ArticlePhysical therapy2020
The WOMAC Pain Scale and Crosstalk From Co-occurring Pain Sites in People With Knee Pain: A Causal Modeling Study.
Article in Physical therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Comparative efficacy and safety of bicompartmental versus total knee arthroplasty: a systematic review and update meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Predictors of Functional Recovery in Individuals Exposed to Late-Stage Exercise Programs After Total Knee Replacement: A Secondary Analysis of a Randomized Controlled Trial.Physical therapy · 2026Trial
- Efficacy and safety of invasive laser acupuncture (650 and 830 nm) on knee osteoarthritis: A pilot randomized clinical trial.PloS one · 2026Trial
- Influence of rapamycin on safety and healthspan metrics after one year: PEARL trial results.Aging · 2025Trial
- A randomized interventional clinical trial assessing the safety and effectiveness of PeaNoc XL tablets in managing joint pain and inflammation in arthritis patients.F1000Research · 2023Trial
- Comparative outcome analyses of stromal vascular fractionWorld journal of experimental medicine · 2025Article
- Unraveling Osteoarthritis: Mechanistic Insights and Emerging Therapies Targeting Pain and Inflammation.Biomolecules · 2025Review
- Effects of Standard Physiotherapy with the Addition of Mechanical Traction on Pain, Physical Activity and Quality of Life in Patients with Knee Osteoarthritis.Medicina (Kaunas, Lithuania) · 2025Observational
- 18F-Sodium Fluoride PET/CT as a Tool to Assess Enthesopathies in X-Linked Hypophosphatemia.Calcified tissue international · 2025Article
- Association between clinical laboratory indicators and WOMAC scores in Qatar Biobank participants: The impact of testosterone and fibrinogen on pain, stiffness, and functional limitation.Scandinavian journal of pain · 2025Article
- Comparison of MRI Osteoarthritis Knee Score with Clinico-Radiological Grading.The Indian journal of radiology & imaging · 2025Article
- Characterization of clinical data for patient stratification in moderate osteoarthritis with support vector machines, regulatory network models, and verification against osteoarthritis Initiative data.Scientific reports · 2024Article
- Nanosurgical and Bioengineering Treatment of Human Anterior Cruciate Ligament Tears with Ultrasound-Guided Injection of Modified Platelet-Rich Plasma Using Human Cell Memory Based on Clinical, Ultrasound, MRI, and Nanoscope Analyses: A Double-Blind Randomized Trial.Journal of clinical medicine · 2024Article
- Utility of Platelet-Rich Plasma Therapy in the Management of Meniscus Injuries: A narrative review.Orthopedic reviews · 2024Article
- Modifiable physical and behavioural factors associated with widespread pain in older adults with radiographic evidence of knee osteoarthritis.Musculoskeletal care · 2023Article
- Effectiveness and Safety of Glucosamine in Osteoarthritis: A Systematic Review.Pharmacy (Basel, Switzerland) · 2023Review
- Review
- Uncovering associations between data-driven learned qMRI biomarkers and chronic pain.Scientific reports · 2021Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain scale quantifies knee pain severity with activities of daily living, but the potential impact of pain in other body regions on WOMAC pain scores has not been explored using a causal modeling approach. The purpose of this study was to determine if pain in other areas of the body impact WOMAC pain scores, a phenomenon referred to as "crosstalk."
methodsCross-sectional datasets were built from public use data available from the Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study (MOST). The WOMAC Pain Scale and generic hip, knee, ankle, foot and back pain measures were included. Three nested regression models grounded in causally based classical test theory determined the extent of crosstalk. Improvements in the coefficient of determination across the 3 models were used to determine the presence of crosstalk.
resultsCausal modeling provided evidence of crosstalk in both OAI and MOST datasets. For example, in OAI, multiple statistical models demonstrated significant increases in coefficient of determination values (P < .0001) as additional pain areas were added to the models.
conclusionsCrosstalk appears to be a clinically important source of error in the WOMAC Pain Scale, particularly for patients with a larger number of painful body regions and when contralateral knee joint pain is more severe. IMPACT STATEMENT: This study has important implications for arthritis research. It also should raise clinician awareness of the threat to score interpretation and the need to consider the extent of pain in other body regions when interpreting WOMAC pain scores.
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