B. Mazières - Academia.edu (original) (raw)
Papers by B. Mazières
Revue du Rhumatisme, 2006
Revue du Rhumatisme, 2001
A task force for the EULAR standing committee for Clinical Trials determined the methodological a... more A task force for the EULAR standing committee for Clinical Trials determined the methodological and logistical approach required for the development of evidence based guidelines for treatment of knee OA. Methods. The first stage was the selection of treatment modalities to be considered. The second stage comprised a search of the databases of all European language publications. All of the relevant studies were quality scored. The third stage involved determination of key clinical propositions by expert consensus employing a Delphi approach. The final stage involved ranking of these propositions according to the available evidence. A second set of propositions relating to a future research agenda was determined by expert consensus. Results. 744 studies presented outcome data of the effects of specific treatments on knee OA. Quantitative analysis of treatment effect was possible in only 61 studies. Recommendations for the management of knee OA based on currently available data and expert opinion are presented. Proposals for a future research agenda are highlighted. Conclusions. These are the first clinical guidelines on knee OA to combine an evidence-based approach and a consensus approach across a wide range of treatment modalities. It is apparent that only certain clinical propositions are supported by substantial research– based evidence. There is thus an urgent need for future well designed trials to address key clinical questions.
Osteoarthritis and Cartilage, 2008
Revue du Rhumatisme, 2007
Revue du Rhumatisme, 2006
Introduction. -Les patients atteints de spondylarthropathie (SpA) sont à risque de développer une... more Introduction. -Les patients atteints de spondylarthropathie (SpA) sont à risque de développer une ostéoporose, expliquée par l'activité inflammatoire de la maladie et l'immobilisation. Des études préliminaires conduites dans des petits effectifs et sur une courte durée (inférieure ou égale à un an), ont montré le bénéfice des anti-TNF alpha sur la densité osseuse chez les patients atteints de SpA, et une augmentation du poids.
Arthritis research & therapy, 2005
Joint space width (JSW) and narrowing (JSN) measurements on radiographs are currently the best wa... more Joint space width (JSW) and narrowing (JSN) measurements on radiographs are currently the best way to assess disease severity or progression in hip osteoarthritis, yet we lack data regarding the most accurate and sensitive measurement technique. This study was conducted to determine the optimal radiograph and number of readers for measuring JSW and JSN. Fifty pairs of radiographs taken three years apart were obtained from patients included in a structure modification trial in hip osteoarthritis. Three radiographs were taken with the patient standing: pelvis, target hip anteroposterior (AP) and oblique views. Two trained readers, blinded to each other's findings, time sequence and treatment, each read the six radiographs gathered for each patient twice (time interval > or = 15 days), using a 0.1 mm graduated magnifying glass. Radiographs were randomly coded for each reading. The interobserver and intraobserver cross-sectional (M0 and M36) and longitudinal (M0-M36) reproducibil...
The Journal of Rheumatology
To assess if total hip arthroplasty (THA) is a valid outcome measure of hip osteoarthritis (OA), ... more To assess if total hip arthroplasty (THA) is a valid outcome measure of hip osteoarthritis (OA), in respect to clinical and radiological assessments. A prospective 3 year study of patients who had painful hip OA with an initial radiographic joint space width > or =1 mm at the narrowest point. Dependent variable was THA. Patient data including body mass index, OA structural severity by radiograph, OA symptomatic severity (pain, function), and OA localization were recorded at entry. Pelvic radiographs were obtained before THA, when available, and once yearly during the study. During the study 106 of 506 patients underwent THA. Risk was estimated (Kaplan-Meier method) to be 8+/-1, 16+/-2, and 23+/-2% after 1, 2, and 3 years, respectively. Factors predisposing to requirement for surgery were: age > or =70 years, female sex, superolateral migration of the femoral head, joint space width <2 mm, Kellgren-Lawrence grade > or =3, pain (visual analog scale) > or =50 mm, and Lequesne index > or =10 with a relative risk of 1.65, 1.71, 1.96, 1.85, 1.89, 1.86, and 2.59, respectively. Mean change in joint space width was 0.22+/-0.50 vs 0.97+/-1.35 mm/year in patients without and with THA, respectively (p<0.0001). Changes in radiological joint space width during the first year were highly predictive of requirement for THA during the 2 following years (risk of 5, 13, 25, and 79% in patients with a radiological joint space width worsening during the first year of 0, < or =25, >25 and < or =50, and >50%, respectively). These data suggest that THA could be considered as a valid outcome measure in OA. However, further studies should be conducted in other countries with different health care systems to evaluate the inter-country reliability of this measurement.
