Evidence map›Paper›PMID 29284048›Full record

ArticlePloS one2017

The mediating effect of body mass index on the relationship between smoking and hip or knee replacement due to primary osteoarthritis. A population-based cohort study (the HUNT Study).

Marianne Bakke Johnsen, Alf Inge Hellevik, Milada Cvancarova Småstuen, Arnulf Langhammer, Ove Furnes, Gunnar Birkeland Flugsrud, Lars Nordsletten, John Anker Zwart, Kjersti Storheim

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
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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

9 authors at 3 institutions in 1 country.

Marianne Bakke JohnsenResearch and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.ORCID 0000-0003-4300-5250
Alf Inge HellevikDivision of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Milada Cvancarova SmåstuenResearch and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.
Arnulf LanghammerThe HUNT Research Centre, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Levanger, Norway.
Ove FurnesThe Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.
Gunnar Birkeland FlugsrudDivision of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Lars NordslettenFaculty of Medicine, University of Oslo, Oslo, Norway.
John Anker ZwartResearch and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.
Kjersti StorheimResearch and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.
Oslo University Hospital · NOHaukeland University Hospital · NONorwegian University of Science and Technology · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To investigate the total effect of smoking on total hip or knee replacement (THR/TKR) due to primary osteoarthritis (OA) and to quantify the indirect effect of smoking through body mass index (BMI). Participants from the Nord-Trøndelag Health Study (the HUNT Study) were linked to the Norwegian Arthroplasty Register to detect the first THR or TKR due to primary OA. A mediation analysis was used to decompose the total effect of smoking into a direct and indirect effect. BMI was considered a mediator in the analysis. All effects were estimated as hazard ratios (HRs) with 95% confidence intervals (CIs). The indirect effect of smoking mediated through BMI was expressed as a percentage (proportion*100). In total 55 188 participants were followed up during 17.2 years (median). We identified 1322 THRs and 754 TKRs. For men, the total effect of current vs. never smoking revealed a decreased risk of THR (HR 0.59, 95% CI 0.46-0.76) and TKR (HR 0.47, 95% CI 0.32-0.66). For women, current smoking increased the risk of THR (HR 1.34, 95% CI 1.11-1.60). For men, 6% and 7% of the risk reduction for THR and TKR, respectively, was mediated by BMI. We found a negative association between smoking and THR or TKR for men. On the contrary, smoking was associated with increased risk of THR for women. Most of the effect of smoking on joint replacement risk remained unexplained by BMI.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeBody Mass IndexSmokingAdultCohort StudiesFemaleHumansMaleMiddle AgedOsteoarthritis, HipOsteoarthritis, Knee

Identifiers

PMID29284048
PMCPMC5746263
OpenAlexW2777437786

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.