PMID- 11886962
OWN - NLM
STAT- MEDLINE
DCOM- 20020418
LR  - 20191210
IS  - 1462-0324 (Print)
IS  - 1462-0324 (Linking)
VI  - 41
IP  - 2
DP  - 2002 Feb
TI  - Relevant change in radiological progression in patients with hip osteoarthritis. 
      II. Determination using an expert opinion approach.
PG  - 148-52
AB  - AIM: To determine the minimum clinically important difference (MCID) in joint 
      space width (JSW) progression in patients with hip osteoarthritis (OA), based 
      upon evaluation by a panel of clinical experts as a gold standard. METHODS: A 
      sample of 298 patients with hip OA was selected from a multicentre, prospective, 
      longitudinal, 3-yr follow-up study. A pelvic radiograph was obtained at entry and 
      after 3 yr. For each film, the narrowest JSW was measured using a 0.1-mm 
      graduated magnifying glass. The difference between baseline and 3-yr follow-up 
      JSW was calculated. Two senior rheumatologists, who were experts in 
      osteoarthritis, evaluated each pair of films and noted whether a clinically 
      relevant deterioration in osteoarthritis stage occurred at 3 yr compared with 
      baseline. Interobserver reliabilities were evaluated using the kappa coefficient 
      and proportions of agreements. Then, for each measured difference in JSW (0.1 mm 
      per 0.1 mm), the sensitivity and specificity for MCID, defined as the assessment 
      of expert 1, expert 2 or a combination of both, were calculated. This allowed us 
      to obtain, from graphic representations of the correct classification 
      probabilities, the best measured JSW threshold, with the maximal true positive 
      and the minimal false positive results. RESULTS: The mean measured change in JSW 
      was -0.63 +/- 0.74 mm. Experts 1 and 2 considered the decrease in JSW to be 
      clinically relevant in 122 (40.9%) and 100 pairs (33.6%) respectively. The 
      proportion of agreements between the experts was 79.9%, with a kappa coefficient 
      of 0.572. The best measured JSW threshold was -0.4 mm for expert 1, expert 2 and 
      the combination of both; sensitivity and specificity were 0.75 and 0.8, 0.71 and 
      0.72, and 0.75 and 0.7 respectively. CONCLUSION: This study suggests that a 
      change of at least 0.4 mm in the radiological JSW could be considered clinically 
      relevant. Other studies using other sets of patients and other methods are needed 
      for validation.
FAU - Maillefert, J F
AU  - Maillefert JF
AD  - Rene Descartes University, Cochin Hospital, Institut de Rhumatologie, Paris, 
      France.
FAU - Nguyen, M
AU  - Nguyen M
FAU - Gueguen, A
AU  - Gueguen A
FAU - Berdah, L
AU  - Berdah L
FAU - Lequesne, M
AU  - Lequesne M
FAU - Mazieres, B
AU  - Mazieres B
FAU - Vignon, E
AU  - Vignon E
FAU - Dougados, M
AU  - Dougados M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Rheumatology (Oxford)
JT  - Rheumatology (Oxford, England)
JID - 100883501
SB  - IM
MH  - Aged
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Osteoarthritis, Hip/*diagnostic imaging
MH  - Outcome Assessment, Health Care
MH  - Prospective Studies
MH  - Radiography
MH  - Random Allocation
MH  - Rheumatology/*statistics & numerical data
MH  - Sensitivity and Specificity
EDAT- 2002/03/12 10:00
MHDA- 2002/04/19 10:01
CRDT- 2002/03/12 10:00
PHST- 2002/03/12 10:00 [pubmed]
PHST- 2002/04/19 10:01 [medline]
PHST- 2002/03/12 10:00 [entrez]
AID - 10.1093/rheumatology/41.2.148 [doi]
PST - ppublish
SO  - Rheumatology (Oxford). 2002 Feb;41(2):148-52. doi: 10.1093/rheumatology/41.2.148.