SAT0050 Standardisation of synovial biopsies analysis: a eular synovitis study group initiative using a delphi survey.
Authors: A. Najm, B. Le Goff, C. Orr, J. Fonseca, B. Lauwerys, D. Veale
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Synovial biopsies are increasingly performed in both clinical setting and translational research.<sup>1</sup> An unmet need in the field is the standardisation of synovial biopsies handling and analysis procedures. <h3>Objectives</h3> The aim of this collaborative work was to create a consensual set of points to consider for handling and analysis of synovial biopsies in clinical practice and translational research through EULAR Synovitis Study Group (ESSG). <h3>Methods</h3> The items were identified and formulated based on a comprehensive literature review.<sup>1</sup> A task force (TF) of EULAR Synovitis Study Group (ESSG) members were constituted and TF members were consulted through a 2-stage eDelphi process. the 2 sequential rounds occurred in 9 months. The first written round occurred in June 2016. Members were sent a written questionnaire containing items divided in 2 parts. The items were identified and formulated based on a comprehensive literature review. The first part of the questionnaire referred to clinical practice containing 5 subsections: biopsy sampling, biopsy handling, histological analysis, staining and immunohistochemistry (IHC), biopsy analysis and pathologist’s report. The second part referred to translational research and contained 6 subsections (same 5 plus RNA analysis). Every participant was asked to score each item with a 5 points Likert (0: strongly disagree, 5: strongly agree), comments were allowed for each item. Items with a median score above 3.5 on 5 and a percentage of agreement above 70% were for the next round. Items with lower score were either suppressed of modified according to participants’ comments. Anonymized detailed results were circulating through participants between each round. The face to face meeting occurred at ESSG meeting in June 2017. <h3>Results</h3> 27 ESSG members from 19 centres were contacted by email. 20 participants from 17 centres answered (response rate of 74%). Response rates for next rounds were 100%. First questionnaire contained 44 items for Part 1 Clinical practice. 52.3% (23items/44) were selected for the second round based on their score and agreement percentage. 83% (19items/23) were selected for the third round. First questionnaire contained 43 items for the second part about translational research. 44% (19 items/43) were selected for second round based on their score and agreement percentage. 95% (18 items/19) were selected for third round (figure 1). Third oral round allowed to obtain a final set of items unanimously (table 1). <h3>Conclusions</h3> We hereby propose a set of consensual points to consider on analysis of synovial biopsies in clinical practice and translational research. This standardisation initiative was conducted through ESSG members using a validated consensus method. <h3>Reference</h3> [1] Orr C, Sousa E, Boyle DL, Buch MH, Buckley CD, Cañete JD, et al. Synovial tissue research: a state-of-the-art review. Nat Rev Rheumatol2017;13(8):463–75. <h3>Disclosure of Interest</h3> None declared