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Zeng M, Cicuttini F, Lim YZ, Samaras K, Brodaty H, Sachdev PS, Crawford JD, Wang Y. Associations of Osteoarthritis with Prevalence and Incidence of Cardiovascular Disease over 10 Years in Community-Dwelling Older Adults: The Sydney Memory and Ageing Study. Gerontology 2024; 70:351-360. [PMID: 38330922 PMCID: PMC11006274 DOI: 10.1159/000537721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 02/02/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION The data are limited for the association between osteoarthritis (OA) and cardiovascular disease (CVD) in community-based older populations and whether there is sex difference. This study aimed to examine the relationship between OA and prevalence and incidence of CVD over 10 years in community-dwelling older adults. METHODS Data on self-reported OA, high cholesterol, hypertension, and type 2 diabetes were collected from 1,025 community-dwelling participants aged 70-90 years in the Sydney Memory and Ageing Study. The presence of CVD at baseline was defined as self-reported presence of stroke, heart attack, transient ischaemic attack, angina, aortic aneurysm, or claudication. The incidence of CVD was defined by a combination of incident self-reported CVD or CVD mortality at different follow-up timepoints over 10 years. RESULTS At baseline, 395 (38.5%) participants self-reported OA (252 [44.6%] women, 143 [31.1%] men). Self-reported OA was associated with increased prevalence of CVD in women (OR 1.67, 95% CI 1.12-2.47) but not men (1.26, 0.80-1.98). In the total population, self-reported OA at baseline was associated with increased incidence of CVD at 4 years (OR 1.77, 95% CI 1.10-2.83), 6 years (1.59, 1.03-2.46), 8 years (1.56, 1.02-2.38), and 10 years (1.66, 1.10-2.50), but not at 2 years (1.43, 0.79-2.57). Significant associations were observed in female participants at 4, 8, and 10 years, with no significant associations seen in male participants. CONCLUSION OA was associated with increased prevalence at baseline and incidence of CVD over 10 years in community-based older adults, especially women. Identifying those with OA to target their cardiovascular risk factors while managing their OA has the potential to reduce the burden of CVD in older people, particularly women.
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Affiliation(s)
- Mengjie Zeng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,
| | - Flavia Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuan Z Lim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Katherine Samaras
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia
- St Vincent's Clinical School, University of New South Wales Sydney, Kensington, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales Sydney, Kensington, New South Wales, Australia
- Dementia Centre for Research Collaboration, School of Psychiatry, University of New South Wales Sydney, Kensington, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales Sydney, Kensington, New South Wales, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales Sydney, Kensington, New South Wales, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Wilfong JM, Perruccio AV, Badley EM. Examination of the Increased Risk for Falls Among Individuals With Knee Osteoarthritis: A Canadian Longitudinal Study on Aging Population-Based Study. Arthritis Care Res (Hoboken) 2023; 75:2336-2344. [PMID: 37221150 DOI: 10.1002/acr.25163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/21/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To characterize the profile of individuals with and without knee osteoarthritis (OA) who fell, and to identify factors contributing to an individual with knee OA experiencing 1 or multiple injurious falls. METHODS Data are from the baseline and 3-year follow-up questionnaires of the Canadian Longitudinal Study on Aging, a population-based study of people ages 45-85 years at baseline. Analyses were limited to individuals either reporting knee OA or no arthritis at baseline (n = 21,710). Differences between falling patterns among those with and without knee OA were tested using chi-square tests and multivariable-adjusted logistic regression models. An ordinal logistic regression model examined predictors of experiencing 1 or more injurious falls among individuals with knee OA. RESULTS Among individuals reporting knee OA, 10% reported 1 or more injurious falls; 6% reported 1 fall, and 4% reported 2+ falls. Having knee OA significantly contributed to the risk of falling (odds ratio [OR] 1.33 [95% confidence interval (95% CI) 1.14-1.56]), and individuals with knee OA were more likely to report having a fall indoors while standing or walking. Among individuals with knee OA, reporting a previous fall (OR 1.75 [95% CI 1.22-2.52]), previous fracture (OR 1.42 [95% CI 1.12-1.80]), and having urinary incontinence (OR 1.38 [95% CI 1.01-1.88]) were significant predictors of falling. CONCLUSION Our findings support the idea that knee OA is an independent risk factor for falls. The circumstances in which falls occur differ from those for individuals without knee OA. The risk factors and environments that are associated with falling may provide opportunities for clinical intervention and fall prevention strategies.
