Machine-learning predicted and actual 2-year structural progression in the IMI-APPROACH cohort
Quantitative Imaging in Medicine and Surgery, vol. 13, pp. 3298–3306
Abstract
In the Innovative Medicine's Initiative Applied Public-Private Research enabling OsteoArthritis Clinical Headway (IMI-APPROACH) knee osteoarthritis (OA) study, machine learning models were trained to predict the probability of structural progression (s-score), predefined as >0.3 mm/year joint space width (JSW) decrease and used as inclusion criterion. The current objective was to evaluate predicted and observed structural progression over 2 years according to different radiographic and magnetic resonance imaging (MRI)-based structural parameters. Radiographs and MRI scans were acquired at baseline and 2-year follow-up. Radiographic (JSW, subchondral bone density, osteophytes), MRI quantitative (cartilage thickness), and MRI semiquantitative [SQ; cartilage damage, bone marrow lesions (BMLs), osteophytes] measurements were obtained. The number of progressors was calculated based on a change exceeding the smallest detectable change (SDC) for quantitative measures or a full SQ-score increase in any feature. Prediction of structural progression based on baseline s-scores and Kellgren-Lawrence (KL) grades was analyzed using logistic regression. Among 237 participants, around 1 in 6 participants was a structural progressor based on the predefined JSW-threshold. The highest progression rate was seen for radiographic bone density (39%), MRI cartilage thickness (38%), and radiographic osteophyte size (35%). Baseline s-scores could only predict JSW progression parameters (most P>0.05), while KL grades could predict progression of most MRI-based and radiographic parameters (P<0.05). In conclusion, between 1/6 and 1/3 of participants showed structural progression during 2-year follow-up. KL scores were observed to outperform the machine-learning-based s-scores as progression predictor. The large amount of data collected, and the wide range of disease stage, can be used for further development of more sensitive and successful (whole joint) prediction models. Trial Registration: Clinicaltrials.gov number NCT03883568.
Authors 15
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University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands;
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Paracelsus Medical University · Chondrometrics (Germany)
Affiliation as printed
Chondrometrics GmbH, Freilassing, Germany
Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
Ludwig Boltzmann Inst. for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
Chondrometrics GmbH, Freilassing, Germany;
Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria;
Ludwig Boltzmann Inst. for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria;
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Affiliation as printed
School of Computing, Newcastle University, Newcastle, UK
School of Computing, Newcastle University, Newcastle, UK;
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University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands;
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University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands;
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M. Kloppenburg Aachen Clinical Epidemiology Department of Rheumatology, Leiden University Medical Center
Leiden University Medical Center
Affiliation as printed
Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands;
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands;
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Universidade da Coruña · Servicio Gallego de Salud · Instituto de Investigación Biomédica de A Coruña
Affiliation as printed
Grupo de Investigación de Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario de A Coruña, SERGAS, Centro de Investigación CICA, Departamento de Fisioterapia y Medicina, Universidad de A Coruña, A Coruña, SpainServicio de Reumatologia, INIBIC-Universidade de A Coruña, A Coruña, Spain
Grupo de Investigación de Reumatología (GIR), INIBIC-Complejo Hospitalario Universitario de A Coruña, SERGAS, Centro de Investigación CICA, Departamento de Fisioterapia y Medicina, Universidad de A Coruña, A Coruña, SpainServicio de Reumatologia,
INIBIC-Universidade de A Coruña, A Coruña, Spain;
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Affiliation as printed
Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway;
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Inserm · Sorbonne Université · Assistance Publique – Hôpitaux de Paris · Hôpital Saint-Antoine
Affiliation as printed
Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France
INSERM, Sorbonne University, Paris, France
Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France;
INSERM, Sorbonne University, Paris, France;
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Affiliation as printed
Independent Consultant, Darmstadt, Germany
Independent Consultant, Darmstadt, Germany;
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Marieke Loef Aachen Clinical Epidemiology Department of Rheumatology, Leiden University Medical Center
Leiden University Medical Center
Affiliation as printed
Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands;
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands;
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University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands;
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University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands;
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University Medical Center Utrecht
Affiliation as printed
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands;
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Boston University · Friedrich-Alexander-Universität Erlangen-Nürnberg · Universitätsklinikum Erlangen
Affiliation as printed
Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA;
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