Cohort Profile: Cohort Hip and Cohort Knee (CHECK) study

s u m m a r yObjective: To design an automated workflow for hip radiographs focused on joint shape and tests its prognostic value for future hip osteoarthritis. Design: We used baseline and 8-year follow-up data from 1,002 participants of the CHECK-study. The primary outcome was definite radiographic hip osteoarthritis (rHOA) (KellgreneLawrence grade 2 or joint replacement) at 8-year follow-up. We designed a method to automatically segment the hip joint from radiographs. Subsequently, we applied machine learning algorithms (elastic net with automated parameter optimization) to provide the Shape-Score, a single value describing the risk for future rHOA based solely on joint shape. We built and internally validated prediction models using baseline demographics, physical examination, and radiologists scores and tested the added prognostic value of the Shape-Score using Area-Under-the-Curve (AUC). Missing data was imputed by multiple imputation by chained equations. Only hips with pain in the corresponding leg were included. Results: 84% were female, mean age was 56 (±5.1) years, mean BMI 26.3 (±4.2). Of 1,044 hips with pain at baseline and complete follow-up, 143 showed radiographic osteoarthritis and 42 were replaced. 91.5% of the hips had follow-up data available. The Shape-Score was a significant predictor of rHOA (odds ratio per decimal increase 5.21, 95%-CI (3.74e7.24)). The prediction model using demographics, physical examination, and radiologists scores demonstrated an AUC of 0.795, 95%-CI (0.757e0.834). After addition of the Shape-Score the AUC rose to 0.864, 95%-CI (0.833e0.895). Conclusions: Our Shape-Score, automatically derived from radiographs using a novel machine learning workflow, may strongly improve risk prediction in hip osteoarthritis.

Section: Participantsmentioning

confidence: 99%

An automated workflow based on hip shape improves personalized risk prediction for hip osteoarthritis in the CHECK study

Gielis

Weinans

Welsing

et al. 2020

“…The third study is a nation-wide prospective cohort study of 1,002 individuals with early symptomatic OA of hip and/or knee (Cohort Hip & Cohort Knee; CHECK), of which 103 were included and assessed at the Sint Maartenskliniek Nijmegen 13 . Patients included at the Sint Maartenskliniek Nijmegen, with predominant knee symptoms, were eligible for the current study.…”

Section: Patientsmentioning

confidence: 99%

Exploring longitudinal associations of histologically assessed inflammation with symptoms and radiographic damage in knee osteoarthritis: combined results of three prospective cohort studies

Minten

Blom

Snijders

et al. 2019

s u m m a r yObjective: To explore the associations between different histologically assessed, inflammatory synovial characteristics and subsequent clinical and structural aspects in knee osteoarthritis (OA). Design: Knee OA patients, ranging in stage from early to advanced, were recruited from three different ongoing studies. Synovial tissue biopsies were taken and histologically assessed for six features (four inflammatory related aspects, fibrosis and fibrin deposition). Clinical aspects (WOMAC pain, functioning and stiffness and SF-36 vitality) and structural aspects (Kellgren and Lawrence (KL)-grade, joint space narrowing (JSN; 0e3) and osteophytes (0e3), and reception of total knee replacement (TKR)) were repeatedly assessed during follow-up. Associations between histology and clinical and structural aspects were analysed using linear mixed model analyses and cox proportional hazards analysis. Results: Biopsies of 83 patients (median complaint duration: 5 [2e8] years) were analysed. Follow-up was a median of 1.4 [0.8e2.7] years for clinical and 1.8 [0.2e5.2] years for structural aspects. Fibrosis and fibrin deposition were inversely correlated with the inflammatory features. A higher fibrosis score was associated with a lower scores for KL-grade, JSN and osteophytes, while higher scores for perivascular oedema, synovial lining thickness and vascularisation were associated with higher scores for structural aspects during follow-up. No associations were found between each of the histological features and any of the clinical aspects or the chance for TKR during follow-up. Conclusions: Inflammatory related histological aspects are associated with subsequent increased radiological severity in knee OA, while fibrosis seems to protect against this, providing a potential therapeutic target for OA treatment.

“…The CHECK study included 1002 participants aged 45e65 years living in the Netherlands, with early symptomatic OA characterized by pain of knee and/or hip, entered the cohort in the period October 2002 to September 2005. They were included at or within 6 months of their first visit to the general practitioner for these symptoms 8 . Participants with a pathological condition that could explain the hip symptoms were excluded including intra-articular fractures, RA, congenital dysplasia, Perthes disease, subluxation, osteochondritis dissecans, septic arthritis, previous hip joint replacement, previous hip surgery, and individuals having only symptoms of bursitis or tendinitis.…”

Section: Study Populationsmentioning

confidence: 99%

Development of a prediction model for future risk of radiographic hip osteoarthritis

Hosnijeh

Kavousi

Boer

et al. 2018