Multi-centre modified Delphi exercise to identify candidate items for classifying early-stage symptomatic knee osteoarthritis. King, L. K., Liew, J. W., Mahmoudian, A., Wang, Q., Jansen, N. E. J., Stanaitis, I., Hung, V., Berenbaum, F., Das, S., Ding, C., Emery, C. A., Filbay, S. R., Hochberg, M. C., Ishijima, M., Kloppenburg, M., Lane, N. E., Losina, E., Mobasheri, A., Turkiewicz, A., Runhaar, J., Haugen, I. K., Appleton, C. T., Lohmander, L. S., Englund, M., Neogi, T., Hawker, G. A., & OARSI Early-stage Symptomatic Knee Osteoarthritis Initiative Osteoarthritis and Cartilage, 33(1):155–165, January, 2025.
doi  abstract   bibtex   
OBJECTIVE: To generate a list of candidate items potentially useful for discriminating individuals with Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) from those with other conditions and from established osteoarthritis (OA), and to reduce this list based on expert consensus. DESIGN: We conducted a three-round online international modified Delphi exercise with OA clinicians and researchers ("OA experts"). In Round 1, participants reviewed 84 candidate items and nominated additional item(s) potentially useful for EsSKOA classification; those nominated by ≥3 participants were added. In Round 2, participants rated perceived usefulness of 108 items (1 [not at all useful] to 9 [extremely useful]). In Round 3, participants could revise their ratings after reviewing Round 2 group median and quartiles. Following Round 3, we retained items with a median usefulness score \textgreater5 and ≥33.3% of participants categorised the item as useful (7 to 9), overall and in subgroup analysis by clinician field. RESULTS: There were 128 participants in Round 1 and 113 (88%) completed all rounds. We retained 77 items that spanned multiple domains (demographics, symptoms, physical exam, performance-based measures, imaging, laboratory investigations, and gross inspection/arthroscopy). Highly rated items included (median usefulness score): prior knee joint injury (8), diagnosis of OA in a different joint (7), and activity-related knee pain (7). The interquartile range was most often 3. CONCLUSION: We identified 77 items that OA experts consider potentially useful for EsSKOA classification. The results highlight experts' uncertainty around item usefulness. Next, candidate items will be further assessed and reduced using data-driven and multicriteria decision analysis methods.
@article{king_multi-centre_2025,
	title = {Multi-centre modified {Delphi} exercise to identify candidate items for classifying early-stage symptomatic knee osteoarthritis},
	volume = {33},
	issn = {1522-9653},
	doi = {10.1016/j.joca.2024.10.016},
	abstract = {OBJECTIVE: To generate a list of candidate items potentially useful for discriminating individuals with Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) from those with other conditions and from established osteoarthritis (OA), and to reduce this list based on expert consensus.
DESIGN: We conducted a three-round online international modified Delphi exercise with OA clinicians and researchers ("OA experts"). In Round 1, participants reviewed 84 candidate items and nominated additional item(s) potentially useful for EsSKOA classification; those nominated by ≥3 participants were added. In Round 2, participants rated perceived usefulness of 108 items (1 [not at all useful] to 9 [extremely useful]). In Round 3, participants could revise their ratings after reviewing Round 2 group median and quartiles. Following Round 3, we retained items with a median usefulness score {\textgreater}5 and ≥33.3\% of participants categorised the item as useful (7 to 9), overall and in subgroup analysis by clinician field.
RESULTS: There were 128 participants in Round 1 and 113 (88\%) completed all rounds. We retained 77 items that spanned multiple domains (demographics, symptoms, physical exam, performance-based measures, imaging, laboratory investigations, and gross inspection/arthroscopy). Highly rated items included (median usefulness score): prior knee joint injury (8), diagnosis of OA in a different joint (7), and activity-related knee pain (7). The interquartile range was most often 3.
CONCLUSION: We identified 77 items that OA experts consider potentially useful for EsSKOA classification. The results highlight experts' uncertainty around item usefulness. Next, candidate items will be further assessed and reduced using data-driven and multicriteria decision analysis methods.},
	language = {eng},
	number = {1},
	journal = {Osteoarthritis and Cartilage},
	author = {King, L. K. and Liew, J. W. and Mahmoudian, A. and Wang, Q. and Jansen, N. E. J. and Stanaitis, I. and Hung, V. and Berenbaum, F. and Das, S. and Ding, C. and Emery, C. A. and Filbay, S. R. and Hochberg, M. C. and Ishijima, M. and Kloppenburg, M. and Lane, N. E. and Losina, E. and Mobasheri, A. and Turkiewicz, A. and Runhaar, J. and Haugen, I. K. and Appleton, C. T. and Lohmander, L. S. and Englund, M. and Neogi, T. and Hawker, G. A. and {OARSI Early-stage Symptomatic Knee Osteoarthritis Initiative}},
	month = jan,
	year = {2025},
	keywords = {Aged, Classification criteria, Consensus, Delphi, Delphi Technique, Early-stage, Female, Humans, Knee osteoarthritis, Male, Middle Aged, Osteoarthritis, Knee, Severity of Illness Index, Symptoms},
	pages = {155--165},
}
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