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Developing prediction models for total knee replacement surgery in patients with osteoarthritis: Statistical analysis
Sharmala Thuraisingam1, Michelle Dowsey1, Jo-Anne Manski-Nankervis2
1Department of Surgery, University of Melbourne, 29 Regent Street, Fitzroy, Victoria 3065, Australia.
Osteoarthritis and Cartilage Open
|December 7, 2022
Summary
Developing prediction tools can identify osteoarthritis patients unlikely to benefit from total knee replacement (TKR). This allows for optimized first-line treatments to delay surgery and reserve TKR for suitable candidates.
Area of Science:
- Orthopedics and Sports Medicine
- Biostatistics and Health Informatics
Background:
- 12-20% of osteoarthritis patients in Australia report no improvement after total knee replacement (TKR).
- A need exists for prediction tools to identify TKR non-responders in general practice.
- Early identification enables optimized first-line treatments to delay or prevent TKR.
Purpose of the Study:
- To detail statistical methods for developing and validating TKR prediction models.
- To create tools for general practitioners to identify TKR candidates and non-responders.
- To support personalized treatment strategies for osteoarthritis management.
Main Methods:
- Statistical analysis plan (SAP) pre-specified prior to data analysis.
- Detailed methodology for predictor selection, model development, and performance measurement.
- Internal model validation procedures outlined.
Main Results:
- This study outlines the statistical methodology for developing prediction models.
- The SAP details data sources, sample size estimations, and planned analyses.
- Methodologies for candidate predictor selection and model validation are described.
Conclusions:
- Pre-specified statistical methods ensure robust development of TKR prediction tools.
- Validated prediction models can improve patient selection for total knee replacement.
- This approach supports evidence-based decision-making in osteoarthritis management.
Keywords:
ABS, Australian Bureau of StatisticsAIHW, Australian Institute of Health and WelfareAOANJRR, Australian Orthopaedic Association National Joint Replacement RegistryATC, Anatomical Therapeutic ChemicalBMI, Body Mass IndexCPT, clinical prediction toolClinical prediction toolsDQA, data quality assessmentEMR, electronic medical recordElectronic health recordElectronic medical recordGP, General PractitionerGeneral practiceKOS-ADLS, Knee Outcome Survey-Activities of Daily Living SubscaleKnee replacementNDI, National Death IndexNPS, National Prescribing ServiceOA, osteoarthritisOARSI, Osteoarthritis Research Society InternationalOMERACT, Outcome Measures in RheumatologyPrediction modelsPrimary careSAP, statistical analysis planSF-12, 12-Item Short Form SurveySF-36, 36-Item Short Form Health SurveyStatistical analysis planTKR, total knee replacement
