Evidence map›Paper›PMID 32085906›Full record

Trial reportThe Journal of arthroplasty2020

Association of the Intensive Lifestyle Intervention With Total Knee Replacement in the Look AHEAD (Action for Health in Diabetes) Clinical Trial.

Phyllis A Richey, Karen C Johnson, Rebecca H Neiberg, Judy L Bahnson, Kunal Singhal, Mace Coday, Fridtjof Thomas, Cora E Lewis, William M Mihalko, Look AHEAD Research Group

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Journal of arthroplasty, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-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

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. 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

10 authors at 3 institutions in 1 country.

Phyllis A RicheyDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN; Department of Physical Therapy, University of Tennessee Health Science Center, Memphis, TN.
Karen C JohnsonDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
Rebecca H NeibergDepartment of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC.
Judy L BahnsonDepartment of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC.
Kunal SinghalDepartment of Physical Therapy, University of Tennessee Health Science Center, Memphis, TN.
Mace CodayDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
Fridtjof ThomasDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
Cora E LewisDepartment of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
William M MihalkoDepartment of Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN.
Look AHEAD Research Group
University of Tennessee Health Science Center · USWake Forest University · USUniversity of Alabama at Birmingham · US

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
UNIVERSITY OF PITTSBURGH CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE: BPCAUL1RR024153 · NCRR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2006 to 2011
$73.9M
Look AHEAD: Action for Health in DiabetesU01DK057136 · NIDDK · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ESPELAND, MARK ANDREW, WAGENKNECHT, LYNNE E · 1999 to 2020
$54.9M
ZOPOLRESTAT PHARMACOKINETICS IN DIABETICS WITH VARYING RENAL FUNCTIONM01RR000051 · NCRR · UNIVERSITY OF COLORADO DENVER · PI CAMPBELL, THOMAS A · 1985 to 2008
$52.6M
Vector and Transgenic Mouse CoreP30DK017047 · NIDDK · UNIVERSITY OF WASHINGTON · PI Sakeneh Zraika · 1986 to 2026
$41.4M
ZD6416 Analgesic--Painful Distal Symmetrical PolyneuropaM01RR001066 · NCRR · MASSACHUSETTS GENERAL HOSPITAL · PI HALL, JANET E · 1985 to 2008
$37.4M
PILOT STUDY--SUBSTRATE METABOLISM IN EXTREMELY LOW BIRTH WEIGHT INFANTSP30DK048520 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI JANINE A HIGGINS · 1995 to 2026
$32.6M
WITHIN SUBJ VARIABILITY IN MEASUREMENTS DRUG METABOL ENZYMES IN HLTY SUBJM01RR000056 · NCRR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI LEVINE, ARTHUR S · 1985 to 2006
$29.2M
ZOLEDRONATE VS AREDIA IN MULTIPLE MYELOMA/BREAST CANCER W /BONE DISORDERSM01RR001346 · NCRR · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI WALSH, NICOLAS EUGENE · 1985 to 2008
$23.1M
SHOW PROJECTU01DK057154 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI NATHAN, DAVID M · 1999 to 2020
$23.1M
Look AHEAD: Action for Health DiabetesU01DK057178 · NIDDK · ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS · PI LAFERRERE, BLANDINE B · 1999 to 2020
$21.2M
ZINC THERAPY FOR SCLERODERMA--PHASE I STUDYM01RR002719 · NCRR · JOHNS HOPKINS UNIVERSITY · PI GOTTLIEB, SHELDON H · 1986 to 2007
$20.2M
NCRR NIH HHS M01 RR000051NCRR NIH HHS M01 RR000056NCRR NIH HHS M01 RR001066NCRR NIH HHS M01 RR001346NCRR NIH HHS M01 RR002719NCRR NIH HHS UL1 RR024153NCRR NIH HHS UL1 RR025758NIAMS NIH HHS R34 AR074066NIDDK NIH HHS P30 DK017047NIDDK NIH HHS P30 DK046204NIDDK NIH HHS P30 DK048520NIDDK NIH HHS P30 DK079626NIDDK NIH HHS U01 DK056990NIDDK NIH HHS U01 DK056992NIDDK NIH HHS U01 DK057002NIDDK NIH HHS U01 DK057008NIDDK NIH HHS U01 DK057078NIDDK NIH HHS U01 DK057131NIDDK NIH HHS U01 DK057135NIDDK NIH HHS U01 DK057136NIDDK NIH HHS U01 DK057149NIDDK NIH HHS U01 DK057151NIDDK NIH HHS U01 DK057154NIDDK NIH HHS U01 DK057171NIDDK NIH HHS U01 DK057177NIDDK NIH HHS U01 DK057178NIDDK NIH HHS U01 DK057182NIDDK NIH HHS U01 DK057219
6 · The paper itself

Abstract

backgroundEvidence has established obesity as a risk factor for total knee replacement (TKR) due to osteoarthritis. Obesity is a risk factor for TKR. Randomized trials such as Look AHEAD (Action for Health in Diabetes) have shown long-term successful weight loss with an intensive lifestyle intervention (ILI). It is unknown, however, if intentional weight loss can reduce the risk of TKR.

methodsLook AHEAD randomized persons aged 45-76 with type 2 diabetes who had overweight or obesity to either an ILI to achieve/maintain 7% weight loss or to standard diabetes support and education (DSE). Reported knee pain was assessed using the Visual Analog Scale and Western Ontario McMaster University Osteoarthritis Index questionnaire in 5125 participants without previous TKR. Cox proportional hazard regression was used to model differences in risk of TKR in relation to randomization group assignment (ILI vs DSE) along with baseline body mass index category and baseline knee pain as potential confounders from baseline through Look AHEAD-Extension.

resultsBaseline mean ± SD Western Ontario McMaster University Osteoarthritis Index knee pain scores did not differ by treatment assignment (ILI: 3.6 ± 2.9, DSE: 3.9 ± 3.0, P = .08); as expected due to randomization. During follow up, the 631 (12%) participants who reported having a TKR were more likely to have been heavier (P < .001) and older (P < .001) at enrollment, but risk of TKR did not differ by treatment group assignment (hazard ratio [HR] 1.07, 95% confidence interval [CI] 0.91-1.25, P = .43). Heterogeneity of treatment effect was observed according to baseline knee pain (interaction P = .02). In persons without knee pain at baseline, there was a 29% reduced risk of TKR in ILI compared to DSE (HR 0.71, 95% CI 0.52-0.96). However, in persons with knee pain at baseline, there was no statistically significant association of treatment assignment with respect to subsequent TKR incidence (HR 1.11, 95% CI 0.92-1.33).

conclusionFindings suggest that intensive lifestyle change including physical activity, dietary restriction and behavioral changes to achieve weight loss for prevention of TKR may be most effective in preventing TKR prior to the development of knee pain.

Indexed as

Arthroplasty, Replacement, KneeDiabetes Mellitus, Type 2Life StyleAgedHumansMiddle AgedOntarioWeight Lossarthroplastykneeobesityosteoarthritisphysical activityweight loss

Identifiers

PMID32085906
PMCPMC7247950
OpenAlexW3008520336

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.