Population trends in the incidence and initial management of osteoarthritis: age-period-cohort analysis of the Clinical Practice Research Datalink, 1992–2013

Yu, Dahai; Jordan, Kelvin P.; Bedson, John; Englund, Martin; Blyth, Fiona; Turkiewicz, Aleksandra; Prieto‐Alhambra, Daniel; Peat, George

doi:10.1093/rheumatology/kex270

Cited by 68 publications

(89 citation statements)

References 40 publications

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“…To observe the period effect on the recorded OA diagnosis, the analyses were repeated stratified by year of THR/TKR between 2000 and 2015. We present the findings for 3- and 10-year look-back periods in the main results, as we have shown previously that the 3-year is the minimum period needed to pick up recorded OA in CPRD 15 and 10-year is the reasonable maximum period to capture existing diagnosis of OA as shown in previous studies. 2 , 15 , 16 The full set of findings is provided in the Supplementary materials .…”

Section: Methodsmentioning

confidence: 74%

Underrecording of osteoarthritis in United Kingdom primary care electronic health record data

Yu¹,

Jordan²,

Peat³

2018

CLEP

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PurposePrimary care electronic health records are increasingly used to estimate the occurrence of osteoarthritis (OA). We aimed to estimate the extent and trend over time of underrecording of severe OA patients in UK primary care electronic health records using first primary total hip and knee replacements (THR/TKR) – >90% of which are performed for OA – as the reference population.Patients and methodsWe identified patients with a first primary THR or TKR recorded in the UK Clinical Practice Research Datalink between 2000 and 2015. We then searched for a diagnostic/problem code for OA up to 10 years prior to THR/TKR using 3 definitions: “diagnosed OA (joint-specific),” “diagnosed OA (any joint),” “clinical OA” (diagnosed OA or relevant peripheral joint pain symptom code).ResultsAmong 34,299 THR patients identified, 28.1%, 53.4%, and 74.4% had a prior record of diagnosed OA (hip), diagnosed OA (any), and clinical OA, respectively. Among 47,588 TKR patients, the corresponding figures were, 25.5% (diagnosed OA [knee]), 43.7%, and 74.8%. In the UK Clinical Practice Research Datalink, the proportion of patients with prior recorded OA decreased between 2000 and 2015.ConclusionAn increasing trend of underrecording of OA or joint pain among patients with THR or TKR (severe OA patients) between 2000 and 2015 was identified. An underestimate health care demand could be derived based on consultation incidence and prevalence of OA from electronic health record data that relies on osteoarthritis diagnostic codes. Further studies are warranted to investigate the validity of OA or joint pain recorded in primary care settings, which might be used to correct the consultation incidence and prevalence of OA.

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Section: Methodsmentioning

confidence: 74%

Underrecording of osteoarthritis in United Kingdom primary care electronic health record data

Yu¹,

Jordan²,

Peat³

2018

CLEP

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“…High rates of sensitivity (82%40) and specificity (100%41) have been reported for OA identified via medical records but these estimates are dependent on the reference standard selected. The diagnoses of OA in medical record may also underestimate the diagnoses of hand OA and it is expected that there will only be a small number of people classified as having OA who have only hand OA42; the majority of those with OA in this study will have lower limb OA.…”

Section: Discussionmentioning

confidence: 96%

Reasons why osteoarthritis predicts mortality: path analysis within a Cox proportional hazards model

et al. 2019

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ObjectivesTo identify potentially modifiable factors that mediate the association between symptomatic osteoarthritis (OA) and premature mortality.MethodsA population-based prospective cohort study; primary care medical record data were linked to self-report information collected by questionnaire in adults aged 50 years and over (n=10 415). OA was defined by primary care consultation and moderate-to-severe pain interference in daily life. A Cox proportional hazards analysis determined the total effect (TE) of OA on mortality after adjustment for potential confounders. Within the Cox model, path analysis was used to decompose the TE to assess the indirect and direct effects for selected potential mediators (anxiety, depression, unrefreshed sleep and walking frequency). Results are expressed as HRs with 95% CIs derived from bootstrap resampling.ResultsOA was significantly associated with mortality (TE-adjusted HR 1.14; 95% CI 1.00 to 1.29). The indirect effects for walking frequency were 1.05 (95% CI 1.04 to 1.06), depression 1.02 (95% CI 1.02 to 1.03), anxiety 1.01 (95% CI 1.00 to 1.02) and unrefreshed sleep 1.01 (95% CI 1.00 to 1.01).ConclusionsThe analysis indicates that encouraging people to walk and ‘get out and about’ in addition to targeting OA could be protective against excessive mortality. The findings also suggest that depression, anxiety and unrefreshed sleep have a role in premature mortality for people with OA; however, this has low clinical significance.

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“…Gonarthrosis is the most common cause of discomfort among people over 50, it is also a significant research and social problem [21,22]. The disease in the early stage can be treated with physiotherapy, in the advanced stage, the proposed treatment is surgery of endoprosthesis knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Functional and psychological evaluation of patients enrolled into total knee arthroplasty and its effect on the treatment outcome – preliminary reports

Adamski¹

2018

Chir. Narzadow Ruchu Ortop. Pol.

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Introduction. In knee osteoarthritis, the treatment of choice is knee arthroplasty. The primary indication to perform TKA -Total Knee Arthroplasty is pain preventing the functioning of the patient. Aim. The main aim of this study was the assessment of the effects of knee osteoarthritis treatment of patients undergoing arthroplasty and the influence of psychological and physical factors in predicting pain and knee function after treatment. Material and methods. The study involved 60 patients between the ages of 50 and 80, who were enrolled in TKA treatments due to the presence of OAOsteoarthritis. The first control test measurement was held to 8 weeks before the surgery, the second during the control visit 6-9 weeks after the surgery. Both measurements included: interview with the patient, functional assessment (KOOS -Knee Injury and Osteoarthritis Outcome Study), the fall risk assessment, walk test evaluation (TUG -Timed Up and Go), mental health questionnaire (GHQ-28 -General Health Questionnaire), pain intensity assessment (VAS -Visual Analogue Scale). Conclusions. On the basis of this analysis, it was concluded that concern for a lower level of anxiety among patients in the perioperative TKA period reduces the risk of falling and also provides successful surgical treatment of knee osteoarthritis.

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Population trends in the incidence and initial management of osteoarthritis: age-period-cohort analysis of the Clinical Practice Research Datalink, 1992–2013

Cited by 68 publications

References 40 publications

Underrecording of osteoarthritis in United Kingdom primary care electronic health record data

Underrecording of osteoarthritis in United Kingdom primary care electronic health record data

Reasons why osteoarthritis predicts mortality: path analysis within a Cox proportional hazards model

Functional and psychological evaluation of patients enrolled into total knee arthroplasty and its effect on the treatment outcome – preliminary reports

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