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Affiliation(s)
- Jessica M Wilfong
- Schroeder Arthritis Institute, University Health Network, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Epidemiology Unit, Toronto, Ontario, Canada
| | - Anthony V Perruccio
- Schroeder Arthritis Institute, University Health Network, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Epidemiology Unit, Toronto, Ontario, Canada
| | - Elizabeth M Badley
- Schroeder Arthritis Institute, University Health Network, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Epidemiology Unit, Toronto, Ontario, Canada
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3
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Sun Y, Wang YX, Qian D, Mustieles V, Zhang Y, Messerlian C. Blood Trihalomethane Concentrations and Osteoarthritis among U.S. Population Aged over 50 Years. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:16166-16175. [PMID: 37852642 DOI: 10.1021/acs.est.3c01495] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Exposure to trihalomethanes (THMs) has been associated with inflammation and oxidative stress, which are implicated in osteoarthritis. However, the association of THM exposure with osteoarthritis is unknown. Therefore, we pooled seven independent National Health and Nutrition Examination Survey cycles (1999-2012) among participants aged over 50 years who had quantified blood concentrations of chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM). Among 4,077 adults aged over 50 years, 781 (21.3%) reported osteoarthritis. Logistic regression models showed increased odds of osteoarthritis across the categories of blood BDCM, DBCM, and brominated THM (Br-THM, which was the sum of BDCM, DBCM, and TBM) concentrations [odds ratios = 1.46 (95% CI 1.09-1.94), 1.53 (95% CI 1.15-2.04), and 1.35 (95% CI 0.97-1.88), respectively], comparing highest versus lowest exposure categories (quartiles or tertiles). Additionally, we found positive dose-response relationships between blood BDCM, DBCM, and Br-THM concentrations and serum markers of oxidative stress (i.e., gamma-glutamyltransferase). In summary, blood Br-THM concentrations were associated with elevated serum levels of gamma-glutamyltransferase as well as an increased risk of osteoarthritis among U.S. adults aged over 50 years. However, more prospective population studies are needed to verify these findings and explore the underlying mechanisms.
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Affiliation(s)
- Yang Sun
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Yi-Xin Wang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Dongyang Qian
- Department of Orthopedics, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510515, China
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts 02115, United States
| | - Vicente Mustieles
- Instituto de Investigación Biosanitaria Ibs GRANADA, 18012 Granada, Spain
- Center for Biomedical Research (CIBM), University of Granada, 18010 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Yu Zhang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Carmen Messerlian
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
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4
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Leung T, Janssen DM, van der Steen MC, Delvaux EJLG, Hendriks JGE, Janssen RPA. Digital Health Applications to Establish a Remote Diagnosis of Orthopedic Knee Disorders: Scoping Review. J Med Internet Res 2023; 25:e40504. [PMID: 36566450 PMCID: PMC9951077 DOI: 10.2196/40504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/04/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Knee pain is highly prevalent worldwide, and this number is expected to rise in the future. The COVID-19 outbreak, in combination with the aging population, rising health care costs, and the need to make health care more accessible worldwide, has led to an increasing demand for digital health care applications to deliver care for patients with musculoskeletal conditions. Digital health and other forms of telemedicine can add value in optimizing health care for patients and health care providers. This might reduce health care costs and make health care more accessible while maintaining a high level of quality. Although expectations are high, there is currently no overview comparing digital health applications with face-to-face contact in clinical trials to establish a primary knee diagnosis in orthopedic surgery. OBJECTIVE This study aimed to investigate the currently available digital health and telemedicine applications to establish a primary knee diagnosis in orthopedic surgery in the general population in comparison with imaging or face-to-face contact between patients and physicians. METHODS A scoping review was conducted using the PubMed and Embase databases according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) statement. The inclusion criteria were studies reporting methods to determine a primary knee diagnosis in orthopedic surgery using digital health or telemedicine. On April 28 and 29, 2021, searches were conducted in PubMed (MEDLINE) and Embase. Data charting was conducted using a predefined form and included details on general study information, study population, type of application, comparator, analyses, and key findings. A risk-of-bias analysis was not deemed relevant considering the scoping review design of the study. RESULTS After screening 5639 articles, 7 (0.12%) were included. In total, 2 categories to determine a primary diagnosis were identified: screening studies (4/7, 57%) and decision support studies (3/7, 43%). There was great heterogeneity in the included studies in algorithms used, disorders, input parameters, and outcome measurements. No more than 25 knee disorders were included in the studies. The included studies showed a relatively high sensitivity (67%-91%). The accuracy of the different studies was generally lower, with a specificity of 27% to 48% for decision support studies and 73% to 96% for screening studies. CONCLUSIONS This scoping review shows that there are a limited number of available applications to establish a remote diagnosis of knee disorders in orthopedic surgery. To date, there is limited evidence that digital health applications can assist patients or orthopedic surgeons in establishing the primary diagnosis of knee disorders. Future research should aim to integrate multiple sources of information and a standardized study design with close collaboration among clinicians, data scientists, data managers, lawyers, and service users to create reliable and secure databases.
