المؤلفون: MacFarlane, Lindsey A., Mass, Hanna, Collins, Jamie E., Losina, Elena, Katz, Jeffrey N., Chen, Antonia F.

المصدر: Osteoarthritis and Cartilage Open ; volume 5, issue 2, page 100361 ; ISSN 2665-9131

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1016/j.ocarto.2023.100361Test
https://api.elsevier.com/content/article/PII:S2665913123000286?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2665913123000286?httpAccept=text/plainTest

المؤلفون: Kopp, Paul T., Yang, Catherine, Yang, Heidi, Katz, Jeffrey N., Paltiel, A. David, Hunter, David J., Callahan, Leigh F., Mihalko, Shannon L., Newman, Jovita J., DeVita, Paul, Loeser, Richard F., Miller, Gary D., Messier, Stephen P., Losina, Elena

المصدر: Arthritis Care & Research; Jul2024, Vol. 76 Issue 7, p1018-1027, 10p

مصطلحات موضوعية: KNEE osteoarthritis, COST effectiveness, OBESITY, QUALITY-adjusted life years, WEIGHT loss

مستخلص: Objective: Obesity exacerbates pain and functional limitation in persons with knee osteoarthritis (OA). In the Weight Loss and Exercise for Communities with Arthritis in North Carolina (WE‐CAN) study, a community‐based diet and exercise (D + E) intervention led to an additional 6 kg weight loss and 20% greater pain relief in persons with knee OA and body mass index (BMI) >27 kg/m2 relative to a group‐based health education (HE) intervention. We sought to determine the incremental cost‐effectiveness of the usual care (UC), UC + HE, and UC + (D + E) programs, comparing each strategy with the "next‐best" strategy ranked by increasing lifetime cost. Methods: We used the Osteoarthritis Policy Model to project long‐term clinical and economic benefits of the WE‐CAN interventions. We considered three strategies: UC, UC + HE, and UC + (D + E). We derived cohort characteristics, weight, and pain reduction from the WE‐CAN trial. Our outcomes included quality‐adjusted life years (QALYs), cost, and incremental cost‐effectiveness ratios (ICERs). Results: In a cohort with mean age 65 years, BMI 37 kg/m2, and Western Ontario and McMaster Universities Osteoarthritis Index pain score 38 (scale 0–100, 100 = worst), UC leads to 9.36 QALYs/person, compared with 9.44 QALYs for UC + HE and 9.49 QALYS for UC + (D + E). The corresponding lifetime costs are $147,102, $148,139, and $151,478. From the societal perspective, UC + HE leads to an ICER of $12,700/QALY; adding D + E to UC leads to an ICER of $61,700/QALY. Conclusion: The community‐based D + E program for persons with knee OA and BMI >27kg/m2 could be cost‐effective for willingness‐to‐pay thresholds greater than $62,000/QALY. These findings suggest that incorporation of community‐based D + E programs into OA care may be beneficial for public health. [ABSTRACT FROM AUTHOR]

: Copyright of Arthritis Care & Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Waddell, Lily M., Musbahi, Omar, Collins, Jamie E., Jones, Morgan H., Selzer, Faith, Losina, Elena, Katz, Jeffrey N.

المصدر: Arthritis Care & Research; Jun2024, Vol. 76 Issue 6, p882-888, 7p

مصطلحات موضوعية: PAIN measurement, ORTHOPEDIC surgery, ELECTIVE surgery

مستخلص: Objective: Musculoskeletal (MSK) disorders affect ~50% of US adults and 75% of those over the age of 65, representing a sizable economic and disability burden. Outcome measures, both objective and subjective, help clinicians and investigators determine whether interventions to treat MSK conditions are effective. This narrative review qualitatively compared the responsiveness of different types of outcome measures, a key measurement characteristic that assesses an outcome measure's ability to detect change in patient status. Methods: We evaluated elective orthopedic interventions as a model for assessing responsiveness because the great majority of patients improves following surgery. We searched for articles reporting responsiveness (quantified as effect size [ES]) of subjective and objective outcome measures after orthopedic surgery and included 16 articles reporting 17 interventions in this review. Results: In 14 of 17 interventions, subjective function measures had an ES 10% greater than that of objective function measures. Two reported a difference in ES of <10%. The sole intervention that demonstrated higher ES of objective function used a composite measure. Sixteen interventions reported measures of subjective pain and/or mixed measures and subjective function. In nine interventions, subjective pain had a higher ES than subjective function by >10%, in three, subjective function had a higher ES than subjective pain by >10%, and in the remaining four, the difference between pain and function was <10%. Conclusion: These findings reinforce the clinical observation that subjective pain generally changes more than function following elective orthopedic surgery. They also suggest that subjective function measures are more responsive than objective function measures, and composite scores may be more responsive than individual performance tests. [ABSTRACT FROM AUTHOR]

