How should worsening in osteoarthritis be defined? Development and initial validation of preliminary criteria for clinical worsening in knee and hip osteoarthritis
| Autor: | Eam Mahler, Vjjf Busch, F.H.J. van den Hoogen, Thasia G. Woodworth, A.A. den Broeder, Chm van den Ende, J. W. J. Bijlsma |
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| Rok vydání: | 2017 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Consensus Psychometrics Immunology Osteoarthritis Sensitivity and Specificity Osteoarthritis Hip 03 medical and health sciences 0302 clinical medicine Rheumatology medicine Hip osteoarthritis Humans Immunology and Allergy 030212 general & internal medicine Netherlands 030203 arthritis & rheumatology business.industry Patient Selection General Medicine Middle Aged Osteoarthritis Knee medicine.disease Expert group Derivation cohort Conservative treatment Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] Disease Progression Physical therapy Female Observational study Symptom Assessment business Validation cohort |
| Zdroj: | Scandinavian Journal of Rheumatology, 46, 5, pp. 396-406 Scandinavian Journal of Rheumatology, 46, 396-406 |
| ISSN: | 0300-9742 |
| DOI: | 10.1080/03009742.2016.1235226 |
| Popis: | Item does not contain fulltext OBJECTIVES: There is a need to define and validate measures of clinical worsening in knee and hip osteoarthritis (OA). The objectives of this exploratory project were: (i) to characterize worsening criteria in knee and hip OA using psychometric methods; (ii) to estimate their sensitivity and specificity; and (iii) to validate and compare these criteria with worsening criteria previously described in the literature. METHOD: An Expert Group reached consensus on 10 sets of worsening criteria to be tested in observational data sets of patients with knee or hip OA who received multimodal conservative treatment. These sets included 219 patients (derivation cohort) and 296 patients (validation cohort). We estimated minimal clinically important worsening (MCIW) values for pain, function, stiffness, and patient global assessment, and tested candidate worsening criteria in the derivation cohort. Finally, using patient judgement, we examined the sensitivity and specificity of literature-based as well as candidate worsening criteria in the validation cohort. RESULTS: Literature-based worsening criteria were found to have high specificity (range 60-92%) but low sensitivity (range 22-59%). Two out of 10 candidate worsening criteria constructed by the Expert Group showed an acceptable combination of sensitivity and specificity in the derivation cohort, which was confirmed in the validation cohort (ranging from 54% to 65% and 67% to 74%, respectively). CONCLUSIONS: This is the first study to describe symptomatic worsening criteria based on expert consensus after examining the performance of candidate criteria derived from the literature applied to data in an observational study. The newly proposed worsening criteria show an acceptable combination of sensitivity and specificity. |
| Databáze: | OpenAIRE |
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