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Affiliation(s)
| | - Daan M Janssen
- Department of Orthopedic Surgery & Trauma, Máxima Medical Center, Veldhoven, Netherlands
| | - Maria C van der Steen
- Department of Orthopedic Surgery & Trauma, Máxima Medical Center, Veldhoven, Netherlands.,Department of Orthopedic Surgery & Trauma, Catharina Hospital, Eindhoven, Netherlands
| | | | - Johannes G E Hendriks
- Department of Orthopedic Surgery & Trauma, Máxima Medical Center, Veldhoven, Netherlands
| | - Rob P A Janssen
- Department of Orthopedic Surgery & Trauma, Máxima Medical Center, Veldhoven, Netherlands.,Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.,Value-Based Health Care, Department of Paramedical Sciences, Fontys University of Applied Sciences, Eindhoven, Netherlands
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5
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Badley EM, Zahid S, Wilfong JM, Perruccio AV. Relationship Between Body Mass Index and Osteoarthritis for Single and Multisite Osteoarthritis of the Hand, Hip, or Knee: Findings From a Canadian Longitudinal Study on Aging. Arthritis Care Res (Hoboken) 2022; 74:1879-1887. [PMID: 34121361 DOI: 10.1002/acr.24729] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 05/10/2021] [Accepted: 06/08/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine whether an apparent association between hand osteoarthritis (OA) and adiposity is explained by the presence of OA at other joint sites. METHODS Data from the Canadian Longitudinal Study on Aging, first cycle, comprehensive cohort, were used. Respondents age 45-85 years (n = 18,279) were asked separate questions about doctor-diagnosed OA in the hand, hip, or knee. Multinomial logistic regression was used to investigate the relationship between all combinations of hand, hip, and knee OA and body mass index (BMI) and waist-to-height ratio (WHtR). RESULTS OA was reported by 34.6% of respondents, 28.0% with OA at >1 joint site. Hand OA was not significantly associated with BMI after accounting for OA at other joint sites, with similar findings for WHtR. All joint site combinations containing the knee were strongly associated with BMI, with odds ratios (ORs) ranging from OR 2.92 (95% confidence interval [95% CI] 2.53-3.37) for knee OA only with obesity class I to OR 9.98 (95% CI 7.12-13.88) for multi-joint knee, hip, hand OA with obesity class II/III. BMI distributions including knee OA were broader and shifted to higher BMI levels than those for hand or hip OA. CONCLUSION Apparent associations between hand OA and BMI may be explained by concurrent OA at other joint sites. Recognizing that OA is a multi-joint disease is crucial for studies of the associations of adiposity with OA in a particular joint, especially the hand. The association between knee OA and BMI appears to be distinct from those for OA at other joint sites.
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Affiliation(s)
- Elizabeth M Badley
- Krembil Research Institute and Schroeder Arthritis Institute, University Health Network, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shatabdy Zahid
- Krembil Research Institute and Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Jessica M Wilfong
- Krembil Research Institute and Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Anthony V Perruccio
- Krembil Research Institute and Schroeder Arthritis Institute, University Health Network, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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6
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Selçuk H, Roos EM, Grønne DT, Ernst MT, Skou ST. Agreement Between Self-Reported Information and Administrative Data on Comorbidities, Imaging and Treatment in Denmark - A Validation Study of 38,745 Patients with Knee or Hip Osteoarthritis. Clin Epidemiol 2021; 13:779-790. [PMID: 34512031 PMCID: PMC8416180 DOI: 10.2147/clep.s309364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To validate self-reported information obtained from patients with knee or hip osteoarthritis (OA) in primary care against administrative data from the three national Danish registries. Patients and Methods We compared the baseline and 12-month follow-up data from 38,745 patients with knee or hip OA participating in the Good Life with osteoArthritis in Denmark (GLA:D®) program with registry-based data on joint surgeries, pain medication dispensing, radiographs, and hospital diagnoses. Agreement was calculated using Cohen's Kappa (k) and percentage agreement, both with 95% CI. Results There was a moderate agreement between self-report and registry-based data for previous knee surgery (k=0.58, 84.99%) and a substantial agreement for previous hip surgery (k=0.73, 97.05%). Agreement varied from 0.05 to 0.95 and 84.99% to 99.94% for different types of surgeries with lowest agreement for collateral ligament surgery (k=0.05, 99.82%) and highest agreement for joint replacement (k=0.95, 99.54% for knee; k=0.95, 99.48% for hip). There was a moderate agreement (k=0.41, 81.59%) for knee and a slight agreement (k=0.20, 64.79%) for hip radiographs. Agreement varied from 0.01 to 0.53 and 65.39% to 99.90% for pain medication with lowest agreement for topical NSAID (k=0.01, 95.00%) and highest agreement for opioids (k=0.53, 92.56%). For comorbidities, agreement varied from 0.14 to 0.90 and 78.07% to 98.91%, with lowest agreement for anemia or other blood disease (k=0.14, 97.63%) and highest agreement for diabetes (k=0.90, 98.73%). Conclusion As the most common types of pain medication used by patients with OA can be bought over-the-counter and as most OA patients are treated in primary care, which is often not covered by national registries, self-report of pain medication use and comorbidities is preferred but cannot be sufficiently validated against registry-based data. Future studies collecting self-reported information on joint surgery and pain medication from patients with OA should use a less detailed categorization to improve accuracy.