Revue du rhumatisme (English ed.)
To evaluate potential radiographic predictors of hip osteoarthritis progression. A prospective, l... more To evaluate potential radiographic predictors of hip osteoarthritis progression. A prospective, longitudinal two-year study was conducted in patients meeting American College of Rheumatology criteria for hip osteoarthritis. Hip osteoarthritis progression was defined as a greater than 0.5-mm decrease in joint space width measured using a magnifying glass marked at intervals of 0.1 mm, at the site of maximum joint space narrowing, by a single investigator who was blinded to the chronological order of the radiographs. Radiographic parameters determined at study entry were as follows: presence of osteophytes, osteosclerosis, and subchondral cysts; femoral head migration (superolateral, superomedial, concentric); and severity (joint space width in mm, Kellgren and Lawrence grade, subjective evaluation of joint space narrowing). In the 463 study patients, joint space width decreased from 2.2 +/- 0.8 at baseline to 1.7 +/- 1.0 mm after two years (P < 0.0001). Radiographic progression wa...
Revue du Rhumatisme, 2009
Prévalence et évaluation de l'impact du psoriasis sur l'évolution naturelle de la coxarthrose. Ré... more Prévalence et évaluation de l'impact du psoriasis sur l'évolution naturelle de la coxarthrose. Résultats d'un suivi sur dix ans de 507 patients (étude Echodiah) ଝ Self-reported prevalence of psoriasis and evaluation of the impact on the natural history of hip osteoarthritis. Results of a 10 years follow-up study of 507 patients (Echodiah study) Accepté le 10 octobre 2008 Disponible sur Internet le 21 juin 2009
Revue du Rhumatisme, 2007
Revue du Rhumatisme, 2006
charge. Elle consulte, 15 jours avant son hospitalisation, pour un syndrome hémorragique fait d'é... more charge. Elle consulte, 15 jours avant son hospitalisation, pour un syndrome hémorragique fait d'épistaxis et d'hématurie associé à une dyspnée stade II de la NYHA, évoluant dans un contexte d'amaigrissement important. L'examen à l'admission trouve une patiente altérée avec une pâleur cutanéo-muqueuse, des déformations typiques d'une PR évoluée, une splénomégalie à 4 travers de doigts, des adénopathies latéro-cervicales et sous maxillaires, une hypertrophie thyroïdienne, une baisse de l'acuité visuelle avec une choriorétinite bilatérale et un kératome bilatéral. A la biologie, on note un syndrome inflammatoire important, une pancytopénie arégénérative profonde. Le facteurs rhumatoïde ainsi que les anticorps antinucléaires sont fortement positifs. Aux radiographies standard, on note un épanchement sissurale droit, une déminéralisation osseuse des mains avec des déformations typiques. L'échographie abdominale trouve une splénomégalie homogène, le tronc porte étant libre. L'échographie cervicale confirme l'hypertrophie thyroïdienne avec des adénopathies intra et extraparenchymenteuses. La patiente a été mise sous traitement symptomatique pour la douleur et sous traitement de fond à base de méthotrexate et d'APS. L'évolution en intra-hospitalier a été marquée par une amélioration de la symptomatologie douloureuse et de l'état clinique.
Rheumatology, 2002
To determine the minimum clinically important difference (MCID) in joint space width (JSW) progre... more 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.
