1. Harmonising measures of knee and hip osteoarthritis in population-based cohort studies: an international study
- Author
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Leyland, KM, Gates, LS, Nevitt, M, Felson, D, Bierma-Zeinstra, SM, Conaghan, PG, Engebretsen, L, Hochberg, M, Hunter, DJ, Jones, G, Jordan, JM, Judge, A, Lohmander, LS, Roos, EM, Sanchez-Santos, MT, Yoshimura, N, van Meurs, JBJ, Batt, ME, Newton, J, Cooper, C, and Arden, NK
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Clinical Research ,Osteoarthritis ,Aging ,Arthritis ,Pain Research ,Chronic Pain ,2.4 Surveillance and distribution ,Aetiology ,Musculoskeletal ,Aged ,Canada ,Cohort Studies ,Consensus ,Disability Evaluation ,Disease Progression ,Female ,Follow-Up Studies ,Humans ,Internationality ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Osteoarthritis ,Hip ,Osteoarthritis ,Knee ,Pain Measurement ,Range of Motion ,Articular ,Severity of Illness Index ,Time Factors ,Tomography ,X-Ray Computed ,Cohort ,Data ,Epidemiology ,Harmonisation ,Biomedical Engineering ,Human Movement and Sports Sciences ,Arthritis & Rheumatology ,Clinical sciences ,Sports science and exercise - Abstract
ObjectivePopulation-based osteoarthritis (OA) cohorts provide vital data on risk factors and outcomes of OA, however the methods to define OA vary between cohorts. We aimed to provide recommendations for combining knee and hip OA data in extant and future population cohort studies, in order to facilitate informative individual participant level analyses.MethodInternational OA experts met to make recommendations on: 1) defining OA by X-ray and/or pain; 2) compare The National Health and Nutrition Examination Survey (NHANES)-type OA pain questions; 3) the comparability of the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) scale to NHANES-type OA pain questions; 4) the best radiographic scoring method; 5) the usefulness of other OA outcome measures. Key issues were explored using new analyses in two population-based OA cohorts (Multicenter Osteoarthritis Study; MOST and Osteoarthritis Initiative OAI).ResultsOA should be defined by both symptoms and radiographs, with symptoms alone as a secondary definition. Kellgren and Lawrence (K/L) grade ≥2 should be used to define radiographic OA (ROA). The variable wording of pain questions can result in varying prevalence between 41.0% and 75.4%, however questions where the time anchor is similar have high sensitivity and specificity (91.2% and 89.9% respectively). A threshold of 3 on a 0-20 scale (95% CI 2.1, 3.9) in the WOMAC pain subscale demonstrated equivalence with the preferred NHANES-type question.ConclusionThis research provides recommendations, based on expert agreement, for harmonising and combining OA data in existing and future population-based cohorts.
- Published
- 2018