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Affiliation(s)
- Halit Selçuk
- Department of Physiotherapy and Rehabilitation, Marmara University, İstanbul, Turkey
| | - Ewa M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Dorte T Grønne
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Martin T Ernst
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
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7
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Badley EM, Wilfong JM, Yip C, Millstone DB, Perruccio AV. The contribution of age and obesity to the number of painful joint sites in individuals reporting osteoarthritis: a population-based study. Rheumatology (Oxford) 2021; 59:3350-3357. [PMID: 32306046 PMCID: PMC7590415 DOI: 10.1093/rheumatology/keaa138] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/26/2020] [Indexed: 12/12/2022] Open
Abstract
Objective To investigate the association of OA risk factors with number of painful joint sites in a representative population sample. Methods Analysis of the 2009 Survey on Living with Chronic Diseases in Canada – Arthritis Component (n = 1614) for respondents reporting symptomatic OA. Variables: painful joints sites (hands, wrists, elbows, shoulders, hips, knees, ankles, feet, back, neck), joint symptom duration, sociodemographic characteristics, smoking, comorbidities and BMI. Zero-truncated negative binomial regressions were used to investigate the association between number of painful joint sites and the variables. Generalizability of findings was assessed by a similar analysis in a clinical hip/knee OA sample. Results The sample comprised 73% women and 56% were aged <65 years. The mean number of painful joint sites was 3.8: 84% reported pain at ≥2 sites, and 45% at ≥4 sites. Age, BMI, education and smoking were not associated with the number of joint sites. Significant associations were found with being female [rate ratio (RR) = 1.23, 95% CI 1.09, 1.39], having more comorbidities (RR = 1.11, 95% CI 1.07, 1.15) and longer symptom duration (RR = 1.16, 95% CI 1.09, 1.24), although the increase in joint sites with duration was small. Similar regression results were found with the clinical OA sample. Conclusion The lack of an association of age and BMI (obesity) with number of painful joint sites in OA raises questions about the role of these risk factors and our understanding of OA as a multi-joint disease. Filling this knowledge gap is critical to making progress with defining OA phenotypes and identifying potential aetiological mechanisms.
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Affiliation(s)
- Elizabeth M Badley
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, Toronto.,Arthritis Program, Krembil Research Institute, University Health Network, Toronto.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jessica M Wilfong
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, Toronto.,Arthritis Program, Krembil Research Institute, University Health Network, Toronto
| | - Calvin Yip
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, Toronto.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Dov B Millstone
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, Toronto
| | - Anthony V Perruccio
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, Toronto.,Arthritis Program, Krembil Research Institute, University Health Network, Toronto.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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8
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Yip C, Badley EM, Canizares M, Power JD, Perruccio AV. Risk Factor Profiles for Individuals With Diagnosed OA and With Symptoms Indicative of OA: Findings From the Canadian Longitudinal Study on Aging. ACR Open Rheumatol 2020; 2:174-179. [PMID: 32114717 PMCID: PMC7077769 DOI: 10.1002/acr2.11120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 01/17/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The vast majority of published estimates of osteoarthritis (OA) burden are based on an OA diagnosis. These data are limited, as individuals often do not visit a physician until their symptoms are moderate to severe. This study compared individuals with an OA diagnosis to those with OA joint symptoms but without a diagnosis considering a number of sociodemographic and health characteristics. A further distinction was made between individuals with symptoms in one joint site and those with symptoms in multiple joint sites. METHODS Data are from 23 186 respondents aged 45 to 85 years from the first cycle of the Canadian Longitudinal Study on Aging. A multinomial logistic regression model examined the relationship between sociodemographic- and health-related characteristics and OA status (diagnosed OA, joint symptoms without OA, no OA or joint symptoms). In addition, logistic regression models assessed the relationship between OA status and usually experiencing pain and having some degree of functional limitation. RESULTS Twenty-one percent of respondents reported a diagnosis of OA, and 25% reported symptoms typical of OA but without an OA diagnosis. Other than being slightly younger, the characteristic profile of individuals with symptoms in two or more joint sites was indistinguishable from that of those with diagnosed OA. CONCLUSION It may be warranted to consider OA-like multiple joint symptoms when deriving estimates of OA-attributed population health and cost burden.
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Affiliation(s)
- Calvin Yip
- Healthcare & Outcomes Research, Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON, Canada and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Elizabeth M Badley
- Healthcare & Outcomes Research, Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON, Canada and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Arthritis Community Research and Evaluation Unit, Toronto, ON, Canada
| | - Mayilee Canizares
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - J Denise Power
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Anthony V Perruccio
- Healthcare & Outcomes Research, Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON, Canada and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Arthritis Community Research and Evaluation Unit, Toronto, ON, Canada.,Department of Surgery, University of Toronto, Toronto, ON, Canada
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Davies MAM, Kerr ZY, DeFreese JD, Arden NK, Marshall SW, Guskiewicz KM, Padua DA, Pietrosimone B. Prevalence of and Risk Factors for Total Hip and Knee Replacement in Retired National Football League Athletes. Am J Sports Med 2019; 47:2863-2870. [PMID: 31498654 DOI: 10.1177/0363546519870804] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osteoarthritis is a substantial cause of disability. Joint replacement prevalence relates to the burden of severe osteoarthritis, and identifying risk factors for end-stage disease may indicate intervention opportunities. American football has high youth and elite participation, and determining risk factors for severe osteoarthritis may support future morbidity prevention. PURPOSE To (1) determine the prevalence of hip and knee replacement in retired National Football League (NFL) athletes, (2) examine risk factors for replacement, and (3) identify the association between knee injuries and knee replacement. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Retired NFL athletes who participated in a general health survey were included. This historical cohort included those playing between 1929 and 2001. The association between self-reported playing or injury history, and replacement after retirement, was assessed with prevalence ratios (PRs). Models were adjusted for potential confounders of age and weight. RESULTS Data for 2432 retired male NFL players (69.3% response rate) who had participated in football for a mean 15.2 years were included, in which 277 players reported replacement after retirement (11.4%). More participants reported knee replacement (7.7%) than hip replacement (4.6%). The majority of participants reported previous severe knee injury (53%), and the most prevalent was meniscal tear (32.2%). In multivariable models, age (10-year increase, PR, 2.23; 95% CI, 1.99-2.51), current weight (PR, 1.10; 95% CI, 1.06-1.14), and reporting 1 (PR, 1.78; 95% CI, 1.14-2.77), 2 (PR, 1.91; 95% CI, 1.16-3.15), or ≥3 knee injuries (PR, 3.44; 95% CI, 2.33-5.09) were associated with knee replacement. Age (10-year increase, PR, 1.86; 95% CI, 1.59-2.18), linemen (PR, 1.62; 95% CI, 1.03-2.55), and reporting 1 (PR, 1.72; 95% CI, 1.05-2.80), 2 (PR, 2.77 95% CI, 1.58-4.84), or ≥3 (PR, 2.44; 95% CI, 1.52-3.91) hip injuries were associated with hip replacement. Each reported knee injury type was cross-sectionally associated with replacement after retirement (P < .05). CONCLUSION Knee replacement was more prevalent than hip replacement. Risk factors differed between the hip and the knee, with age and severe joint injury associated with hip and knee replacement, weight with knee replacement, and playing position associated with hip replacement. Joint injury and weight management may be prevention opportunities to reduce morbidity and end-stage osteoarthritis in this population.