The Journal of Rheumatology
We propose a composite index for considering total hip arthroplasty (THA) in hip osteoarthritis (... more We propose a composite index for considering total hip arthroplasty (THA) in hip osteoarthritis (OA). We carried out a 3 year longitudinal study of patients with painful hip OA from 137 centers. Clinical data were collected at baseline and every 3 months; radiographs were taken at entry and each year. The decision to have surgery was made by the patient, the rheumatologist, and the surgeon, with no reference to outcome measures. Statistical analysis included discrete Cox analysis with time dependent covariates, on 3 month interval grouped data. The dependent variable was THA during the 3 months following the evaluated visit. Time dependent covariates collated at each evaluated visit included radiological joint space width (JSW), percentage decrease in JSW during the year preceding, patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s global assessment. Lequesne index, pain, and nonsteroidal antiinflammatory drug and analgesic intake. We compared 2 analyses differing in symptomatic variables entered: values obtained at a single time point vs mean values between 2 visits at a 3 month interval. Selection of the index was based on the best combination of variables to predict occurrence of THA. Of the 508 patients recruited for study, 42 were excluded. During the 3 year followup, 75 patients underwent THA. Symptomatic, therapeutic, and radiological variables were included in the index resulting from the 2 analyses. Based on the selected cutoff, the positive and negative predictive values for occurrence of THA in the 2 years following were 54.3 and 90.6%, respectively (single point model), and 52.9 and 86.7%, respectively (model using mean values of symptomatic variables between 2 visits). The poor positive predictive value of the composite indices obtained in this study suggests that there are other unmeasured factors determining access to surgery. On the other hand, the high negative predictive values suggest that these composite measures should be used by clinicians to determine which patients should not be referred to THA.
The Journal of rheumatology, 2005
To investigate the associations of molecular markers of joint tissue turnover with clinical and r... more To investigate the associations of molecular markers of joint tissue turnover with clinical and radiological variables in patients with hip osteoarthritis (OA). Patients of the ECHODIAH trial cohort (60% female; mean age 63 yrs, disease duration 5 yrs) fulfilling the American College of Rheumatology criteria for hip OA were studied. Pain was assessed using a 100 mm visual analog scale, and the presence of night pain and morning stiffness was observed as the index of joint inflammation. Joint space width (JSW) and subchondral bone sclerosis were assessed on hip radiographs. Ten markers were measured, 8 in serum: N-propeptides of collagen type I (PINP) and type III (PIIINP), cartilage oligomeric matrix protein (COMP), YKL-40, hyaluronan (HA), matrix metalloproteases (MMP1 and MMP3), and ultrasensitive C-reactive protein (CRP); and 2 in urine: C-terminal crosslinking telopeptides of collagen type I (CTX-I) and type II (CTX-II). Analyses of 376 patients with measurements of all the mark...
Osteoarthritis and Cartilage, 2001
Objective: To determine the most relevant method of measurement of the radiographic hip joint spa... more Objective: To determine the most relevant method of measurement of the radiographic hip joint space width (JSW).
Osteoarthritis and Cartilage, 2010
Osteoarthritis and Cartilage, 2010
Purpose: KL radiographic scale is the most widely used tool altogether to define HOA, assess HOA ... more Purpose: KL radiographic scale is the most widely used tool altogether to define HOA, assess HOA severity and eventually follow-up the radiographic progression. Although widely used for case-definition, its interobserver reliability is usually low in HOA. Objective: To study the impact of a new KL Scoring System Aid (KLSSA) on the reliability of KL scoring. Methods: 20 postero-anterior radiographs of both hands of HOA patients (covering HOA radiographic spectrum of the disease) obtained at random from a clinical trial were initially scored twice by 10 experienced readers at a 15-days interval. Readers were instructed to score the KL method (grades from 0 -4), using the score as detailed by Kallman [1], and their own view of the definition of KL grades. No preliminary training session was organised. During the 1 st session they also scored joint space narrowing (JSN) and osteophytes (0) (0-4). The Distal (DIP), proximal interphalangeal (PIP), metacarpophalangeal (MCP), scaphotrapezial and trapeziometacarpal joints (16 joints) of one hand selected at random (right or left) were scored. 8 out of the 10 readers (the 2 designers of the KLSSA were excluded) were then randomized in 2 groups of 4 to score again twice the 20 radiographs using or not the KLSSA, the group of 4 readers without the KLSSA serving as control group to assess the training effect. The KLSSA combines various amounts of JSN (0-4) and Ost (0-4) for defining KL grades. It is presented as a and was accompanied by hand images to illustrate the grading. Radiographs were numbered at random from 1 to 20 for each of the 4 reading sessions. At each session, only one hand was scored. Statistics: Intra-class correlation coefficient with 95% confidence interval (CI) for inter-and intraobserver precision; Bland-Altman graphical method for intraobserver precision. Results: For interobserver reproducibility appear in the table.
