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Multi-centre modified Delphi exercise to identify candidate items for classifying early-stage symptomatic knee osteoarthritis

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Title: Multi-centre modified Delphi exercise to identify candidate items for classifying early-stage symptomatic knee osteoarthritis
Authors: King, L. K., Liew, J. W., Mahmoudian, A., Wang, Q., Jansen, N. E.J., Stanaitis, I., Hung, V., Berenbaum, F., Das, S., Ding, C., Emery, C. A., Filbay, S. R., Hochberg, M. C., Ishijima, M., Kloppenburg, M., Lane, N. E., Losina, E., Mobasheri, A., Turkiewicz, A., Runhaar, J., Haugen, I. K., Appleton, C. T., Lohmander, L. S., Englund, M., Neogi, T., Hawker, G. A.
Contributors: Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lund OsteoArthritis Division - Clinical Epidemiology Unit, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Lund OsteoArthritis Division - Clinical Epidemiology Unit, Originator, Lund University, Profile areas and other strong research environments, Lund University Profile areas, LU Profile Area: Proactive Ageing, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Lunds universitets profilområden, LU profilområde: Proaktivt åldrande, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Originator, Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), EpiHealth: Epidemiology for Health, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), EpiHealth: Epidemiology for Health, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lund OsteoArthritis Division - Molecular marker research group, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Lund OsteoArthritis Division - Nedbrytning av ledbrosk: en biologisk process som leder till artros, Originator
Source: Osteoarthritis and Cartilage. 33(1):155-165
Subject Terms: Medical and Health Sciences, Clinical Medicine, Orthopaedics, Medicin och hälsovetenskap, Klinisk medicin, Ortopedi
Description: 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.
Access URL: https://doi.org/10.1016/j.joca.2024.10.016
Database: SwePub
Description
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.
ISSN:10634584
15229653
DOI:10.1016/j.joca.2024.10.016