Pain trajectory groups in persons with, or at high risk of, knee osteoarthritis: findings from the Knee Clinical Assessment Study and the Osteoarthritis Initiative

Nicholls, Elaine; Thomas, Elaine; Windt, D.A.W.M. van der; Croft, Peter; Peat, George

doi:10.1016/j.joca.2014.09.026

Cited by 104 publications

(107 citation statements)

References 48 publications

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“…[18][19][20] Using LCGA to define pain trajectories in knee OA is a relatively new technique and has only been applied by a few authors to date. [21][22][23] Holla and colleagues applied this technique on the same study population (CHECK), but used WOMAC physical function as the outcome variable; 22 they identified a three-group model and found similar associations to the study findings presented here. Collins and colleagues applied LCGA on a study population from the Osteoarthritis Initiative (OAI) and used WOMAC pain as the outcome measure; they identified five trajectories 21 and suggest knee OA is characterised by persistent, rather than severe, inevitable progression -this is in contrast with the findings presented here.…”

Section: Comparison With Existing Literaturesupporting

confidence: 60%

“…11 Nicholls and colleagues applied LCGA on a study population from the Knee Clinical Assessment Study and matched their model with a population drawn from the OAI. 23 They also used WOMAC pain as an outcome variable and identified five trajectories. They concluded that different types of symptom progression in knee OA exist, varying from severe progression to regression, which is in accordance with the findings presented here.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

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Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)

et al. 2015

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BackgroundGPs have high consultation rates for symptoms related to knee osteoarthritis (OA). Many risk factors for symptomatic knee OA progression remain unknown. AimTo define distinct knee pain trajectories in individuals with early symptomatic knee OA and determine the risk factors for these pain trajectories. Design and settingData were obtained from the multicentre prospective Cohort Hip and Cohort Knee study in the Netherlands. Participants with knee OA, according to the clinical criteria of the American College of Rheumatology, and a completed 5-year follow-up were included. MethodBaseline demographic, anamnestic, and physical examination characteristics were assessed. Outcome was annually assessed by the Numeric Rating Scale for pain. Pain trajectories were retrieved by latent class growth analysis. Multinomial logistic regression was used to calculate relative risk ratios. ResultsIn total, 705 participants were included. Six distinct pain trajectories were identified with favourable and unfavourable courses. Statistically significant differences were found in baseline characteristics, including body mass index (BMI), symptom severity, and pain coping strategies between the different trajectories. Higher BMI, lower level of education, greater comorbidity, higher activity limitation scores, and joint space tenderness were more often associated with trajectories characterised by more pain at first presentation and pain progression -compared with the reference group with a mild pain trajectory. No association was found for baseline radiographic features. ConclusionThese results can help differentiate those patients who require more specific monitoring in the management of early symptomatic knee OA from those for whom a 'wait-and-see' policy seems justifiable. Radiography provided no additional benefit over clinical diagnosis of early symptomatic knee OA in general practice.Keywords disease progression; knee osteoarthritis; knee pain; pain trajectories; primary health care.e32 British Journal of General Practice, January 2016• aged 45-65 years; and• never consulted a physician for these symptoms, or had done so <6 months prior to recruitment to the study.Participants were excluded from the CHECK study if they had:• other pathological conditions that could explain the existing complaints (for example, other rheumatic disease, previous hip or knee joint replacement, congenital dysplasia, osteochondritis dissecans, intraarticular fractures, septic arthritis, Perthes disease, ligament or meniscus injury, plica syndrome, Baker's cyst);• comorbidity that would not allow physical evaluation during 10 years' follow-up;• malignancy in the past 5 years; and• inability to understand Dutch.For the analyses of the current study participants were included if, at baseline, they:• reported knee pain; and• were considered to have knee OA according to the clinical criteria of the American College of Rheumatology. 4,11If a participant had two affected knees, the knee with the worse score based on pain, Kellgren-Lawrenc...

