Physician diagnosed arthritis, reported arthritis and radiological non-axial osteoarthritis

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Physician diagnosed arthritis, reported arthritis and radiological non-axial osteoarthritis
Osteoarthritis and Cartilage
Volume 16, Issue 7, July 2008, Pages 846-850

C.E.I. Szoeke Ph.D., F.R.A.C.P., M.B.B.S., B.Sc.(Hons.), Dr.‹, ·, L. Dennerstein F.R.A.P., Ph.D.‹, Professor, A.E. Wluka F.R.A.C.P.||, Ph.D., Dr.?, short parallel, J.R. Guthrie Ph.D., Dr.‹, J. Taffe Ph.D., Dr.?, M.S. Clark Ph.D., Dr.‹ and F.M. Cicuttini F.R.A.C.P, Ph.D.?, ?, Professor

‹Office for Gender and Health, Department of Psychiatry, University of Melbourne, Victoria, Australia
·Department of Medicine, The Royal Melbourne Hospital, Victoria, Australia
||Baker Heart Research Institute, Melbourne, Victoria, Australia
?Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
?Department of Rheumatology, Alfred Hospital, Prahran, Victoria, Australia

Received 30 May 2007;
accepted 3 December 2007.
Available online 15 January 2008.

Summary
Objective
To determine the question that best predicts radiographic evidence of non-axial osteoarthritis (OA).

Design
The Melbourne Women's Mid-life Health Project (MWMHP), commenced in 1991, is a population-based prospective study of 438 Australian-born. Two hundred and fifty-seven (57%) women remained in longitudinal assessment in 2002 and 224 (87%) women agreed to undergo X-rays of their hands and knees between 2002 and 2003.

Methods
Annually participants were asked about aches and stiff joints and arthritis or rheumatism. In the eleventh year of follow-up X-rays were scored for evidence of OA using a validated scale, by two investigators who were blinded to questionnaire results. Information on hormone therapy use, physical activity, mood, smoking, body mass index (BMI) and age were obtained by both self-administered and face-to-face questionnaires.

Results
Patient reported physician diagnosed arthritis was the best predictor of radiological OA (ROA). The question had a specificity of 64%, a positive predictive value of 57% and a negative predictive value of 71%. Even the most reliable question about arthritis still had a relatively low specificity for radiologically diagnosed OA. Reporting symptoms were significantly more common in participants who were depressed, those who had a higher negative affect and those with a higher BMI.

Conclusion
In large epidemiological studies where questionnaire assessment of OA is required, the greatest accuracy is achieved by asking about physician diagnosed arthritis. Concurrent application of a validated scale for mood is important.

Key words: Radiological; Osteoarthritis; Mood; Joint symptoms; Menopause; Weight; Physical activity