TY - JOUR T1 - OMERACT/OARSI initiative to define states of severity and indication for joint replacement in hip and knee osteoarthritis. JF - The Journal of Rheumatology JO - J Rheumatol SP - 1432 LP - 1435 VL - 34 IS - 6 AU - Laure Gossec AU - Gillian Hawker AU - Aileen M Davis AU - Jean Francis Maillefert AU - L Stefan Lohmander AU - Roy Altman AU - Jolanda Cibere AU - Philip G Conaghan AU - Marc C Hochberg AU - Joanne M Jordan AU - Jeffrey N Katz AU - Lyn March AU - Nizar Mahomed AU - Karel Pavelka AU - Ewa M Roos AU - Maria E Suarez-Almazor AU - Gustavo Zanoli AU - Maxime Dougados Y1 - 2007/06/01 UR - http://www.jrheum.org/content/34/6/1432.abstract N2 - OBJECTIVE: Time to theoretical indication of joint replacement surgery has been proposed as a primary outcome for potential structure-modifying interventions for osteoarthritis (OA). The objectives of this OMERACT/OARSI Working Group were to identify pain, physical function, and structure states that represent the progression from early to late disease for individuals with OA of the hip and knee, and to create a composite measure of these 3 domains to define states of OA severity and a surrogate measure of "need for joint replacement surgery." METHODS: For pain, focus groups and one-on-one interviews were used. For function, Rasch analysis was performed on existing indices the Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) and the Knee injury and Osteoarthritis Outcome Score (KOOS), each of which subsumes the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questions. For structure, a comparison of existing indices (Kellgren-Lawrence, OARSI stages, and joint space width) was performed for the hip and the knee. RESULTS: For pain, key features of pain that are most distressing to people with OA from early to late disease were identified. For function, the reduction of the number of items based on the existing indices continues. For structure, the analysis is also ongoing. CONCLUSION: Preliminary results were presented at OMERACT 8; the final objective will be to combine the 3 domains (pain, function, and structure) and to create a composite index that could define states of severity and "need for total joint replacement," which could be used to evaluate treatment response to disease-modifying drugs in OA clinical trials. ER -