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• W3020792937 abstract "Purpose: Diagnosing hip osteoarthritis (OA) using clinical criteria has the potential to identify patients early in the disease process and reduce the use of routine imaging. Unfortunately, no international consensus on the clinical diagnosis of hip OA has been reached. Commonly used clinical criteria have been developed by the American College of Rheumatology (ACR) and National Institute for Health and Care Excellence (NICE). The Danish Health Authority (DHA) has also developed clinical criteria for diagnosing hip OA. However, all of these criteria were developed in secondary care settings or through a guideline development process and thus, have not be extensively evaluated in the primary care setting where most OA patients should be diagnosed and treated according to current treatment guidelines. Therefore, this study was conducted to compare the proportion of patients in a primary care setting that have hip OA based on differing clinical criteria. This study examined and compared the prevalence of hip OA according to the ACR, NICE, and DHA criteria. The secondary objective of this study was to compare the prevalence estimates according to each set of criteria in a subgroup of patients with self-reported radiographic hip OA. Methods: A cross-sectional analysis of baseline data from patients participating in the Good Life with osteoArthritis in Denmark (GLA:D®) program from February 2017 until December 2018 was performed. GLA:D® is a primary care treatment program for patients with symptoms or functional limitations associated with hip OA. In GLA:D®, patients are examined at baseline for inclusion by a physiotherapist. As part of this examination, the physiotherapist performs a routine clinical examination of the hip and the patient is required to answer a series of questions, including self-report of symptoms. Variables corresponding to the included clinical criteria were extracted to allow for calculation of prevalence estimates. Prevalence estimates for hip OA were calculated using the ACR clinical classification decision tree, DHA, and NICE criteria. The prevalence of hip OA according to each set of criteria was also calculated in the subgroup of patients with self-reported radiographic changes associated with hip OA. These methods have been used previously in the GLA:D® cohort to evaluate and compare clinical criteria for knee OA. Results: 4699 patients with hip OA had available data on clinical criteria and were thus included in the study. Included patients had a mean (SD) age of 66.8 (9.7) years and 71% were female. Mean (SD) body mass index was 27.2 (4.8) kg/m2. Mean (SD) pain intensity was 47.1 (21.7) on the visual analogue scale, while the median (IQR) duration of symptoms was 12 (6-36) months. 82% of participants reported having received a hip radiograph showing changes consistent with hip OA. A total of 64% of patients met the ACR criteria for hip OA, while 80% of patients fulfilled the DHA criteria. The NICE criteria identified the most patients, as 94% of patients were identified. A Venn-diagram illustrating the overlap between criteria is presented in Figure 1. Only 4% of patients with hip OA did not fulfill any of the clinical criteria. The corresponding prevalence estimates in the subgroup of those self-reporting radiographic hip OA were 66%, 81%, and 94%, respectively. Conclusions: To our knowledge, this is the first study to compare three sets of clinical criteria for hip OA in primary care. Overall, the Results of this study suggest the NICE criteria are best able to identify patients with symptoms and functional limitations associated with hip OA in a primary care sample. This data also suggests that the ACR criteria, while being the most commonly used clinical criteria, may not be the most relevant criteria for primary care, as only two-thirds of patients were identified. Additionally, the presence of self-reported radiographic hip OA made little difference to the prevalence estimates, as each set of criteria performed relatively the same in this subgroup. Lastly, only a small proportion of patients with hip OA in primary care do not fulfil any of the criteria evaluated in this study." @default.
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• W3020792937 date "2020-04-01" @default.
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• W3020792937 title "Comparison of clinical criteria for hip osteoarthritis in primary care: a cross sectional study from good life with osteoarthritis in Denmark (GLA:D)" @default.
• W3020792937 doi "https://doi.org/10.1016/j.joca.2020.02.635" @default.
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