Revue du Rhumatisme, 2006
Revue du Rhumatisme, 2001
A task force for the EULAR standing committee for Clinical Trials determined the methodological a... more A task force for the EULAR standing committee for Clinical Trials determined the methodological and logistical approach required for the development of evidence based guidelines for treatment of knee OA. Methods. The first stage was the selection of treatment modalities to be considered. The second stage comprised a search of the databases of all European language publications. All of the relevant studies were quality scored. The third stage involved determination of key clinical propositions by expert consensus employing a Delphi approach. The final stage involved ranking of these propositions according to the available evidence. A second set of propositions relating to a future research agenda was determined by expert consensus. Results. 744 studies presented outcome data of the effects of specific treatments on knee OA. Quantitative analysis of treatment effect was possible in only 61 studies. Recommendations for the management of knee OA based on currently available data and expert opinion are presented. Proposals for a future research agenda are highlighted. Conclusions. These are the first clinical guidelines on knee OA to combine an evidence-based approach and a consensus approach across a wide range of treatment modalities. It is apparent that only certain clinical propositions are supported by substantial research– based evidence. There is thus an urgent need for future well designed trials to address key clinical questions.
Osteoarthritis and Cartilage, 2008
Revue du Rhumatisme, 2007
Revue du Rhumatisme, 2006
Introduction. -Les patients atteints de spondylarthropathie (SpA) sont à risque de développer une... more Introduction. -Les patients atteints de spondylarthropathie (SpA) sont à risque de développer une ostéoporose, expliquée par l'activité inflammatoire de la maladie et l'immobilisation. Des études préliminaires conduites dans des petits effectifs et sur une courte durée (inférieure ou égale à un an), ont montré le bénéfice des anti-TNF alpha sur la densité osseuse chez les patients atteints de SpA, et une augmentation du poids.
Arthritis research & therapy, 2005
Joint space width (JSW) and narrowing (JSN) measurements on radiographs are currently the best wa... more Joint space width (JSW) and narrowing (JSN) measurements on radiographs are currently the best way to assess disease severity or progression in hip osteoarthritis, yet we lack data regarding the most accurate and sensitive measurement technique. This study was conducted to determine the optimal radiograph and number of readers for measuring JSW and JSN. Fifty pairs of radiographs taken three years apart were obtained from patients included in a structure modification trial in hip osteoarthritis. Three radiographs were taken with the patient standing: pelvis, target hip anteroposterior (AP) and oblique views. Two trained readers, blinded to each other's findings, time sequence and treatment, each read the six radiographs gathered for each patient twice (time interval > or = 15 days), using a 0.1 mm graduated magnifying glass. Radiographs were randomly coded for each reading. The interobserver and intraobserver cross-sectional (M0 and M36) and longitudinal (M0-M36) reproducibil...
The Journal of Rheumatology
To assess if total hip arthroplasty (THA) is a valid outcome measure of hip osteoarthritis (OA), ... more To assess if total hip arthroplasty (THA) is a valid outcome measure of hip osteoarthritis (OA), in respect to clinical and radiological assessments. A prospective 3 year study of patients who had painful hip OA with an initial radiographic joint space width &amp;gt; or =1 mm at the narrowest point. Dependent variable was THA. Patient data including body mass index, OA structural severity by radiograph, OA symptomatic severity (pain, function), and OA localization were recorded at entry. Pelvic radiographs were obtained before THA, when available, and once yearly during the study. During the study 106 of 506 patients underwent THA. Risk was estimated (Kaplan-Meier method) to be 8+/-1, 16+/-2, and 23+/-2% after 1, 2, and 3 years, respectively. Factors predisposing to requirement for surgery were: age &amp;gt; or =70 years, female sex, superolateral migration of the femoral head, joint space width &amp;lt;2 mm, Kellgren-Lawrence grade &amp;gt; or =3, pain (visual analog scale) &amp;gt; or =50 mm, and Lequesne index &amp;gt; or =10 with a relative risk of 1.65, 1.71, 1.96, 1.85, 1.89, 1.86, and 2.59, respectively. Mean change in joint space width was 0.22+/-0.50 vs 0.97+/-1.35 mm/year in patients without and with THA, respectively (p&amp;lt;0.0001). Changes in radiological joint space width during the first year were highly predictive of requirement for THA during the 2 following years (risk of 5, 13, 25, and 79% in patients with a radiological joint space width worsening during the first year of 0, &amp;lt; or =25, &amp;gt;25 and &amp;lt; or =50, and &amp;gt;50%, respectively). These data suggest that THA could be considered as a valid outcome measure in OA. However, further studies should be conducted in other countries with different health care systems to evaluate the inter-country reliability of this measurement.