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Affiliation(s)
- Madeleine A M Davies
- Department of Health, University of Bath, Bath, UK.,The Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Center for the Study of Retired Athletes, University of North Carolina, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - J D DeFreese
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Center for the Study of Retired Athletes, University of North Carolina, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nigel K Arden
- The Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK
| | - Stephen W Marshall
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Center for the Study of Retired Athletes, University of North Carolina, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kevin M Guskiewicz
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.,Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Center for the Study of Retired Athletes, University of North Carolina, Chapel Hill, North Carolina, USA.,Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Darin A Padua
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
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10
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Ueda K, Sasaki N, Goren A, Calhoun SR, Shinjo K, Enomoto H, Muneta T. Treatment satisfaction with pharmaceutical interventions in Japanese adults with osteoarthritis and chronic knee pain: an analysis of a web-based survey. Clin Interv Aging 2018; 13:2179-2191. [PMID: 30464427 PMCID: PMC6211312 DOI: 10.2147/cia.s176289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose Patient satisfaction is an important outcome in successful osteoarthritis (OA) treatment. The aim of this study was to evaluate treatment satisfaction for medication (TSM) in people with knee OA (KOA), identify the factors predictive of treatment satisfaction, and describe the burden of illness. Patients and methods This cross-sectional, patient-reported study used an Internet-based survey and analyzed responses of respondents with KOA (N=400) on characteristics including pain sites and levels (including pain ratings using the Numerical Rating Scale and Short-Form McGill Pain Questionnaire), treatment satisfaction (Global, Effectiveness, and Convenience scores) based on the Treatment Satisfaction Questionnaire for Medication (TSQM-9), and quality of life (QoL; based on the Arthritis Impact Measurement Scale 2-Short Form). Respondents with only KOA (n=237) were compared with those having KOA and additional painful sites (KOA+; n=163). Factors predicting TSM were identified using multivariable linear regression analyses. Results Respondents with KOA were more likely to report intermittent pain for 3 months or more compared with those with KOA+ (58.6% vs 48.5%, respectively; P=0.044), while those with KOA+ were more likely to report consistent pain for 3 months or more (P=0.022). Respondents with KOA+ also had more difficulty due to their knee pain while sleeping (P=0.022) and resting (P=0.015). Reported TSM did not differ significantly across KOA vs KOA+ groups, with both groups reporting low satisfaction; all domains of QoL were worse for those with KOA+. Knee pain reduction by medication predicted higher satisfaction across domains, while lower pre-medication pain and post-medication pain matching expectations predicted higher TSQM-9 Global and Effectiveness scores. Conclusion Medication treatment satisfaction rates were low among Japanese respondents with KOA. Given that lower pain, greater pain reduction post-medication, and meeting pain management expectations were predictive of higher satisfaction, treatment strategies that can better address pain may prove beneficial for overall patient satisfaction.
