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Screening for pain in knee osteoarthritis: which question?
S C O'Reilly1, K R Muir, M Doherty
1Rheumatology Unit, City Hospital, Nottingham, United Kingdom.
Annals of the Rheumatic Diseases
|December 1, 1996
Summary
Question wording significantly impacts knee pain prevalence and disability estimates. The American College of Rheumatology (ACR) criteria question better predicts disability but is less sensitive for community screening.
Area of Science:
- Epidemiology
- Rheumatology
- Public Health
Background:
- Knee pain is a common condition affecting individuals aged 40-79.
- Accurate assessment of knee pain prevalence and its impact on disability is crucial for public health initiatives.
- Different questioning methods may yield varying estimates of knee pain and associated outcomes.
Purpose of the Study:
- To compare the prevalence of knee pain and its association with disability and structural changes using three distinct survey questions.
- To evaluate the sensitivity and specificity of each question for identifying knee osteoarthritis (OA).
Main Methods:
- A postal survey was administered to 4057 men and women aged 40-79 years.
- Three different questions were used to define knee pain, including the American College of Rheumatology (ACR) criteria.
- Disability was assessed using the SF-36 questionnaire, and knee radiographs were analyzed for osteophyte grading in a subset of participants.
Main Results:
- Knee pain prevalence varied by question, ranging from 19.3% to 28.3%.
- The ACR criteria question identified the highest rates of disability (71.3%).
- Question C (ACR criteria) was most specific (72.7%) but least sensitive (45.4%) for detecting knee OA (grade ≥1 osteophyte).
Conclusions:
- Minor variations in survey question wording significantly influence knee pain and disability estimates.
- The ACR criteria question may be a more effective predictor of disability but has limitations for broad community screening due to lower sensitivity.