Multi-centre modified Delphi exercise to identify candidate items for classifying early-stage symptomatic knee osteoarthritis
Osteoarthritis and Cartilage, vol. 33, pp. 155–165
Abstract
OBJECTIVE: To generate a list of candidate items potentially useful for discriminating individuals with Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) from those with other conditions and from established osteoarthritis (OA), and to reduce this list based on expert consensus. DESIGN: We conducted a three-round online international modified Delphi exercise with OA clinicians and researchers ("OA experts"). In Round 1, participants reviewed 84 candidate items and nominated additional item(s) potentially useful for EsSKOA classification; those nominated by ≥3 participants were added. In Round 2, participants rated perceived usefulness of 108 items (1 [not at all useful] to 9 [extremely useful]). In Round 3, participants could revise their ratings after reviewing Round 2 group median and quartiles. Following Round 3, we retained items with a median usefulness score >5 and ≥33.3% of participants categorised the item as useful (7 to 9), overall and in subgroup analysis by clinician field. RESULTS: There were 128 participants in Round 1 and 113 (88%) completed all rounds. We retained 77 items that spanned multiple domains (demographics, symptoms, physical exam, performance-based measures, imaging, laboratory investigations, and gross inspection/arthroscopy). Highly rated items included (median usefulness score): prior knee joint injury (8), diagnosis of OA in a different joint (7), and activity-related knee pain (7). The interquartile range was most often 3. CONCLUSION: We identified 77 items that OA experts consider potentially useful for EsSKOA classification. The results highlight experts' uncertainty around item usefulness. Next, candidate items will be further assessed and reduced using data-driven and multicriteria decision analysis methods.
Authors 25
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L.K. King corresponding
Affiliation as printed
Department of Medicine, University of Toronto, Toronto, Canada. Electronic address: l.king@mail.utoronto.ca
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J.W. Liew corresponding
Affiliation as printed
Boston University Chobanian & Avedisian School of Medicine, Boston, USA. Electronic address: jwliew@bu.edu
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Armaghan Mahmoudian corresponding
Lund University · University of West Florida
Affiliation as printed
Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden; Department of Movement Sciences and Health, University of West Florida, Pensacola, USA. Electronic address: armaghan.mahmoudian@gmail.com
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Qing Wang corresponding
Shanghai Sixth People's Hospital
Affiliation as printed
Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai, China. Electronic address: qiukewang@sina.com
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Nuria E J Jansen corresponding
Affiliation as printed
Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands. Electronic address: n.jansen@erasmusmc.nl
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I. Stanaitis corresponding
Affiliation as printed
Research and Innovation Institute, Women's College Hospital, Toronto, Canada. Electronic address: ian.stanaitis@wchospital.ca
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Françis Berenbaum corresponding
Inserm · Sorbonne Université · Assistance Publique – Hôpitaux de Paris · Hôpital Saint-Antoine
Affiliation as printed
Sorbonne University INSERM, Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France. Electronic address: francis.berenbaum@aphp.fr
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Sandhitsu R. Das corresponding
Era's Lucknow Medical College and Hospital
Affiliation as printed
Department of Rheumatology, Era's University, Lucknow, India. Electronic address: daslko@gmail.com
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Changhai Ding corresponding
University of Tasmania · Zhujiang Hospital · Menzies Institute for Medical Research · Southern Medical University
Affiliation as printed
Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. Electronic address: changhai.ding@utas.edu.au
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Carolyn A. Emery corresponding
Affiliation as printed
Sport Injury Prevention Research Centre, Faculty of Kinesiology and Cumming School of Medicine, University of Calgary, Alberta, Canada. Electronic address: caemery@ucalgary.ca
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Stephanie Rose Filbay corresponding
Affiliation as printed
Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Australia. Electronic address: stephanie.filbay@unimelb.edu.au
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M.C. Hochberg corresponding
University of Maryland, Baltimore
Affiliation as printed
Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA. Electronic address: mhochberg@som.umaryland.edu
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M. Ishijima corresponding
Affiliation as printed
Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo, Japan. Electronic address: ishijima@juntendo.ac.jp
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Rheumatology, Leiden University Medical Center, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, the Netherlands. Electronic address: g.kloppenburg@lumc.nl
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N.E. Lane corresponding
Affiliation as printed
Department of Medicine, UC Davis Health, Sacramento, USA. Electronic address: nelane@ucdavis.edu
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E. Losina corresponding
Brigham and Women's Hospital · Harvard University
Affiliation as printed
Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, USA; Department of Orthopedic Surgery, Harvard Medical School, Boston, USA. Electronic address: elosina@bwh.harvard.edu
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Ali Mobasheri corresponding
University of Liège · State Research Institute Centre for Innovative Medicine · The First Affiliated Hospital, Sun Yat-sen University · University of Oulu
Affiliation as printed
Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania; Department of Joint Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Université de Liège, Liège, Belgium. Electronic address: ali.mobasheri@oulu.fi
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A. Turkiewicz corresponding
Affiliation as printed
Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden. Electronic address: aleksandra.turkiewicz@med.lu.se
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J. Runhaar corresponding
Affiliation as printed
Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands. Electronic address: j.runhaar@erasmusmc.nl
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I.K. Haugen corresponding
Affiliation as printed
Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway. Electronic address: ida.k.haugen@gmail.com
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Christopher Thomas Appleton corresponding
Affiliation as printed
Department of Physiology and Pharmacology Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada; Department of Medicine, The University of Western Ontario, London, Canada; Western Bone and Joint Institute, London, Canada. Electronic address: tom.appleton@sjhc.london.on.ca
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Stefan L. Lohmander corresponding
Affiliation as printed
Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden. Electronic address: stefan.lohmander@med.lu.se
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M. Englund corresponding
Affiliation as printed
Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden. Electronic address: martin.englund@med.lu.se
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Tuhina Neogi corresponding
Affiliation as printed
Boston University Chobanian & Avedisian School of Medicine, Boston, USA. Electronic address: tneogi@bu.edu
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GILLIAN A. HAWKER corresponding
University of Toronto · Women's College Hospital
Affiliation as printed
Department of Medicine, University of Toronto, Toronto, Canada; Research and Innovation Institute, Women's College Hospital, Toronto, Canada. Electronic address: g.hawker@utoronto.ca
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