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Section: Comparison With Existing Literaturesupporting

confidence: 60%

Section: Comparison With Existing Literaturementioning

confidence: 99%

Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)

et al. 2015

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“…The natural history of OA involves fluctuation of symptoms, and these people may well have lower pain values on reassessment in the absence of an intervention, introducing regression to the mean (9). In addition, people entering a study in a painful phase of their disease have been shown to have more missing visits in longitudinal cohort studies (10). The second issue with published longitudinal functional values in people with knee OA is that people lost to followup have been shown to be older and have poorer function than those without missing visits (11,12).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Course of Physical Function in People With Symptomatic Knee Osteoarthritis: Data From the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative

Øiestad

White

Booton

et al. 2016

Arthritis Care & Research

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Objective Pain and functional decline are hallmarks of knee osteoarthritis (OA). Nevertheless, longitudinal studies unexpectedly reveal stable or improved physical function. The aim of this study was to impute missing and pre–total knee replacement (TKR) values to describe physical function over time among people with symptomatic knee OA. Methods We included participants from the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI) with incident symptomatic knee OA, observed during the first 30 months in MOST and 36 months in OAI. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function (WOMAC-PF), the 5-times sit-to-stand test, and the 20-meter-walk test were assessed at 4 and 5 years in MOST and at 6 years in OAI. We used a multiple imputation method for missing visits, and estimated pre-TKR values close to the time of TKR, using a fitted local regression smoothing curve. In mixed-effect models, we investigated the physical function change over time, using data before and after imputation and calculation of pre-TKR values. Results In MOST, 225 (8%) had incident knee OA, with corresponding 577 (12.7%) in OAI. After adjusting for pre-TKR values and imputing missing values, we found that WOMAC-PF values remained stable or slightly declined over time, and the 20-meter-walk test results changed from stable in nonimputed analyses to worsening using imputed data. Conclusion Data from MOST and OAI showed stable to worsening physical function over time in people with incident symptomatic knee OA after imputing missing values and adjusting pre-TKR values.

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“…Model fit was based on statistical criteria (Bayesian information criterion (BIC)) and on a judgement of model interpretability [12]. In our study, the latent class mixed-effects model was specified with linear, quadratic and cubic time terms to model non-linear change over time [13-15]. Coefficients were allowed to vary between latent groups.…”

Section: Methodsmentioning

confidence: 99%

Dialysate Creatinine Response Patterns During Peritoneal Equilibration Test and the Association Between Cardiovascular Mortality: Findings from a Prospective Cohort Study

Cai

Qin

et al. 2018

Kidney Blood Press Res

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Background/Aims: During peritoneal equilibrium test (PET), intermediate measures of Dt/P (dialysate/plasma creatinine ratio), D0/P, D2/P and D4/P ratios might provide additional information regarding a patient’s cardiovascular mortality. We aimed to characterise heterogeneity of dialysate creatinine response patterns based on three ratios and compare cardiovascular mortality risks by response patterns. Methods: 3,477 patients initialising peritoneal dialysis (PD) between 2007-2015 were measured D0/P, D2/P and D4/P at baseline and 2-year cardiovascular mortality was defined as the primary outcome. Latent class mixed-effect models were fitted to identify distinct patterns of dialysate creatinine response. Multivariable Logistic regression model with adjustment of cardiometabolic factors were used to compare cardiovascular mortality by latent classes. Results: The 1^st latent class including 36% of participants was characterised by consistently increasing and high Dt/P ratios both at 2-hour and 4-hour. The 2^nd class including 61% of participants characterised by sharply increased ratio at 2-hour and slightly increased ratio at 4-hour. The 3^rd class included 3% of participants with decreased ratio at 2-hour and increased ratio at 4-hour. Comparing the 1^st class, the lower cardiovascular mortality risk was identified in the 2^nd and 3^rd class with adjusted odds ratio 0.65 (95% confidence interval: 0.62-0.69) and 0.48 (0.41-0.57), respectively. Conclusion: Patients with decreased Dt/P ratio between 0-hour and 2-hour and low ratios at 2-hour and 4-hour tend to have low cardiovascular mortality. Latent class analysis seems to be a promising method to reveal unidentified subgroups that do not fit into the risk category defined by Dt/P ratio at 4-hour.

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Pain trajectory groups in persons with, or at high risk of, knee osteoarthritis: findings from the Knee Clinical Assessment Study and the Osteoarthritis Initiative

Cited by 104 publications

References 48 publications

Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)

Defining knee pain trajectories in early symptomatic knee osteoarthritis in primary care: 5-year results from a nationwide prospective cohort study (CHECK)

Longitudinal Course of Physical Function in People With Symptomatic Knee Osteoarthritis: Data From the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative

Dialysate Creatinine Response Patterns During Peritoneal Equilibration Test and the Association Between Cardiovascular Mortality: Findings from a Prospective Cohort Study

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