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Affiliation(s)
- Kaname Ueda
- Health Outcomes/Health Technology Assessment/Real World Evidence, Eli Lilly Japan, Kobe, Japan,
| | - Nao Sasaki
- Bio-Medicines, Medicines Development Unit, Eli Lilly Japan, Kobe, Japan
| | - Amir Goren
- Health Outcomes, Kantar Health, New York, NY, USA
| | | | - Katsuhiro Shinjo
- Bio-Medicines, Medicines Development Unit, Eli Lilly Japan, Tokyo, Japan
| | - Hiroyuki Enomoto
- Bio-Medicines, Medicines Development Unit, Eli Lilly Japan, Tokyo, Japan
| | - Takeshi Muneta
- Department of Orthopaedic Surgery, National Disaster Medical Center, Tokyo, Japan
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11
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Leyland K, Gates L, Nevitt M, Felson D, Bierma-Zeinstra S, Conaghan P, Engebretsen L, Hochberg M, Hunter D, Jones G, Jordan J, Judge A, Lohmander L, Roos E, Sanchez-Santos M, Yoshimura N, van Meurs J, Batt M, Newton J, Cooper C, Arden N. Harmonising measures of knee and hip osteoarthritis in population-based cohort studies: an international study. Osteoarthritis Cartilage 2018; 26:872-879. [PMID: 29426005 PMCID: PMC6010158 DOI: 10.1016/j.joca.2018.01.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 01/26/2018] [Accepted: 01/30/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Population-based osteoarthritis (OA) cohorts provide vital data on risk factors and outcomes of OA, however the methods to define OA vary between cohorts. We aimed to provide recommendations for combining knee and hip OA data in extant and future population cohort studies, in order to facilitate informative individual participant level analyses. METHOD International OA experts met to make recommendations on: 1) defining OA by X-ray and/or pain; 2) compare The National Health and Nutrition Examination Survey (NHANES)-type OA pain questions; 3) the comparability of the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) scale to NHANES-type OA pain questions; 4) the best radiographic scoring method; 5) the usefulness of other OA outcome measures. Key issues were explored using new analyses in two population-based OA cohorts (Multicenter Osteoarthritis Study; MOST and Osteoarthritis Initiative OAI). RESULTS OA should be defined by both symptoms and radiographs, with symptoms alone as a secondary definition. Kellgren and Lawrence (K/L) grade ≥2 should be used to define radiographic OA (ROA). The variable wording of pain questions can result in varying prevalence between 41.0% and 75.4%, however questions where the time anchor is similar have high sensitivity and specificity (91.2% and 89.9% respectively). A threshold of 3 on a 0-20 scale (95% CI 2.1, 3.9) in the WOMAC pain subscale demonstrated equivalence with the preferred NHANES-type question. CONCLUSION This research provides recommendations, based on expert agreement, for harmonising and combining OA data in existing and future population-based cohorts.
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Affiliation(s)
- K.M. Leyland
- NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - L.S. Gates
- NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - M. Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - D. Felson
- Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, USA
| | - S.M. Bierma-Zeinstra
- Department of General Practice, Erasmus University Medical Centre, Rotterdam, the Netherlands,Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - P.G. Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - L. Engebretsen
- Department of Orthopaedic Surgery, Oslo University Hospital and Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
| | - M. Hochberg
- University of Maryland School of Medicine, Baltimore, USA
| | - D.J. Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia,Rheumatology Department, Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - G. Jones
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - J.M. Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - A. Judge
- NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK
| | - L.S. Lohmander
- Lund University, Department of Clinical Sciences Lund, Orthopaedics, Lund, Sweden
| | - E.M. Roos
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - M.T. Sanchez-Santos
- NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK
| | - N. Yoshimura
- Department of Joint Disease Research, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - J.B.J. van Meurs
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M.E. Batt
- Centrefor Sports Medicine, Nottingham University Hospitals and Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nottingham, UK
| | - J. Newton
- NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK
| | - C. Cooper
- NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - N.K Arden
- NIHR Musculoskeletal Biomedical Research Unit and Arthritis Research UK Centre for Sport, Exercise, and Osteoarthritis, University of Oxford, Oxford, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
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12
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Leung YY, Ma S, Noviani M, Wong SBS, Lee CM, Soh IAL, Thumboo J. Validation of screening questionnaires for evaluation of knee osteoarthritis prevalence in the general population of Singapore. Int J Rheum Dis 2017; 21:629-638. [PMID: 29271108 PMCID: PMC5887938 DOI: 10.1111/1756-185x.13252] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background The prevalence of symptomatic knee osteoarthritis (KOA) in Singapore is unknown. We aimed to: (i) validate questionnaires to screen for symptomatic KOA; and (ii) estimate the prevalence of symptomatic KOA in Singapore using the validated algorithms. Methods Subjects aged ≥50 years were evaluated for symptomatic KOA based on American College of Rheumatology clinical and radiographic criteria in a rheumatology clinic, and completed three sets of adapted screening questionnaires. The better performing screening questionnaire with adequate sensitivity and specificity was adminitered to a nationally representative sample of survey subjects (n = 3364) to estimate the weighted prevalence of symptomatic KOA in Singapore. Results Out of 146 subjects evaluated in the clinic, 45 had symptomatic KOA. A screening algorithm which consisted of three KOA symptoms or one symptom plus physician‐diagnosed KOA produced high specificity (0.95, 95% confidence intervals [CI]: 0.88–0.98) but low sensivity (0.44, 95% CI: 0.30–0.60). Replacing the term ‘KOA’ with ‘physician‐diagnosed ageing‐related knee problem’ improved the sensivity (0.62, 95% CI: 0.47–0.76) without significantly compromising the specificity (0.87, 95% CI: 0.79–0.93). The prevalence of symptomatic KOA weighted to the Singapore population distribution were 4.7% and 11%, using the most conservative and more liberal algorithms, respectively. There was a sharp rise in prevalence after age of 40. The weighted prevalence of KOA was higher in women and among Indian and Malay than Chinese. Conclusion Our study adapted and validated questionnaires to the local context to screen for symptomatic KOA. We estimated the prevalence of symptomatic KOA in Singapore utilizing the better‐performing algorithms.