: Copyright of Arthritis Care & Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Acosta Julbe, José I., Gottreich, Julia R., Ermann, Joerg, Isaac, Zacharia, DeFilipp, Miriam, Andrew, Michael N., Yuchiao Chang, Zampini, Jay M., Katz, Jeffrey N., Mandell, Jacob C.

المصدر: Spine (03622436); 5/15/2024, Vol. 49 Issue 10, p733-740, 8p

المؤلفون: Kraus, Virginia Byers, Collins, Jamie E, Hargrove, David, Losina, Elena, Nevitt, Michael, Katz, Jeffrey N, Wang, Susanne X, Sandell, Linda J, Hoffmann, Steven C, Hunter, David J

المصدر: Annals of the Rheumatic Diseases. 76(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Aging, Chronic Pain, Pain Research, Arthritis, Clinical Research, Musculoskeletal, Aged, Biomarkers, Case-Control Studies, Disease Progression, Female, Humans, Male, Middle Aged, Osteoarthritis, Knee, Pain Measurement, Predictive Value of Tests, Prognosis, ROC Curve, Radiography, Sensitivity and Specificity, Severity of Illness Index, OA Biomarkers Consortium, Disease Activity, Knee Osteoarthritis, Osteoarthritis, Immunology, Public Health and Health Services, Arthritis & Rheumatology, Clinical sciences

الوصف: ObjectiveTo investigate a targeted set of biochemical biomarkers as predictors of clinically relevant osteoarthritis (OA) progression.MethodsEighteen biomarkers were measured at baseline, 12 months (M) and 24 M in serum (s) and/or urine (u) of cases (n=194) from the OA initiative cohort with knee OA and radiographic and persistent pain worsening from 24 to 48 M and controls (n=406) not meeting both end point criteria. Primary analyses used multivariable regression models to evaluate the association between biomarkers (baseline and time-integrated concentrations (TICs) over 12 and 24 M, transposed to z values) and case status, adjusted for age, sex, body mass index, race, baseline radiographic joint space width, Kellgren-Lawrence grade, pain and pain medication use. For biomarkers with adjusted p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/18b9038bTest

المؤلفون: Roemer, Frank W, Guermazi, Ali, Collins, Jamie E, Losina, Elena, Nevitt, Michael C, Lynch, John A, Katz, Jeffrey N, Kwoh, C Kent, Kraus, Virginia B, Hunter, David J

المصدر: BMC musculoskeletal disorders. 17(1)

مصطلحات موضوعية: Cartilage, Articular, Menisci, Tibial, Bone Marrow, Humans, Osteoarthritis, Knee, Synovitis, Disease Progression, Magnetic Resonance Imaging, Case-Control Studies, Aged, Middle Aged, Female, Male, Osteophyte, Biomarkers, MRI, Osteoarthritis, Progression, Scoring, Cartilage, Articular, Menisci, Tibial, Knee, Clinical Sciences, Orthopedics

الوصف: BackgroundTo describe the scoring methodology and MRI assessments used to evaluate the cross-sectional features observed in cases and controls, to define change over time for different MRI features, and to report the extent of changes over a 24-month period in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium study nested within the larger Osteoarthritis Initiative (OAI) Study.MethodsWe conducted a nested case-control study. Cases (n = 406) were knees having both radiographic and pain progression. Controls (n = 194) were knee osteoarthritis subjects who did not meet the case definition. Groups were matched for Kellgren-Lawrence grade and body mass index. MRIs were acquired using 3 T MRI systems and assessed using the semi-quantitative MOAKS system. MRIs were read at baseline and 24 months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. We provide the definition and distribution of change in these biomarkers over time.ResultsSeventy-three percent of the cases had subregions with BML worsening (vs. 66 % in controls) (p = 0.102). Little change in osteophytes was seen over 24 months. Twenty-eight percent of cases and 10 % of controls had worsening in meniscal scores in at least one subregion (p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3d57p99kTest