Revue du rhumatisme (English ed.)
To evaluate potential radiographic predictors of hip osteoarthritis progression. A prospective, l... more To evaluate potential radiographic predictors of hip osteoarthritis progression. A prospective, longitudinal two-year study was conducted in patients meeting American College of Rheumatology criteria for hip osteoarthritis. Hip osteoarthritis progression was defined as a greater than 0.5-mm decrease in joint space width measured using a magnifying glass marked at intervals of 0.1 mm, at the site of maximum joint space narrowing, by a single investigator who was blinded to the chronological order of the radiographs. Radiographic parameters determined at study entry were as follows: presence of osteophytes, osteosclerosis, and subchondral cysts; femoral head migration (superolateral, superomedial, concentric); and severity (joint space width in mm, Kellgren and Lawrence grade, subjective evaluation of joint space narrowing). In the 463 study patients, joint space width decreased from 2.2 +/- 0.8 at baseline to 1.7 +/- 1.0 mm after two years (P < 0.0001). Radiographic progression wa...
Revue du Rhumatisme, 2009
Prévalence et évaluation de l'impact du psoriasis sur l'évolution naturelle de la coxarthrose. Ré... more Prévalence et évaluation de l'impact du psoriasis sur l'évolution naturelle de la coxarthrose. Résultats d'un suivi sur dix ans de 507 patients (étude Echodiah) ଝ Self-reported prevalence of psoriasis and evaluation of the impact on the natural history of hip osteoarthritis. Results of a 10 years follow-up study of 507 patients (Echodiah study) Accepté le 10 octobre 2008 Disponible sur Internet le 21 juin 2009
Revue du Rhumatisme, 2007
Revue du Rhumatisme, 2006
charge. Elle consulte, 15 jours avant son hospitalisation, pour un syndrome hémorragique fait d'é... more charge. Elle consulte, 15 jours avant son hospitalisation, pour un syndrome hémorragique fait d'épistaxis et d'hématurie associé à une dyspnée stade II de la NYHA, évoluant dans un contexte d'amaigrissement important. L'examen à l'admission trouve une patiente altérée avec une pâleur cutanéo-muqueuse, des déformations typiques d'une PR évoluée, une splénomégalie à 4 travers de doigts, des adénopathies latéro-cervicales et sous maxillaires, une hypertrophie thyroïdienne, une baisse de l'acuité visuelle avec une choriorétinite bilatérale et un kératome bilatéral. A la biologie, on note un syndrome inflammatoire important, une pancytopénie arégénérative profonde. Le facteurs rhumatoïde ainsi que les anticorps antinucléaires sont fortement positifs. Aux radiographies standard, on note un épanchement sissurale droit, une déminéralisation osseuse des mains avec des déformations typiques. L'échographie abdominale trouve une splénomégalie homogène, le tronc porte étant libre. L'échographie cervicale confirme l'hypertrophie thyroïdienne avec des adénopathies intra et extraparenchymenteuses. La patiente a été mise sous traitement symptomatique pour la douleur et sous traitement de fond à base de méthotrexate et d'APS. L'évolution en intra-hospitalier a été marquée par une amélioration de la symptomatologie douloureuse et de l'état clinique.
Rheumatology, 2002
To determine the minimum clinically important difference (MCID) in joint space width (JSW) progre... more 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.
