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Development of radiographic classification criteria for hand osteoarthritis: a methodological report (Phase 2)

Haugen, Ida K; Felson, David; Abhishek, Abhishek; Berenbaum, Francis; James Edwards, John; Herrero Beaumont, Gabriel; Hermann-Eriksen, Merete; Hill, Catherine L; Ishimori, Mariko; Jonsson, Helgi; Karjalainen, Teemu; Ying Leung, Ying; Maheu, Emmanuel; Mallen, Christian D; Helene Moe, Rikke; Ramonda, Roberta; Ritschl, Valentin; Stamm, Tanja A; Szekanecz, Zoltan; van der Giesen, Florus J; Ritt, Marco J P F; Wittoek, Ruth; Kjeken, Ingvild; Osteras, Nina; van de Stadt, Lotte A; Englund, Martin; Dziedzic, Krysia S; Marshall, Michelle; Bierma-Zeinstra, Sita; Hansen, Paul; Greibrokk, Elsie; Smeets, Wilma; Kloppenburg, Margreet

Development of radiographic classification criteria for hand osteoarthritis: a methodological report (Phase 2) Thumbnail


Ida K Haugen

David Felson

Abhishek Abhishek

Francis Berenbaum

John James Edwards

Gabriel Herrero Beaumont

Merete Hermann-Eriksen

Catherine L Hill

Mariko Ishimori

Helgi Jonsson

Teemu Karjalainen

Ying Ying Leung

Emmanuel Maheu

Rikke Helene Moe

Roberta Ramonda

Valentin Ritschl

Tanja A Stamm

Zoltan Szekanecz

Florus J van der Giesen

Marco J P F Ritt

Ruth Wittoek

Ingvild Kjeken

Nina Osteras

Lotte A van de Stadt

Martin Englund

Sita Bierma-Zeinstra

Paul Hansen

Elsie Greibrokk

Wilma Smeets

Margreet Kloppenburg


Objectives In Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features associated with hand OA were identified in a population with hand complaints. Radiographic findings could better discriminate patients with hand OA and controls than clinical examination findings. The objective of Phase 2 was to achieve consensus on the features and their weights to be included in three radiographic criteria sets of overall hand OA, interphalangeal OA and thumb base OA. Methods Multidisciplinary, international expert panels were convened. Patient vignettes were used to identify important features consistent with hand OA. A consensus-based decision analysis approach implemented using 1000minds software was applied to identify the most important features and their relative importance influencing the likelihood of symptoms being due to hand OA. Analyses were repeated for interphalangeal and thumb base OA. The reliability and validity of the proposed criteria sets were tested. Results The experts agreed that the criteria sets should be applied in a population with pain, aching or stiffness in hand joint(s) not explained by another disease or acute injury. In this setting, five additional criteria were considered important: age, morning stiffness, radiographic osteophytes, radiographic joint space narrowing and concordance between symptoms and radiographic findings. The reliability and validity were very good. Conclusion Radiographic features were considered critical when determining whether a patient had symptoms due to hand OA. The consensus-based decision analysis approach in Phase 2 complemented the data-driven results from Phase 1, which will form the basis of the final classification criteria sets.

Journal Article Type Article
Acceptance Date Jan 5, 2022
Publication Date Feb 4, 2022
Journal RMD Open
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 8
Issue 1
Pages e002024 - e002024
Keywords osteoarthritis; outcome assessment; health care; epidemiology
Publisher URL
PMID 35121640


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