Machine Learning Can be Used to Predict Function but Not Pain After Surgery for Thumb Carpometacarpal Osteoarthritis

Abstract

Background Surgery for thumb carpometacarpal osteoarthritis is offered to patients who do not benefit from nonoperative treatment. Although surgery is generally successful in reducing symptoms, not all patients benefit. Predicting clinical improvement after surgery could provide decision support and enhance preoperative patient selection.Questions/purposes This study aimed to develop and validate prediction models for clinically important improvement in (1) pain and (2) hand function 12 months after surgery for thumb carpometacarpal osteoarthritis. Methods Between November 2011 and June 2020, 2653 patients were surgically treated for thumb carpometacarpal a Members of the Hand-Wrist Study Group are listed in an Appendix at the end of this article. Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.

CORR Insights®: Machine Learning Can be Used to Predict Function but Not Pain After Surgery for Thumb Carpometacarpal Osteoarthritis

“…Loos et al [7] created a machine learning tool to help clinicians predict the chance of improvement in their patients after thumb CMC surgery for osteoarthritis, and they shared their results in this month’s Clinical Orthopaedics and Related Research ® . Based on their discovery, surgeons can now enter a patient’s preoperative Michigan Hand Outcomes Questionnaire (MHQ) scores into an internet application (provided in the paper) and receive guidance about what functional improvement a patient can expect after surgery.…”

“…However, machine learning is subject to many of the same limitations as other clinical outcomes studies are (such as transfer bias; that is, whether the follow-up period is sufficiently long to detect all relevant harms and benefits of treatment). In particular, machine learning studies The authors of the current study [7] used the VAS for pain and MHQ to predict pain and functional improvement after CMC arthroplasty. The use of a clinically validated instrument such as the MHQ is essential in developing reliable diagnostic and prognostic models.…”

“…The authors of the current study [7] used the VAS for pain and MHQ to predict pain and functional improvement after CMC arthroplasty. The use of a clinically validated instrument such as the MHQ is essential in developing reliable diagnostic and prognostic models.…”

Letter to the Editor: Machine Learning Can be Used to Predict Function but Not Pain After Surgery for Thumb Carpometacarpal Osteoarthritis

“…Despite a widespread awareness of the importance of anxiety as a covariate in this context, Loos et al [2] did not include anxiety in the model. They accounted for age, gender, occupation intensity, BMI, smoking, medical history, disease severity, quality of life, and general mental health.…”

Reply to the Letter to the Editor: Machine Learning Can be Used to Predict Function but Not Pain After Surgery for Thumb Carpometacarpal Osteoarthritis

“…We would like to thank Kabuli et al for their interest in our study [5] and for sharing their perspectives on the importance of anxiety on the outcomes of surgery.…”