Evidence map›Paper›PMID 31243017›Full record

ArticleAnnals of the rheumatic diseases2019

Development and validation of risk stratification trees for incident slow gait speed in persons at high risk for knee osteoarthritis.

Leena Sharma, Kent Kwoh, Jungwha Julia Lee, Jane Cauley, Rebecca Jackson, Marc Hochberg, Alison H Chang, Charles Eaton, Michael Nevitt, Jing Song and 2 more

Abstract readEvaluation StudyMulticenter StudyValidation Study
In one paragraph

Article in Annals of the rheumatic diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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. Trial
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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

12 authors.

Leena SharmaDepartments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA l-sharma@northwestern.edu.ORCID 0000-0002-5571-1622
Kent KwohUniversity of Arizona, Tucson, Arizona, USA.
Jungwha Julia LeePreventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Jane CauleyUniversity of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Rebecca JacksonOhio State University, Columbus, Ohio, USA.
Marc HochbergUniversity of Maryland Baltimore, Baltimore, Maryland, USA.
Alison H ChangPhysical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Charles EatonBrown University Warren Alpert Medical School, Providence, Rhode Island, USA.
Michael NevittUniversity of California San Francisco, San Francisco, California, USA.
Jing SongDepartment of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Orit AlmagorDepartment of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Joan S ChmielPreventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Funding

Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
Multicenter Osteoarthritis Study (MOST) Second Renewal: Iowa Clinical CenterU01AG018832 · NIA · UNIVERSITY OF IOWA · PI SEGAL, NEIL A, TORNER, JAMES C · 2001 to 2020
$14.1M
Multicenter Osteoarthritis Study (MOST) Second Renewal - Boston UniversityU01AG018820 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI FELSON, DAVID TOBIN · 2001 to 2019
$13.6M
Multicenter Osteoarthritis Study (MOST) Second Renewal - UAB Clinical CenterU01AG018947 · NIA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI LEWIS, CORA E · 2001 to 2020
$13.2M
Resource CoreP30AR072579 · NIAMS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Leena Sharma · 2017 to 2026
$8.3M
Risk of Incident Knee OA & Clinical Outcomes Based on Imaging BiomarkersR01AR066601 · NIAMS · UNIVERSITY OF ARIZONA · PI GUERMAZI, ALI, KWOH, C KENT · 2014 to 2018
$6.2M
Long-term Significance of Pre-radiographic Lesions in Persons at Risk for Knee OAR01AR065473 · NIAMS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI SHARMA, LEENA · 2014 to 2018
$5.7M
NCATS NIH HHS UL1 TR001422NIAMS NIH HHS P30 AR072579NIAMS NIH HHS R01 AR065473NIAMS NIH HHS R01 AR066601NIA NIH HHS U01 AG018820NIA NIH HHS U01 AG018832NIA NIH HHS U01 AG018947
6 · The paper itself

Abstract

objectivesDisability prevention strategies are more achievable before osteoarthritis disease drives impairment. It is critical to identify high-risk groups, for strategy implementation and trial eligibility. An established measure, gait speed is associated with disability and mortality. We sought to develop and validate risk stratification trees for incident slow gait in persons at high risk for knee osteoarthritis, feasible in community and clinical settings.

methodsOsteoarthritis Initiative (derivation cohort) and Multicenter Osteoarthritis Study (validation cohort) participants at high risk for knee osteoarthritis were included. Outcome was incident slow gait over up to 10-year follow-up. Derivation cohort classification and regression tree analysis identified predictors from easily assessed variables and developed risk stratification models, then applied to the validation cohort. Logistic regression compared risk group predictive values; area under the receiver operating characteristic curves (AUCs) summarised discrimination ability.

results1870 (derivation) and 1279 (validation) persons were included. The most parsimonious tree identified three risk groups, from stratification based on age and WOMAC Function. A 7-risk-group tree also included education, strenuous sport/recreational activity, obesity and depressive symptoms; outcome occurred in 11%, varying 0%-29 % (derivation) and 2%-23 % (validation) depending on risk group. AUCs were comparable in the two cohorts (7-risk-group tree, 0.75, 95% CI 0.72 to 0.78 (derivation); 0.72, 95% CI 0.68 to 0.76 (validation)).

conclusionsIn persons at high risk for knee osteoarthritis, easily acquired data can be used to identify those at high risk of incident functional impairment. Outcome risk varied greatly depending on tree-based risk group membership. These trees can inform individual awareness of risk for impaired function and define eligibility for prevention trials.

Indexed as

Decision TreesDisability EvaluationAgedArea Under CurveFeasibility StudiesFemaleGait Disorders, NeurologicHumansIncidenceLogistic ModelsMaleMiddle AgedOsteoarthritis, KneeReproducibility of ResultsRisk AssessmentRisk Factorsdisabilityfunctional impairmentknee osteoarthritisosteoarthritisprevention

Identifiers

PMID31243017
PMCPMC7044716

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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.