المؤلفون: Collins, Jamie E, Losina, Elena, Nevitt, Michael C, Roemer, Frank W, Guermazi, Ali, Lynch, John A, Katz, Jeffrey N, Kwoh, C Kent, Kraus, Virginia B, Hunter, David J

المصدر: Arthritis & Rheumatology. 68(10)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Arthritis, Pain Research, Osteoarthritis, Aging, Chronic Pain, Musculoskeletal, Aged, Arthralgia, Bone Marrow, Bone Marrow Diseases, Cartilage, Articular, Case-Control Studies, Disease Progression, Female, Humans, Knee Joint, Logistic Models, Magnetic Resonance Imaging, Male, Menisci, Tibial, Middle Aged, Multivariate Analysis, Organ Size, Osteoarthritis, Knee, Osteophyte, Radiography, Synovitis, Tibial Meniscus Injuries, Immunology, Public Health and Health Services, Arthritis & Rheumatology, Clinical sciences

الوصف: ObjectiveTo determine the association between changes in semiquantitative magnetic resonance imaging (MRI) biomarkers over 24 months and radiographic and pain progression over 48 months in knees with mild-to-moderate osteoarthritis (OA).MethodsWe undertook a nested case-control study as part of the Foundation for the National Institutes of Health Biomarkers Consortium Project. We used multivariable logistic regression models to examine the association between change over 24 months in semiquantitative MRI markers and radiographic and pain progression in knee OA. MRIs were read according to the MRI OA Knee Score system. We focused on changes in cartilage, osteophytes, meniscus, bone marrow lesions, Hoffa-synovitis, and effusion-synovitis.ResultsThe most parsimonious model included changes in cartilage thickness and surface area, effusion-synovitis, Hoffa-synovitis, and meniscal morphology (C statistic 0.740). Compared with no worsening, worsening in cartilage thickness in ≥3 subregions was associated with 2.8-fold (95% confidence interval [95% CI] 1.3-5.9) greater odds of being a case, and worsening in cartilage surface area in ≥3 subregions was associated with 2.4-fold (95% CI 1.3-4.4) greater odds of being a case. Worsening of meniscal morphology in any region was associated with 2.2-fold (95% CI 1.3-3.8) greater odds of being a case. Worsening effusion-synovitis and Hoffa-synovitis were also associated with a greater odds of being a case (odds ratios 2.7 and 2.0, respectively).ConclusionTwenty-four-month changes in cartilage thickness, cartilage surface area, effusion-synovitis, Hoffa-synovitis, and meniscal morphology were independently associated with OA progression, suggesting that these factors may serve as efficacy biomarkers in clinical trials of disease-modifying interventions for knee OA.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/14n7r761Test

المؤلفون: Kopp, Paul T, Yang, Catherine, Yang, Heidi, Katz, Jeffrey N, Paltiel, A David, Hunter, David J, Callahan, Leigh F, Mihalko, Shannon L, Newman, Jovita J, DeVita, Paul, Loeser, Richard F, Miller, Gary D, Messier, Stephen P, Losina, Elena

المصدر: Arthritis Care Res (Hoboken) ; ISSN:2151-4658 ; Volume:76 ; Issue:7

الوصف: Obesity exacerbates pain and functional limitation in persons with knee osteoarthritis (OA). In the Weight Loss and Exercise for Communities with Arthritis in North Carolina (WE-CAN) study, a community-based diet and exercise (D + E) intervention led to an additional 6 kg weight loss and 20% greater pain relief in persons with knee OA and body mass index (BMI) >27 kg/m2 relative to a group-based health education (HE) intervention. We sought to determine the incremental cost-effectiveness of the usual care (UC), UC + HE, and UC + (D + E) programs, comparing each strategy with the "next-best" strategy ranked by increasing lifetime cost.

