicine &#40;CEBM&#41; system&#46; Nine response categories have been set per each item ranging between 1 and 9&#46; Round 2&#44; aimed to reach preliminary consensus &#8220;in&#8221; or &#8220;out&#8221; for domains&#46; It included all items that were rated &#8220;critical&#8221; by at least 80&#37; of the participants as well as any new domains proposed in round 1&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The participants to the first&#44; and second round were 11 experts&#46; Fourteen domains were discussed in the two rounds&#46; At the end of the survey&#44; the final report template of NFC in rheumatology reached a consensus&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A nailfold capillaroscopy report template has been developed by this study&#44; based on outcomes of a Delphi process&#44; by international participants panel&#46; All domains met the 80&#37; voting threshold set in this work&#46; The reporting template can be used for both clinical research as well as day to day practice to provide guidance and standardize the NFC reporting&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La microangiopat&#237;a perif&#233;rica puede ser evaluada y estudiada adecuadamente mediante capilaroscopia ungueal &#40;NFC&#41;&#44; que es una t&#233;cnica segura y no invasiva&#46; Se ha informado que la NFC tiene valores tanto diagn&#243;sticos como pron&#243;sticos en pacientes que presentan el fen&#243;meno de Raynaud&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El objetivo general de este trabajo fue aportar de manera objetiva y lograr un consenso sobre los dominios que se incluir&#225;n en los resultados de un modelo de informe de la NFC y que pueda ser aplicable tanto para la pr&#225;ctica cl&#237;nica est&#225;ndar como para la investigaci&#243;n cl&#237;nica en reumatolog&#237;a&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se elabor&#243; un cuestionario Delphi sobre el informe de capilaroscopia a partir de una revisi&#243;n bibliogr&#225;fica y del consenso de expertos&#46; La primera ronda Delphi incluy&#243; 14 &#225;reas centrales&#44; sus 18 dominios con 50 subdominios&#44; derivados de una revisi&#243;n sistem&#225;tica de la literatura&#46; El nivel de evidencia se determin&#243; para cada conjunto b&#225;sico utilizando el sistema del Centro de Medicina basada en la Evidencia de Oxford&#46; Se han establecido 9 categor&#237;as de respuesta para cada &#237;tem&#44; que oscilan entre 1 y 9&#46; La ronda 2 ten&#237;a como objetivo llegar a un consenso preliminar &#171;dentro&#187; o &#171;fuera&#187; de los dominios&#46; Inclu&#237;a todos los elementos que fueron calificados como &#171;cr&#237;ticos&#187; por al menos el 80&#37; de los participantes&#44; as&#237; como cualquier dominio nuevo propuesto en la ronda 1&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">En la primera y segunda ronda participaron 11 expertos&#46; En las 2 rondas se discutieron 14 dominios&#46; Al final de la encuesta&#44; el modelo de informe final de la NFC en reumatolog&#237;a alcanz&#243; un consenso&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusi&#243;n</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Este estudio desarroll&#243; una plantilla de informe de capilaroscopia ungueal&#44; basada en los resultados de un proceso Delphi por un panel internacional de participantes&#46; Todos los dominios alcanzaron el umbral de votaci&#243;n del 80&#37; establecido en este trabajo&#46; La plantilla de informes se puede utilizar tanto para la investigaci&#243;n cl&#237;nica como para la pr&#225;ctica diaria&#44; para proporcionar orientaci&#243;n y estandarizar los informes de la NFC&#46;</p></span>"
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Definition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Capillary density&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Number of capillaries&#47;1<span class="elsevierStyleHsp" style=""></span>mm&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Capillary length&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Distance between the capillary apex and the point where the capillary loop is no longer visible&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Capillary diameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Width of the arterial &#40;afferent&#41;&#44; apical&#44; venous &#40;efferent&#41; loop &#40;especially apical loop&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Giant capillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A homogeneously &#40;very&#41; enlarged capillary&#44; with a diameter of &#62;50<span class="elsevierStyleHsp" style=""></span>mm&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morphology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The shape of each individual capillary&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blood flow&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regular erythrocytes column&#44; slowed down&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ghost capillary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A capillary that slips in and out of the field of view &#40;during live imaging&#41; because it is only intermittently perfused&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Avascular area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Section of the nailfold where no capillaries can be seen&#46; It can sometimes be difficult to decide whether this is &#8216;true&#8217; avascularity or due to difficulties in visualizing &#40;sections of&#41; the distal row&#46; When using a contact probe&#44; a section of the nailfold can appear avascular if too much pressure is applied&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Haemorrhage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dark areas of hemosiderin on the nailfold capillary bed due to the capillary wall rupture&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Angiogenesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abnormal shapes &#40;other shapes than hairpin&#44; tortuous&#44; or crossing&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pericapillary oedema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pericapillary increase of interstitial fluid&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            "identificador" => "at2"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Domain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean rate<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37; of agreement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Level of agreement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; patient&#39;s demographics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; examining health care professionals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; reason for referral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; Raynaud&#39;s phenomenon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; medical status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; medications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; lab results&#58; ANA&#47;ENA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; preparation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; device&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; the procedure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; image quality&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">8&#46;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; findings&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; interpretation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Core area&#58; recommendations&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
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                  """
              ]
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                  \t\t\t\t">&#8226; Reason for referral&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;81&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Raynaud&#39;s phenomenon&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;9&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Medical status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;81&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;18&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Medications&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9 &#40;81&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;9&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;9&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Lab results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8 &#40;72&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1 &#40;9&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;18&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">11 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8226; Preparation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9 &#40;81&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;18&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Delphi round 2 results&#58; core domains set for nailfold capillaroscopy reporting&#46;</p>"
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          "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0200">Key summary points</span><span id="sec0135" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0205">What is already known on this topic</span><p id="par0135" class="elsevierStylePara elsevierViewall">Standardization of nailfold capillaroscopy examination for the assessment of patients with Raynaud&#39;s phenomenon and systemic sclerosis has been recently published by the Study Group on Microcirculation in Rheumatic Diseases &#40;EULAR SG&#47;MC RD group&#41;&#46;</p></span><span id="sec0140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0210">What this study adds</span><p id="par0140" class="elsevierStylePara elsevierViewall">Building up the expert consensus from the EULAR SG MC group&#44; it was recognized that the available evidence is insufficient to make definitive recommendations for nailfold capillaroscopy reporting&#46; A further step is required towards standardization&#44; and development of core set areas and domains for a future Nailfold capillaroscopy report that is fit for use in both clinical practice as well as research&#46; This study fills this gap&#46;</p></span><span id="sec0145" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0215">How this study might affect research&#44; practice or policy</span><p id="par0145" class="elsevierStylePara elsevierViewall">The current study aimed to bring objectivity and achieve consensus about outcome domains to be included in a model of nailfold capillaroscopy report&#46; Also&#44; to ensure that the level of the details included in the report meet the expected standards for both clinical practice as well as clinical research&#46;</p></span></span></span>"
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Información del artículo
ISSN: 1699258X
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