Association between Several Clinical and Radiological Determinants with Long-Term Clinical Progression and Good Prognosis of Lower Limb Osteoarthritis

OBJECTIVE: To investigate the factors associated with clinical progression and good prognosis in patients with lower limb osteoarthritis (OA). METHODS: Cohort study of 145 patients with OA in either knee, hip or both. Progression was defined as 1) new joint prosthesis or 2) increase in WOMAC pain or function score during 6-years follow-up above pre-defined thresholds. Patients without progression with decrease in WOMAC pain or function score lower than pre-defined thresholds were categorized as good prognosis. Relative risks (RRs) for progression and good prognosis with 95% confidence interval (95% CI) were calculated by comparing the highest tertile or category to the lowest tertile, for baseline determinants (age, sex, BMI, WOMAC pain and function scores, pain on physical examination, total range of motion (tROM), osteophytes and joint space narrowing (JSN) scores), and for worsening in WOMAC pain and function score in 1-year. Adjustments were performed for age, sex, and BMI. RESULTS: Follow-up was completed by 117 patients (81%, median age 60 years, 84% female); 62 (53%) and 31 patients (26%) showed progression and good prognosis, respectively. These following determinants were associated with progression: pain on physical examination (RR 1.2 (1.0 to 1.5)); tROM (1.4 (1.1 to 1.6); worsening in WOMAC pain (1.9 (1.2 to 2.3)); worsening in WOMAC function (2.4 (1.7 to 2.6)); osteophytes 1.5 (1.0 to 1.8); and JSN scores (2.3 (1.5 to 2.7)). Worsening in WOMAC pain (0.1 (0.1 to 0.8)) and function score (0.1 (0.1 to 0.7)), were negatively associated with good prognosis. CONCLUSION: Worsening of self-reported pain and function in one year, limited tROM and higher osteophytes and JSN scores were associated with clinical progression. Worsening in WOMAC pain and function score in 1- year were associated with lower risk to have good prognosis. These findings help to inform patients with regard to their OA prognosis

NeuroBridge: a prototype platform for discovery of the long-tail neuroimaging data

Introduction Open science initiatives have enabled sharing of large amounts of already collected data. However, significant gaps remain regarding how to find appropriate data, including underutilized data that exist in the long tail of science. We demonstrate the NeuroBridge prototype and its ability to search PubMed Central full-text papers for information relevant to neuroimaging data collected from schizophrenia and addiction studies. Methods The NeuroBridge architecture contained the following components: (1) Extensible ontology for modeling study metadata: subject population, imaging techniques, and relevant behavioral, cognitive, or clinical data. Details are described in the companion paper in this special issue; (2) A natural-language based document processor that leveraged pre-trained deep-learning models on a small-sample document corpus to establish efficient representations for each article as a collection of machine-recognized ontological terms; (3) Integrated search using ontology-driven similarity to query PubMed Central and NeuroQuery, which provides fMRI activation maps along with PubMed source articles. Results The NeuroBridge prototype contains a corpus of 356 papers from 2018 to 2021 describing schizophrenia and addiction neuroimaging studies, of which 186 were annotated with the NeuroBridge ontology. The search portal on the NeuroBridge website https://neurobridges.org/ provides an interactive Query Builder, where the user builds queries by selecting NeuroBridge ontology terms to preserve the ontology tree structure. For each return entry, links to the PubMed abstract as well as to the PMC full-text article, if available, are presented. For each of the returned articles, we provide a list of clinical assessments described in the Section “Methods” of the article. Articles returned from NeuroQuery based on the same search are also presented. Conclusion The NeuroBridge prototype combines ontology-based search with natural-language text-mining approaches to demonstrate that papers relevant to a user’s research question can be identified. The NeuroBridge prototype takes a first step toward identifying potential neuroimaging data described in full-text papers. Toward the overall goal of discovering “enough data of the right kind,” ongoing work includes validating the document processor with a larger corpus, extending the ontology to include detailed imaging data, and extracting information regarding data availability from the returned publications and incorporating XNAT-based neuroimaging databases to enhance data accessibility

Determinants for clinical progression over 6 years of lower limb osteoarthritis.

<p>^<i>1</i>except for determinants age, sex and BMI themselves, adjustment was made for age, sex and BMI.</p><p>^<i>2</i>multivariate model using a backward selection (R² = 48.6%). The independent variables with univariate associations with a p-value ≤0.10 were included.</p><p>Both models are calculated using approximation formula of Zhang.<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0025426#pone.0025426-Zhang1" target="_blank">[19]</a>.</p>‡<p>: statistically significant.</p><p>Abbreviations: WOMAC: Western Ontario and McMaster Universities, JSN: joint space narrowing, na: not applicable.</p

Determinants of good prognosis of lower limb osteoarthritis over 6 years.

1<p>except for determinants age, sex and BMI themselves, adjustment was made for age, sex and BMI.</p>2<p>multivariate model using a backward selection (R² = 43.3%). The independent variables with univariate associations with a p-value ≤0.10 were included.</p><p>Both models are calculated using approximation formula of Zhang.<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0025426#pone.0025426-Zhang1" target="_blank">[19]</a>.</p>‡<p>: statistically significant.</p><p>Abbreviations: WOMAC: Western Ontario and McMaster Universities, JSN: joint space narrowing, na: not applicable.</p

Mean (standard deviation (SD)) baseline, follow-up (FU), and change scores on self-reported pain and function (WOMAC), physical health (PCS), and pain on physical examination (PE) for the total population and sub-groups.

‡<p>: statistically significant; the significance of physical health summary were tested by comparing the study sample with the norm based population (mean = 50, SD = 10).</p

Cumulative probability plot of Western Ontario and McMaster Universities (WOMAC) scores change of patients without prosthesis during follow-up (n = 81) for WOMAC pain scores change (above) and WOMAC function scores change (below).

<p>The horizontal line above is the line set at minimal perceptible clinical improvement (MPCI) score which is used as the cut-off to define progression and the horizontal line below is the line set to define good prognosis.</p

Baseline characteristics of 168 patients with knee and/or hip OA stratified by availability of follow-up.

<p>*Patients may have OA at multiple joints at one time and can have pain in the knee and hip joint simultaneously. Abbreviation: IQR: interquartile range; BMI: Body Mass Index.</p