Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012:2012:136245.
doi: 10.1155/2012/136245. Epub 2012 Jun 26.

A hierarchy of patient-reported outcomes for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals

Carsten Juhl  1 , Hans Lund, Ewa M Roos, Weiya Zhang, Robin Christensen
Affiliations

A hierarchy of patient-reported outcomes for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals

Carsten Juhl et al. Arthritis. 2012.

Abstract

Objectives. To develop a prioritised list based on responsiveness for extracting patient-reported outcomes (PROs) measuring pain and disability for performing meta-analyses in knee osteoarthritis (OA). Methods. A systematic search was conducted in 20 highest impact factor general and rheumatology journals chosen a priori. Eligible studies were randomised controlled trials, using two or more PROs measuring pain and/or disability. Results. A literature search identified 402 publications and 38 trials were included, resulting in 54 randomised comparisons. Thirty-five trials had sufficient data on pain and 15 trials on disability. The WOMAC "pain" and "function" subscales were the most responsive composite scores. The following list was developed. Pain: (1) WOMAC "pain" subscale, (2) pain during activity (VAS), (3) pain during walking (VAS), (4) general knee pain (VAS), (5) pain at rest (VAS), (6) other composite pain scales, and (7) other single item measures. Disability: (1) WOMAC "function" subscale, (2) SF-36 "physical function" subscale, (3) SF-36 (Physical composite score), and (4) Other composite disability scores. Conclusions. As choosing the PRO most favourable for the intervention from individual trials can lead to biased estimates, using a prioritised list as developed in this study is recommended to reduce risk of biased selection of PROs in meta-analyses.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart: identification of studies.
Figure 2
Figure 2
Impact on different approaches to extracting data for meta-analysis.
See this image and copyright information in PMC

References

    1. Dougados M. Monitoring osteoarthritis progression and therapy. Osteoarthritis and Cartilage. 2004;12:S55–S60. - PubMed
    1. McAlindon TE, La Valley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. Journal of the American Medical Association. 2000;283(11):1469–1475. - PubMed
    1. Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews. 2008;(4) Article ID CD004376. - PubMed
    1. Hutton JL, Williamson PR. Bias in meta-analysis due to outcome variable selection within studies. Journal of the Royal Statistical Society C. 2000;49(3):359–370.
    1. Kirkham JJ, Altman DG, Williamson PR. Bias due to changes in specified outcomes during the systematic review process. PloS ONE. 2010;5(3) Article ID e9810. - PMC - PubMed