Evidence map›Paper›PMID 30092262›Full record

Observational studyOsteoarthritis and cartilage2018

Pain severity as a mediator of the association between depressive symptoms and physical performance in knee osteoarthritis.

A M Rathbun, M D Shardell, E A Stuart, M S Yau, J J Gallo, M S Schuler, M C Hochberg

Open access · bronzeAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Osteoarthritis and cartilage, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 15% 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

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Depression in Osteoarthritis: Current Understanding.Neuropsychiatric disease and treatment · 2022
    Review
  15. Article
  16. Article
  17. Observational
  18. Article
  19. Observational
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

7 authors at 5 institutions in 1 country.

A M RathbunGeriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore VA Medical Center, MD, USA; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: arathbun@som.umaryland.edu.
M D ShardellTranslational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA. Electronic address: michelle.shardell@nih.gov.
E A StuartDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: estuart@jhu.edu.
M S YauInstitute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA. Electronic address: MichelleYau@hsl.harvard.edu.
J J GalloDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: jgallo2@jhu.edu.
M S SchulerRAND Corporation, Boston, MA, USA. Electronic address: m.s.schuler@gmail.com.
M C HochbergGeriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore VA Medical Center, MD, USA; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: mhochber@som.umaryland.edu.
Johns Hopkins University · USUniversity of Maryland, Baltimore · USHarvard University · USNational Institute on Aging · USRAND Corporation · US

Funding

RESEARCH TRAINING IN THE EPIDEMIOLOGY OF AGINGT32AG000262 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI ANN L GRUBER-BALDINI, DENISE L ORWIG · 1998 to 2026
$8.2M
Statistical methods for vitamin D targets for functional outcomes in older adultsR01AG048069 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI SHARDELL, MICHELLE DENISE · 2015 to 2025
$4.3M
Causal mediation methods for studying mechanisms in mental healthR01MH115487 · NIMH · JOHNS HOPKINS UNIVERSITY · PI STUART, ELIZABETH A. · 2018 to 2021
$1.3M
CLINICAL CENTERS FOR THE OSTEOARTHRITIS INITIATIVE-264022259-264022259N01AR022259 · NIAMS · UNIVERSITY OF MARYLAND AT BALT · PI HOCHBERG, MARC C. · 2002 to 2006
–
Intramural NIH HHS Z99 AG999999NIAMS NIH HHS N01 AR022259NIA NIH HHS R01 AG048069NIA NIH HHS T32 AG000262NIMH NIH HHS R01 MH115487
6 · The paper itself

Abstract

objectiveDepressive symptoms in knee osteoarthritis (OA) are associated with increased pain severity and declines in physical performance. This study examined whether pain severity mediates the association between depressive symptoms and physical performance in persons with radiographic knee OA.

methodThree years of annual data from participants (n = 1,463) with radiographic knee OA in the Osteoarthritis Initiative (OAI) were analyzed. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D) scale. Pain severity was evaluated with the Western Ontario and McMaster Universities Arthritis Index. Physical performance was assessed via standardized gait speed. Marginal structural models were used to assess the direct (unmediated) effects of depressive symptoms on physical performance and indirect (mediated) effects through pain severity.

resultsDirect and indirect effects for a difference in CES-D score of 0-1 were -0.0051 (95% confidence intervals (CI): -0.0053, -0.0049) and -0.0016 (95% CI: -0.0024, -0.0007) standard deviations in gait speed, respectively. Higher depressive symptom severity exhibited diminishing, incremental, direct and indirect effects and for a difference in CES-D score of 15-16 were -0.0045 (95% CI: -0.0047, -0.0042) and -0.0009 (95% CI: -0.0014, -0.0004) standard deviations in gait speed, respectively. Therefore, the magnitude of the mediated, indirect effect, was never larger than 24%.

conclusionPain severity mediated approximately one-fifth of the association between depressive symptoms and physical performance in persons with radiographic knee OA, and the diminishing incremental effects may explain why unimodal treatment strategies with a single disease target are often ineffective in depressed OA patients.

Indexed as

Physical Functional PerformanceAgedArthralgiaDepressionDisease ProgressionFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedOsteoarthritis, KneePain MeasurementRetrospective StudiesRisk FactorsSeverity of Illness IndexDepressionMediationOsteoarthritisPainPhysical performance

Identifiers

PMID30092262
PMCPMC6397771
OpenAlexW2885962463

What OpenQuestion holds

Textmetadata
LicenceTDM
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.