Assessment and determinants of aesthetic discomfort in hand osteoarthritis

Hodkinson, Bridget; Maheu, E.; Michon, Mathilde; Carrat, Fabrice; Bérenbaum, Francis

doi:10.1136/ard.2011.153965

Cited by 36 publications

(51 citation statements)

References 26 publications

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“…In the present study in consecutive patients with HOA, a high prevalence (51%) of EOA was found, which is in accordance with prevalences of EOA in other rheumatology clinics 20. An explanation for this high prevalence could be the source of patients being a rheumatology outpatients clinic.…”

Section: Discussionsupporting

confidence: 91%

In erosive hand osteoarthritis more inflammatory signs on ultrasound are found than in the rest of hand osteoarthritis

Kortekaas

Kwok

Reijnierse

et al. 2013

Annals of the Rheumatic Diseases

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Section: Discussionsupporting

confidence: 91%

In erosive hand osteoarthritis more inflammatory signs on ultrasound are found than in the rest of hand osteoarthritis

Kortekaas

Kwok

Reijnierse

et al. 2013

Annals of the Rheumatic Diseases

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“…Hodkinson et al have recently shown aesthetic discomfort to be a major concern for more than 30% of patients with HOA, and associated with depression, anxiety and poor QoL. However, in our study, patients who rated many domains as highly important were similar in their pain, function and global assessment compared to patients who endorsed fewer domains.…”

Section: Discussioncontrasting

confidence: 71%

“…Although there have been some outcome measures used in clinical trials, the majority have not taken into consideration the perspectives of patients who have HOA . For instance, aesthetic discomfort is only recently recognized as a major concern affecting a sizable proportion of patients with HOA …”

Section: Introductionmentioning

confidence: 99%

Domains rated as important by patients with hand osteoarthritis

Leung

Thumboo

2019

Int J of Rheum Dis

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Background:No data exist on patient participation in the selection of core domains for clinical trials of hand osteoarthritis (HOA). We aim to explore HOA patients' perspectives in the relative importance of domains.Methods: Seven domains affecting patients' lives were derived from a prior qualitative study. We recruited consecutive patients with symptomatic HOA to rate on 11point numeric rating scales for each domain, from 0 representing "not important at all" to 10 representing "most important", with consideration in two scenarios: (a) how important the domains are in affecting their current lives; and (b) how important the domains are when there are treatments for HOA (eg exercise or drugs). Results:Forty-five patients (91% female; mean age ± standard deviation 64.3 ± 7.5 years) with mild HOA symptoms were included. Of these, 31%-42% rated current impact of HOA in various domains as highly important. Seven domains with rated scores of ≥7/10 in importance were endorsed for clinical trials in the following order: pain and HOA symptoms (endorsed by 77.8% of patients), physical function (66.7%), ability to participate in social roles (64.4%), ability to participate in social activities (62.2%), work productivity (62.2%), emotional health (60%), and appearance of fingers (55.6%). Conclusion:The preliminary important domains as endorsed by patients with HOA for inclusion into clinical trials were explored. Apart from pain and physical function, further research is needed to refine other domains of impact, such as participation, emotional health and aesthetic concerns, as core domain sets for HOA. K E Y W O R D S core domain set development, Delphi study, hand osteoarthritis, patient participation 2046 | LEUNG Et aL. patients and clinicians. 13,14 Although there are several existing PROMs for the measurement of outcomes in HOA, 15-17 none of these PROMs were developed from patients' perspectives. Deficiencies in concepts that are relevant to patients with HOA in the existing PROMs have been recognized from qualitative studies. 18,19 According to the US Food and Drug Administration guidance to industry in supporting labeling claims, the PROMs should reflect the health status of patients without interpretation by clinicians or anyone else. 20 From the valuebased model in health care, understanding the value of health from the perspectives of patients has become indispensable. 21 The Outcome Measures in Rheumatology initiative (OMERACT) has put forward a methodological framework known as OMERACT Filter 2.0 for standardization of reporting of outcomes in clinical trials. 22 Under this framework, it is recommended that domains of concern relevant to patients are identified and prioritized to develop a "Core Domain Set" ("what to measure") before generating a "Core Outcome Measurement Set" ("how to measure") and evaluating the appropriate PROMs to measure these core domains. Different professional societies have proposed different preliminary core domain sets for HOA for purpose of use in clinical trials. The OMERACT HOA S...

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“…Nodal OA occurs more often in women than in men and occurs most often in the dominant hand, suggesting the involvement of mechanical and hormonal factors 40 . Patients with nodal OA frequently have synovitis, osteophytes, cartilage loss, and central and marginal erosions 42 ; aesthetic discomfort is also common 43 . A strong positive association between the presence of nodes and radiographic OA (in particular the occurrence of JSN) supports the notion that a clinical observation of nodes can be taken as an indication of hand OA without the need for radiographic assessment .…”

Section: [H1] Disease Presentation and Burdenmentioning

confidence: 99%

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

et al. 2018

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Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease.

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Assessment and determinants of aesthetic discomfort in hand osteoarthritis

Abstract: Aesthetic discomfort is a major concern for a significant number of patients with HOA, particularly women, those with a high burden of HOA disease and those with erosive osteoarthritis, and is also associated with depression, anxiety and poor health-related quality of life.

Cited by 36 publications

References 26 publications

In erosive hand osteoarthritis more inflammatory signs on ultrasound are found than in the rest of hand osteoarthritis

In erosive hand osteoarthritis more inflammatory signs on ultrasound are found than in the rest of hand osteoarthritis

Domains rated as important by patients with hand osteoarthritis

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

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