Evidence map›Paper›PMID 27909143›Full record

ArticleThe Journal of rheumatology2016

Interobserver and Intraobserver Reliability of Clinical Assessments in Knee Osteoarthritis.

Nasimah Maricar, Michael J Callaghan, Matthew J Parkes, David T Felson, Terence W O'Neill

Open access · bronzeAbstract read
In one paragraph

Article in The Journal of rheumatology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 45 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Osteoarthritis.Nature reviews. Disease primers · 2025
    Review
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  8. Article
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  12. Article
  13. Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020
    Article
  14. Article
  15. Article
  16. Review
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Nasimah MaricarFrom the Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, MAHSC, Manchester; Department of Physiotherapy, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK; Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA. nasimah.maricar@postgrad.manchester.ac.uk nasimah.maricar@srft.nhs.uk.
Michael J CallaghanFrom the Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, MAHSC, Manchester; Department of Physiotherapy, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK; Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
Matthew J ParkesFrom the Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, MAHSC, Manchester; Department of Physiotherapy, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK; Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
David T FelsonFrom the Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, MAHSC, Manchester; Department of Physiotherapy, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK; Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
Terence W O'NeillFrom the Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre (MAHSC), University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, MAHSC, Manchester; Department of Physiotherapy, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK; Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
Versus Arthritis · GBManchester Academic Health Science Centre · GB

Funding

Strutural Correlates of Knee PainR01AR053161 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI FELSON, DAVID TOBIN · 2006 to 2008
$1.2M
Arthritis Research UK 18676Arthritis Research UK 20380NIAMS NIH HHS R01 AR053161Versus Arthritis 18676
6 · The paper itself

Abstract

objectiveClinical examination of the knee is subject to measurement error. The aim of this analysis was to determine interobserver and intraobserver reliability of commonly used clinical tests in patients with knee osteoarthritis (OA).

methodsWe studied subjects with symptomatic knee OA who were participants in an open-label clinical trial of intraarticular steroid therapy. Following standardization of the clinical test procedures, 2 clinicians assessed 25 subjects independently at the same visit, and the same clinician assessed 88 subjects over an interval period of 2-10 weeks; in both cases prior to the steroid intervention. Clinical examination included assessment of bony enlargement, crepitus, quadriceps wasting, knee effusion, joint-line and anserine tenderness, and knee range of movement (ROM). Intraclass correlation coefficients (ICC), estimated kappa (κ), weighted kappa (κω), and Bland-Altman plots were used to determine interobserver and intraobserver levels of agreement.

resultsUsing Landis and Koch criteria, interobserver κ scores were moderate for patellofemoral joint (κ = 0.53) and anserine tenderness (κ = 0.48); good for bony enlargement (κ = 0.66), quadriceps wasting (κ = 0.78), crepitus (κ = 0.78), medial tibiofemoral joint tenderness (κ = 0.76), and effusion assessed by ballottement (κ = 0.73) and bulge sign (κω = 0.78); and excellent for lateral tibiofemoral joint tenderness (κ = 1.00), flexion (ICC = 0.97), and extension (ICC = 0.87) ROM. Intraobserver κ scores were moderate for lateral tibiofemoral joint tenderness (κ = 0.60); good for crepitus (κ = 0.78), effusion assessed by ballottement test (κ = 0.77), patellofemoral joint (κ = 0.66), medial tibiofemoral joint (κ = 0.64), and anserine tenderness (κ = 0.73); and excellent for effusion assessed by bulge sign (κω = 0.83), bony enlargement (κ = 0.98), quadriceps wasting (κ = 0.83), flexion (ICC = 0.99), and extension (ICC = 0.96) ROM.

conclusionAmong individuals with symptomatic knee OA, the reliability of clinical examination of the knee was at least good for the majority of clinical signs of knee OA.

Indexed as

Physical ExaminationAgedFemaleHumansKnee JointMaleMiddle AgedObserver VariationOsteoarthritis, KneeRange of Motion, ArticularReproducibility of ResultsCLINICAL TESTSINTEROBSERVER RELIABILITYINTRAOBSERVER RELIABILITYKNEE OSTEOARTHRITIS

Identifiers

PMID27909143
PMCPMC5266554
OpenAlexW2529308722

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.