العلاقة: https://doi.org/10.1002/acr.25323Test; https://pubmed.ncbi.nlm.nih.gov/38450873Test

الإتاحة: https://doi.org/10.1002/acr.25323Test
https://pubmed.ncbi.nlm.nih.gov/38450873Test

المؤلفون: Lowenstein, Natalie, Chang, Yuchiao, Mass, Hanna, Mercurio, Angela M., Ukogu, Chierika, Katz, Jeffrey N., Matzkin, Elizabeth G.

المصدر: Alpha Omega Alpha Research Symposium Posters

مصطلحات موضوعية: knee arthroscopy, partial meniscectomy, patient reported outcomes, PROMs, Medicine and Health Sciences, Surgery

الوصف: Problem Statement: - Arthroscopic partial meniscectomy (APM) has been shown to be the most common meniscal surgical treatment in the United States - Pre-op risk factors known to contribute to poor outcomes after APM: Symptom duration and radiographic OA at baseline - Factors with no conclusive effect on post-op outcomes: Baseline knee functional score, location of meniscal tear, BMI, activity level, age, sex, and chondral damage on MRI Project AIM: To create an index score using easily available preoperative risk factors such as Kellgren-Lawrence (KL) grade, age, duration of symptoms, BMI, activity level, and preoperative outcome scores to predict the likelihood of favorable outcomes after APM. ; https://jdc.jefferson.edu/aoa_research_symposium_posters/1003/thumbnail.jpgTest

وصف الملف: application/pdf

العلاقة: https://jdc.jefferson.edu/aoa_research_symposium_posters/4Test; https://jdc.jefferson.edu/context/aoa_research_symposium_posters/article/1003/viewcontent/Lowenstein_Natalie_poster.pdfTest

الإتاحة: https://jdc.jefferson.edu/aoa_research_symposium_posters/4Test
https://jdc.jefferson.edu/context/aoa_research_symposium_posters/article/1003/viewcontent/Lowenstein_Natalie_poster.pdfTest

المؤلفون: Khan, Nazleen F., Bykov, Katsiaryna, Katz, Jeffrey N., Glynn, Robert J., Vine, Seanna M., Kim, Seoyoung C.

المساهمون: National Institute on Aging, National Institute of Arthritis and Musculoskeletal and Skin Diseases

المصدر: Pharmacoepidemiology and Drug Safety ; volume 33, issue 3 ; ISSN 1053-8569 1099-1557

الوصف: Background Osteoarthritis (OA) patients taking prescription opioids for pain are at increased risk of fall or fracture, and the concomitant use of interacting drugs may further increase the risk of these events. Aims To identify prescription opioid‐related medication combinations associated with fall or fracture. Materials & Methods We conducted a case‐crossover‐based screening of two administrative claims databases spanning 2003 through 2021. OA patients were aged 40 years or older with at least 365 days of continuous enrollment and 90 days of continuous prescription opioid use before their first eligible fall or fracture event. The primary analysis quantified the odds ratio (OR) between fall and non‐opioid medications dispensed in the 90 days before the fall date after adjustment for prescription opioid dosage and confounding using a case‐time‐control design. A secondary analogous analysis evaluated medications associated with fracture. The false discovery rate (FDR) was used to account for multiple testing. Results We identified 41 693 OA patients who experienced a fall and 24 891 OA patients who experienced a fracture after at least 90 days of continuous opioid therapy. Top non‐opioid medications by ascending p‐value with OR > 1 for fall were meloxicam (OR 1.22, FDR = 0.08), metoprolol (OR 1.06, FDR >0.99), and celecoxib (OR 1.13, FDR > 0.99). Top non‐opioid medications for fracture were losartan (OR 1.20, FDR = 0.80), alprazolam (OR 1.14, FDR > 0.99), and duloxetine (OR 1.12, FDR = 0.97). Conclusion Clinicians may seek to monitor patients who are co‐prescribed drugs that act on the central nervous system, especially in individuals with OA.

الإتاحة: https://doi.org/10.1002/pds.5773Test