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Affiliation(s)
- Ying-Ying Leung
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore General Hospital, Singapore, Singapore
| | - Stefan Ma
- Epidemiology& Disease Control Division, Ministry of Health, Singapore General Hospital, Singapore, Singapore
| | - Maria Noviani
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore General Hospital, Singapore, Singapore
| | - Steven B-S Wong
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore
| | - Chee Min Lee
- Epidemiology& Disease Control Division, Ministry of Health, Singapore General Hospital, Singapore, Singapore
| | - Irene A-L Soh
- Epidemiology& Disease Control Division, Ministry of Health, Singapore General Hospital, Singapore, Singapore
| | - Julian Thumboo
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore General Hospital, Singapore, Singapore
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13
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Hinman RS, Nelligan RK, Bennell KL, Delany C. "Sounds a Bit Crazy, But It Was Almost More Personal:" A Qualitative Study of Patient and Clinician Experiences of Physical Therapist-Prescribed Exercise For Knee Osteoarthritis Via Skype. Arthritis Care Res (Hoboken) 2017; 69:1834-1844. [PMID: 28217864 DOI: 10.1002/acr.23218] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 02/14/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the experience of patients and physical therapists with Skype for exercise management of knee osteoarthritis (OA). METHODS This was a qualitative study. The Donabedian model for quality assessment in health care (structure, process, and outcomes) informed semistructured individual interview questions. The study involved 12 purposively sampled patients with knee OA who received physical therapist-prescribed exercise over Skype, and all therapists (n = 8) who delivered the intervention in a clinical trial were interviewed about their experiences. Interviews were audio recorded and transcribed. Two investigators undertook coding and analysis using a thematic approach. RESULTS Six themes arose from both patients and therapists. The themes were Structure: technology (easy to use, variable quality, set-up assistance helpful) and patient convenience (time efficient, flexible, increased access); Process: empowerment to self-manage (facilitated by home environment and therapists focusing on effective treatment) and positive therapeutic relationships (personal undivided attention from therapists, supportive friendly interactions); and Outcomes: satisfaction with care (satisfying, enjoyable, patients would recommend, therapists felt Skype more useful as adjunct to usual practice) and patient benefits (reduced pain, improved function, improved confidence and self-efficacy). A seventh theme arose from therapists regarding process: adjusting routine treatment (need to modify habits, discomfort without hands-on, supported by research environment). CONCLUSION Patients and physical therapists described mostly positive experiences using Skype as a service delivery model for physical therapist-supervised exercise management of moderate knee OA. Such a model is feasible and acceptable and has the potential to increase access to supervised exercise management for people with knee OA, either individually or in combination with traditional in-clinic visits.
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Affiliation(s)
- R S Hinman
- University of Melbourne, Melbourne, Victoria, Australia
| | - R K Nelligan
- University of Melbourne, Melbourne, Victoria, Australia
| | - K L Bennell
- University of Melbourne, Melbourne, Victoria, Australia
| | - C Delany
- University of Melbourne, Melbourne, Victoria, Australia
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14
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Cisternas MG, Murphy L, Sacks JJ, Solomon DH, Pasta DJ, Helmick CG. Alternative Methods for Defining Osteoarthritis and the Impact on Estimating Prevalence in a US Population-Based Survey. Arthritis Care Res (Hoboken) 2017; 68:574-80. [PMID: 26315529 DOI: 10.1002/acr.22721] [Citation(s) in RCA: 205] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/10/2015] [Accepted: 08/18/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Provide a contemporary estimate of osteoarthritis (OA) by comparing the accuracy and prevalence of alternative definitions of OA. METHODS The Medical Expenditure Panel Survey (MEPS) household component (HC) records respondent-reported medical conditions as open-ended responses; professional coders translate these responses into International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for the medical conditions files. Using these codes and other data from the MEPS-HC medical conditions files, we constructed 3 case definitions of OA and assessed them against medical provider diagnoses of ICD-9-CM 715 (osteoarthrosis and allied disorders) in a MEPS subsample. The 3 definitions were 1) strict = ICD-9-CM 715; 2) expanded = ICD-9-CM 715, 716 (other and unspecified arthropathies) OR 719 (other and unspecified disorders of joint); and 3) probable = strict OR expanded + respondent-reported prior diagnosis of OA or other arthritis excluding rheumatoid arthritis. RESULTS Sensitivity and specificity of the 3 definitions, respectively, were 34.6% and 97.5% for strict, 73.8% and 90.5% for expanded, and 62.9% and 93.5% for probable. CONCLUSION The strict definition for OA (ICD-9-CM 715) excludes many individuals with OA. The probable definition of OA has the optimal combination of sensitivity and specificity relative to the 2 other MEPS-based definitions and yields a national annual estimate of 30.8 million adults with OA (13.4% of US adult population) for 2008-2011.
