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Radiographic knee osteoarthritis impacts multiple dimensions of health-related quality of life: data from the Osteoarthritis Initiative.

ABSTRACT: Objectives:To estimate the multi-dimensional health impact of radiographic knee OA and quantify the overall health-related quality of life (HRQoL) burden, using a preference-based health utilities measure. Methods:Data on self-reported HRQoL, measured using the SF-12 multi-dimensional health state instrument, were obtained for 2895 patients with radiographic knee OA (Kellgren-Lawrence grade of at least 2) from the Osteoarthritis Initiative and for a general population sample of 3202 from the National Health Measurement Study. The SF-12 was converted to the six-dimensional SF-6D classification to compute preference-based health utilities. Generalized ordinal regression and multinomial regression were used to estimate the health loss on each SF-6D dimension for Osteoarthritis Initiative participants with radiographic knee OA relative to the general population, adjusted for differences in age, BMI, sex, ethnicity and educational level. Predicted SF-6D profiles were then used to compute the average HRQoL loss attributable to radiographic knee OA. Results:Radiographic knee OA was associated with substantial health losses on all dimensions of the SF-6D except for social functioning. Health losses increased with the radiographic severity of OA in dimensions related to physical health, while there was no relationship between worse radiographic disease and worse self-assessed health in mental and emotional dimensions of health. Overall, radiographic knee OA was associated with a HRQoL detriment of 0.040-0.044 at Kellgren-Lawrence grade 2, increasing to 0.045-0.050 at grade 3 and 0.073-0.081 at grade 4. Conclusion:Radiographic knee OA is significantly associated with worse HRQoL across most dimensions of health.

SUBMITTER: Wilson R

PROVIDER: S-EPMC6251551 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Radiographic knee osteoarthritis impacts multiple dimensions of health-related quality of life: data from the Osteoarthritis Initiative.

Wilson Ross R Blakely Tony T Abbott J Haxby JH

Rheumatology (Oxford, England) 20180501 5

<h4>Objectives</h4>To estimate the multi-dimensional health impact of radiographic knee OA and quantify the overall health-related quality of life (HRQoL) burden, using a preference-based health utilities measure.<h4>Methods</h4>Data on self-reported HRQoL, measured using the SF-12 multi-dimensional health state instrument, were obtained for 2895 patients with radiographic knee OA (Kellgren-Lawrence grade of at least 2) from the Osteoarthritis Initiative and for a general population sample of 32 ...[more]

PMID: 29481663

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Project description:BackgroundKnee osteoarthritis (OA) worsens health-related quality of life (HRQoL) but the symptom pathway varies from person to person. We aimed to identify groups of people with knee OA or at its increased risk whose HRQoL changed similarly. Our secondary aim was to evaluate if patient-related characteristics, incidence of knee replacement (KR) and prevalence of pain medication use differed between the identified HRQoL trajectory groups.MethodsEight-year follow-up data of 3053 persons with mild knee OA or at increased risk were obtained from the public Osteoarthritis Initiative (OAI) database. Group-based trajectory modeling was used to identify patterns of experiencing a decrease of ≥10 points (Minimal Important Change, MIC) in the Quality of Life subscale of the Knee injury and Osteoarthritis Outcome Score compared to baseline. Multinomial logistic regression, Cox regression and generalized estimating equation models were used to study secondary aims.ResultsFour HRQoL trajectory groups were identified. Persons in the 'no change' group (62.9%) experienced no worsening in HRQoL. 'Rapidly' (9.5%) and 'slowly' worsening (17.1%) groups displayed an increasing probability of experiencing the MIC in HRQoL. The fourth group (10.4%) had 'improving' HRQoL. Female gender, higher body mass index, smoking, knee pain, and lower income at baseline were associated with belonging to the 'rapidly worsening' group. People in 'rapidly' (hazard ratio (HR) 6.2, 95% confidence interval (CI) 3.6-10.7) and 'slowly' worsening (HR 3.4, 95% CI 2.0-5.9) groups had an increased risk of requiring knee replacement. Pain medication was more rarely used in the 'no change' than in the other groups.ConclusionsHRQoL worsening was associated with several risk factors; surgical and pharmacological interventions were more common in the poorer HRQoL trajectory groups indicating that HRQoL does reflect the need for OA treatment. These findings may have implications for targeting interventions to specific knee OA patient groups.

Project description:OBJECTIVES:To assess whether initial or 12-18-month change in magnetic resonance imaging (MRI) subchondral bone texture is predictive of radiographic knee osteoarthritis (OA) progression over 36 months. METHODS:This was a nested case-control study including 122 knees/122 participants in the Osteoarthritis Initiative (OAI) Bone Ancillary Study, who underwent MRI optimised for subchondral bone assessment at either the 30- or 36-month and 48-month OAI visits. Case knees (n = 61) had radiographic OA progression between the 36- and 72-month OAI visits, defined as ? 0.7 mm minimum medial tibiofemoral radiographic joint space (minJSW) loss. Control knees (n = 61) without radiographic OA progression were matched (1:1) to cases for age, sex, body mass index and initial medial minJSW. Texture analysis was performed on the medial femoral and tibial subchondral bone. We assessed the association of texture features with radiographic progression by creating a composite texture score using penalised logistic regression and calculating odds ratios. We evaluated the predictive performance of texture features for predicting radiographic progression using c-statistics. RESULTS:Initial (odds ratio [95% confidence interval] = 2.13 [1.41-3.40]) and 12- 18-month change (3.76 [2.04-7.82]) texture scores were significantly associated with radiographic OA progression. Combinations of texture features were significant predictors of radiographic progression using initial (c-statistic [95% confidence interval] = 0.65 [0.64-0.65], p = 0.003) and 12-18-month change (0.68 [0.68-0.68], p < 0.001) data. CONCLUSIONS:Initial and 12-18-month changes in MRI subchondral bone texture score were significantly associated with radiographic progression at 36 months, with better predictive performance for 12-18-month change in texture. These results suggest that texture analysis may be a useful biomarker of subchondral bone in OA. KEY POINTS:• Subchondral bone MRI texture analysis is a promising knee osteoarthritis imaging biomarker. • In this study, subchondral bone texture was associated with knee osteoarthritis progression. • This demonstrates predictive and concurrent validity of MRI subchondral bone texture analysis. • This method may be useful in clinical trials with interventions targeting bone.

Dataset Information

Radiographic knee osteoarthritis impacts multiple dimensions of health-related quality of life: data from the Osteoarthritis Initiative.

Publications

Radiographic knee osteoarthritis impacts multiple dimensions of health-related quality of life: data from the Osteoarthritis Initiative.

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