Predicting incident radiographic knee osteoarthritis in middle‐aged women within four years: the importance of knee‐level prognostic factors

<p><strong>Objective</strong></p> <p>To develop and internally validate risk models and a clinical risk score tool to predict incident radiographic knee osteoarthritis (RKOA) in middle‐aged women.</p> <p><strong>Methods</strong></p> <p&...

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Main Authors: Garriga, C, Sánchez‐Santos, MT, Judge, A, Hart, D, Spector, T, Cooper, C, Arden, NK
格式: Journal article
语言:English
出版: Wiley 2019
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author Garriga, C
Sánchez‐Santos, MT
Judge, A
Hart, D
Spector, T
Cooper, C
Arden, NK
author_facet Garriga, C
Sánchez‐Santos, MT
Judge, A
Hart, D
Spector, T
Cooper, C
Arden, NK
author_sort Garriga, C
collection OXFORD
description <p><strong>Objective</strong></p> <p>To develop and internally validate risk models and a clinical risk score tool to predict incident radiographic knee osteoarthritis (RKOA) in middle‐aged women.</p> <p><strong>Methods</strong></p> <p>We analyzed 649 women in the Chingford 1,000 Women study. The outcome was incident RKOA, defined as Kellgren/Lawrence grade 0–1 at baseline and ≥2 at year 5. We estimated predictors’ effects on the outcome using logistic regression models. Two models were generated. The clinical model considered patient characteristics, medication, biomarkers, and knee symptoms. The radiographic model considered the same factors, plus radiographic factors (e.g., angle between the acetabular roof and the ilium's vertical cortex [hip α‐angle]). The models were internally validated. Model performance was assessed using calibration and discrimination (area under the receiver characteristic curve [AUC]).</p> <p><strong>Results</strong></p> <p>The clinical model contained age, quadriceps circumference, and a cartilage degradation marker (C‐terminal telopeptide of type II collagen) as predictors (AUC = 0.692). The radiographic model contained older age, greater quadriceps circumference, knee pain, knee baseline Kellgren/Lawrence grade 1 (versus 0), greater hip α‐angle, greater spinal bone mineral density, and contralateral RKOA at baseline as predictors (AUC = 0.797). Calibration tests showed good agreement between the observed and predicted incident RKOA. A clinical risk score tool was developed from the clinical model.</p> <p><strong>Conclusion</strong></p> <p>Two models predicting incident RKOA within 4 years were developed, including radiographic variables that improved model performance. First‐time predictor hip α‐angle and contralateral RKOA suggest OA origins beyond the knee. The clinical tool has the potential to help physicians identify patients at risk of RKOA in routine practice, but the tool should be externally validated.</p>
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spelling oxford-uuid:ca5ca7f7-bf36-495a-85d8-981c68c00cb32022-03-27T07:06:57ZPredicting incident radiographic knee osteoarthritis in middle‐aged women within four years: the importance of knee‐level prognostic factorsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ca5ca7f7-bf36-495a-85d8-981c68c00cb3EnglishSymplectic Elements at OxfordWiley2019Garriga, CSánchez‐Santos, MTJudge, AHart, DSpector, TCooper, CArden, NK<p><strong>Objective</strong></p> <p>To develop and internally validate risk models and a clinical risk score tool to predict incident radiographic knee osteoarthritis (RKOA) in middle‐aged women.</p> <p><strong>Methods</strong></p> <p>We analyzed 649 women in the Chingford 1,000 Women study. The outcome was incident RKOA, defined as Kellgren/Lawrence grade 0–1 at baseline and ≥2 at year 5. We estimated predictors’ effects on the outcome using logistic regression models. Two models were generated. The clinical model considered patient characteristics, medication, biomarkers, and knee symptoms. The radiographic model considered the same factors, plus radiographic factors (e.g., angle between the acetabular roof and the ilium's vertical cortex [hip α‐angle]). The models were internally validated. Model performance was assessed using calibration and discrimination (area under the receiver characteristic curve [AUC]).</p> <p><strong>Results</strong></p> <p>The clinical model contained age, quadriceps circumference, and a cartilage degradation marker (C‐terminal telopeptide of type II collagen) as predictors (AUC = 0.692). The radiographic model contained older age, greater quadriceps circumference, knee pain, knee baseline Kellgren/Lawrence grade 1 (versus 0), greater hip α‐angle, greater spinal bone mineral density, and contralateral RKOA at baseline as predictors (AUC = 0.797). Calibration tests showed good agreement between the observed and predicted incident RKOA. A clinical risk score tool was developed from the clinical model.</p> <p><strong>Conclusion</strong></p> <p>Two models predicting incident RKOA within 4 years were developed, including radiographic variables that improved model performance. First‐time predictor hip α‐angle and contralateral RKOA suggest OA origins beyond the knee. The clinical tool has the potential to help physicians identify patients at risk of RKOA in routine practice, but the tool should be externally validated.</p>
spellingShingle Garriga, C
Sánchez‐Santos, MT
Judge, A
Hart, D
Spector, T
Cooper, C
Arden, NK
Predicting incident radiographic knee osteoarthritis in middle‐aged women within four years: the importance of knee‐level prognostic factors
title Predicting incident radiographic knee osteoarthritis in middle‐aged women within four years: the importance of knee‐level prognostic factors
title_full Predicting incident radiographic knee osteoarthritis in middle‐aged women within four years: the importance of knee‐level prognostic factors
title_fullStr Predicting incident radiographic knee osteoarthritis in middle‐aged women within four years: the importance of knee‐level prognostic factors
title_full_unstemmed Predicting incident radiographic knee osteoarthritis in middle‐aged women within four years: the importance of knee‐level prognostic factors
title_short Predicting incident radiographic knee osteoarthritis in middle‐aged women within four years: the importance of knee‐level prognostic factors
title_sort predicting incident radiographic knee osteoarthritis in middle aged women within four years the importance of knee level prognostic factors
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