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Affiliation(s)
| | - Louise Murphy
- Centers for Disease Control and Prevention, Atlanta, Georgia
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15
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Roine J, Uusitalo L, Hielm-Björkman A. Validating and reliability testing the descriptive data and three different disease diagnoses of the internet-based DOGRISK questionnaire. BMC Vet Res 2016; 12:30. [PMID: 26897627 PMCID: PMC4761135 DOI: 10.1186/s12917-016-0658-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/15/2016] [Indexed: 12/02/2022] Open
Abstract
Background The DOGRISK questionnaire is an internet-based ongoing study of canine nutrition, living environment, and disease. Here we aim to assess the performance of the questionnaire using data from the first three years in relation to some descriptive and disease variables. We used associated questions, official register records, test-retest repeatability, and email/mail contact with questionnaire respondents. Results Reliability against an official register of gender, season of birth, breed, and results of hip radiography was tested and Cohen’s Kappa was between 0.95–0.99. Internal consistencies of hypothyroidism status and dog’s age were calculated using Cronbach’s Alpha (α = 0.95 and α = 0.99, respectively). Test-retest repeatability of ten variables among 224 participants was analyzed. Gender, season of birth, and born in owner family had Cohen’s Kappa > 0.86, color of coat, vaccination status as an adult, other dogs in household, and vaccination status as a puppy had Cohen’s Kappa between 0.67–0.80, and body condition score under two months of age and tidiness of household, had Cohen’s kappa of 0.45 and 0.42, respectively. In addition, time spent outside had Cohen’s kappa of 0.37. Of the owners contacted by email/mail to confirm their dog’s atopy/allergy (skin symptoms), 8.9 % reported that they had given an incorrect answer (positive predicted value 91 %), but only 69 % of all reaffirmed positive answers had a diagnosis set by a veterinarian. Conclusions Our study showed that owners were diligent with basic information and with the status of three diseases. Cohen’s Kappa in the reliability of the test-retest was in most variables at least 0.67. We propose that the descriptive variables and the disease variables be used as such when we generate hypotheses from the DOGRISK data.
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Affiliation(s)
- Johanna Roine
- Faculty of Agriculture and Forestry, Department of Agricultural Sciences, University of Helsinki, 00014 University of Helsinki, P.O. Box 27, Helsinki, Finland. .,Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, 00014 University of Helsinki, P.O. Box 57, Helsinki, Finland.
| | - Liisa Uusitalo
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, 00014 University of Helsinki, P.O. Box 57, Helsinki, Finland.
| | - Anna Hielm-Björkman
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, 00014 University of Helsinki, P.O. Box 57, Helsinki, Finland.
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16
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Peeters G(G, Alshurafa M, Schaap L, de Vet HC. Diagnostic accuracy of self-reported arthritis in the general adult population is acceptable. J Clin Epidemiol 2015; 68:452-9. [DOI: 10.1016/j.jclinepi.2014.09.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 09/11/2014] [Accepted: 09/24/2014] [Indexed: 11/24/2022]
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17
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Østerås N, Risberg MA, Kvien TK, Engebretsen L, Nordsletten L, Bruusgaard D, Schjervheim UB, Haugen IK, Hammer HB, Provan S, Øiestad BE, Semb AG, Rollefstad S, Hagen KB, Uhlig T, Slatkowsky-Christensen B, Kjeken I, Flugsrud G, Grotle M, Sesseng S, Edvardsen H, Natvig B. Hand, hip and knee osteoarthritis in a Norwegian population-based study--the MUST protocol. BMC Musculoskelet Disord 2013; 14:201. [PMID: 23826721 PMCID: PMC3704709 DOI: 10.1186/1471-2474-14-201] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 06/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knowledge about the prevalence and consequences of osteoarthritis (OA) in the Norwegian population is limited. This study has been designed to gain a greater understanding of musculoskeletal pain in the general population with a focus on clinically and radiologically confirmed OA, as well as risk factors, consequences, and management of OA. METHODS/DESIGN The Musculoskeletal pain in Ullensaker STudy (MUST) has been designed as an observational study comprising a population-based postal survey and a comprehensive clinical examination of a sub-sample with self-reported OA (MUST OA cohort). All inhabitants in Ullensaker municipality, Norway, aged 40 to 79 years receive the initial population-based postal survey questionnaire with questions about life style, general health, musculoskeletal pain, self-reported OA, comorbidities, health care utilisation, medication use, and functional ability. Participants who self-report OA in their hip, knee and/or hand joints are asked to attend a comprehensive clinical examination at Diakonhjemmet Hospital, Oslo, including a comprehensive medical examination, performance-based functional tests, different imaging modalities, cardiovascular assessment, blood and urine samples, and a number of patient-reported questionnaires including five OA disease specific instruments. Data will be merged with six national data registries. A subsample of those who receive the questionnaire has previously participated in postal surveys conducted in 1990, 1994, and 2004 with data on musculoskeletal pain and functional ability in addition to demographic characteristics and a number of health related factors. This subsample constitutes a population based cohort with 20 years follow-up. DISCUSSION This protocol describes the design of an observational population-based study that will involve the collection of data from a postal survey on musculoskeletal pain, and a comprehensive clinical examination on those with self-reported hand, hip and/or knee OA. These data, in addition to data from national registries, will provide unique insights into clinically and radiologically confirmed OA with respect to risk factors, consequences, and management.
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Affiliation(s)
- Nina Østerås
- National Resource, Center for rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
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