Risk scoring for time to end-stage knee osteoarthritis: data from the Osteoarthritis Initiative.
End-stage knee osteoarthritis
Knee osteoarthritis
Predictive modeling
Risk score
Journal
Osteoarthritis and cartilage
ISSN: 1522-9653
Titre abrégé: Osteoarthritis Cartilage
Pays: England
ID NLM: 9305697
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
24
03
2019
revised:
06
11
2019
accepted:
01
01
2020
pubmed:
18
5
2020
medline:
27
7
2021
entrez:
17
5
2020
Statut:
ppublish
Résumé
This study constructs a risk score for patients' progression to end-stage knee osteoarthritis (OA) within 4 years. The Osteoarthritis Initiative (OAI) was a longitudinal study of the onset and progression of knee OA. Using a recent definition of end-stage knee OA, we implement interval-censored survival forests to select predictors of this endpoint. We fit an interval-censored Cox model for time to end-stage knee OA, using the selected predictors. The risk score is the Cox model's fitted linear combination of the nine selected baseline structural and symptomatic knee OA variables. We fit our models on a training set of 2,701 patients, and we evaluate on an independent test set of 1,436 patients. On the test sample, we observe a concordance index of 0.86 between risk score and time to end-stage, AUC of 0.87 for predicting end-stage within 24, 36, and 48 months, and positive predictive values that increase with the risk score. This risk stratification algorithm could enrich clinical trial patient enrollment. By enrolling test sample patients with scores above a threshold, a trial could have included 91% of test set patients who reach end-stage within 4 years while only enrolling 45% of the test sample. Using statistical methods, we construct and validate an interpretable risk score for time to end-stage knee OA. This score can help disease-modifying OA treatment developers to select candidates with the highest risk of fast-progressing knee OA.
Identifiants
pubmed: 32416218
pii: S1063-4584(20)30998-5
doi: 10.1016/j.joca.2019.12.013
pmc: PMC7575033
mid: NIHMS1633009
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1020-1029Subventions
Organisme : NHLBI NIH HHS
ID : N01AR22258
Pays : United States
Organisme : NIAMS NIH HHS
ID : N01AR22260
Pays : United States
Organisme : NIAMS NIH HHS
ID : N01AR22262
Pays : United States
Organisme : NIAMS NIH HHS
ID : N01AR22261
Pays : United States
Organisme : NIAMS NIH HHS
ID : N01AR22259
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020. Published by Elsevier Ltd.
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