The Journal of Rheumatology
We propose a composite index for considering total hip arthroplasty (THA) in hip osteoarthritis (... more We propose a composite index for considering total hip arthroplasty (THA) in hip osteoarthritis (OA). We carried out a 3 year longitudinal study of patients with painful hip OA from 137 centers. Clinical data were collected at baseline and every 3 months; radiographs were taken at entry and each year. The decision to have surgery was made by the patient, the rheumatologist, and the surgeon, with no reference to outcome measures. Statistical analysis included discrete Cox analysis with time dependent covariates, on 3 month interval grouped data. The dependent variable was THA during the 3 months following the evaluated visit. Time dependent covariates collated at each evaluated visit included radiological joint space width (JSW), percentage decrease in JSW during the year preceding, patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s global assessment. Lequesne index, pain, and nonsteroidal antiinflammatory drug and analgesic intake. We compared 2 analyses differing in symptomatic variables entered: values obtained at a single time point vs mean values between 2 visits at a 3 month interval. Selection of the index was based on the best combination of variables to predict occurrence of THA. Of the 508 patients recruited for study, 42 were excluded. During the 3 year followup, 75 patients underwent THA. Symptomatic, therapeutic, and radiological variables were included in the index resulting from the 2 analyses. Based on the selected cutoff, the positive and negative predictive values for occurrence of THA in the 2 years following were 54.3 and 90.6%, respectively (single point model), and 52.9 and 86.7%, respectively (model using mean values of symptomatic variables between 2 visits). The poor positive predictive value of the composite indices obtained in this study suggests that there are other unmeasured factors determining access to surgery. On the other hand, the high negative predictive values suggest that these composite measures should be used by clinicians to determine which patients should not be referred to THA.
The Journal of rheumatology, 2005
To investigate the associations of molecular markers of joint tissue turnover with clinical and r... more To investigate the associations of molecular markers of joint tissue turnover with clinical and radiological variables in patients with hip osteoarthritis (OA). Patients of the ECHODIAH trial cohort (60% female; mean age 63 yrs, disease duration 5 yrs) fulfilling the American College of Rheumatology criteria for hip OA were studied. Pain was assessed using a 100 mm visual analog scale, and the presence of night pain and morning stiffness was observed as the index of joint inflammation. Joint space width (JSW) and subchondral bone sclerosis were assessed on hip radiographs. Ten markers were measured, 8 in serum: N-propeptides of collagen type I (PINP) and type III (PIIINP), cartilage oligomeric matrix protein (COMP), YKL-40, hyaluronan (HA), matrix metalloproteases (MMP1 and MMP3), and ultrasensitive C-reactive protein (CRP); and 2 in urine: C-terminal crosslinking telopeptides of collagen type I (CTX-I) and type II (CTX-II). Analyses of 376 patients with measurements of all the mark...
Osteoarthritis and Cartilage, 2001
Objective: To determine the most relevant method of measurement of the radiographic hip joint spa... more Objective: To determine the most relevant method of measurement of the radiographic hip joint space width (JSW).
Osteoarthritis and Cartilage, 2010
Osteoarthritis and Cartilage, 2010
Purpose: KL radiographic scale is the most widely used tool altogether to define HOA, assess HOA ... more Purpose: KL radiographic scale is the most widely used tool altogether to define HOA, assess HOA severity and eventually follow-up the radiographic progression. Although widely used for case-definition, its interobserver reliability is usually low in HOA. Objective: To study the impact of a new KL Scoring System Aid (KLSSA) on the reliability of KL scoring. Methods: 20 postero-anterior radiographs of both hands of HOA patients (covering HOA radiographic spectrum of the disease) obtained at random from a clinical trial were initially scored twice by 10 experienced readers at a 15-days interval. Readers were instructed to score the KL method (grades from 0 -4), using the score as detailed by Kallman [1], and their own view of the definition of KL grades. No preliminary training session was organised. During the 1 st session they also scored joint space narrowing (JSN) and osteophytes (0) (0-4). The Distal (DIP), proximal interphalangeal (PIP), metacarpophalangeal (MCP), scaphotrapezial and trapeziometacarpal joints (16 joints) of one hand selected at random (right or left) were scored. 8 out of the 10 readers (the 2 designers of the KLSSA were excluded) were then randomized in 2 groups of 4 to score again twice the 20 radiographs using or not the KLSSA, the group of 4 readers without the KLSSA serving as control group to assess the training effect. The KLSSA combines various amounts of JSN (0-4) and Ost (0-4) for defining KL grades. It is presented as a and was accompanied by hand images to illustrate the grading. Radiographs were numbered at random from 1 to 20 for each of the 4 reading sessions. At each session, only one hand was scored. Statistics: Intra-class correlation coefficient with 95% confidence interval (CI) for inter-and intraobserver precision; Bland-Altman graphical method for intraobserver precision. Results: For interobserver reproducibility appear in the table.