Jennifer M. Gierisch, PhD, MPH; Evan R. Myers, MD, MPH; Kristine M. Schmit, MD, MPH; Douglas C. McCrory, MD, MHS; Remy R. Coeytaux, MD, PhD; Matthew J. Crowley, MD; Ranee Chatterjee, MD, MPH; Amy S. Kendrick, RN, MSN; Gillian D. Sanders, PhD
Acknowledgment: The authors thank Megan M. Chobot, MSLS, for project coordination, and Liz Wing, MA, for editorial assistance. They also thank the members of the stakeholder panel: Kelli Allen, PhD; Teresa Brady, PhD; G. Kelley Fitzgerald, PhD; Yvonne M. Golightly, PhD; Lyndon Joseph, PhD; Jeffrey Katz, MD; Gayle Lester, PhD; Dave Mekemson; Paul Rockar, DPT; Jyme Schafer, MD; Nancy Simington; Kim Templeton, MD; and Patience White, MD.
Financial Support: By PCORI.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0318.
Requests for Single Reprints: Jennifer M. Gierisch, PhD, MPH, Department of Medicine, Duke University Medical Center, Campus Box 104427 DUMC, Durham, NC 27701; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Gierisch: Department of Medicine, Duke University Medical Center, Campus Box 104427 DUMC, Durham, NC 27701.
Dr. Myers: Duke University Medical Center, Box 3279, 244 Baker House, Durham, NC 27710.
Drs. Schmit, McCrory, Coeytaux, and Sanders and Ms. Kendrick: Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715.
Dr. Crowley: Durham Veterans Affairs Medical Center, Health Services Research and Development (152), 508 Fulton Street, Durham, NC 27705.
Dr. Chatterjee: Sutton Station Internal Medicine, 5832 Fayetteville Road, Suite 113, Durham, NC 27713.
Author Contributions: Conception and design: J.M. Gierisch, R.R. Coeytaux, M.J. Crowley, G.D. Sanders.
Analysis and interpretation of the data: J.M. Gierisch, E.R. Myers, D.C. McCrory, M.J. Crowley, R. Chatterjee, G.D. Sanders.
Drafting of the article: J.M. Gierisch, R.R. Coeytaux, G.D. Sanders.
Critical revision of the article for important intellectual content: J.M. Gierisch, E.R. Myers, M.J. Crowley, G.D. Sanders.
Final approval of the article: J.M. Gierisch, E.R. Myers, D.C. McCrory, R.R. Coeytaux, M.J. Crowley, R. Chatterjee, A.S. Kendrick, G.D. Sanders.
Provision of study materials or patients: A.S. Kendrick, G.D. Sanders.
Statistical expertise: G.D. Sanders.
Obtaining of funding: G.D. Sanders.
Administrative, technical, or logistic support: J.M. Gierisch, A.S. Kendrick, G.D. Sanders.
Collection and assembly of data: J.M. Gierisch, E.R. Myers, K.M. Schmit, D.C. McCrory, R.R. Coeytaux, M.J. Crowley, R. Chatterjee, A.S. Kendrick, G.D. Sanders.
Osteoarthritis is a leading cause of disability in the United States. This article describes a prioritized research agenda about osteoarthritis management developed for the Patient-Centered Outcomes Research Institute. Evidence gaps were identified by reviewing existing literature and engaging diverse stakeholders to expand and refine gaps. Stakeholders ranked evidence gaps by importance from their perspectives.
Prioritized evidence gaps included the need to determine or evaluate key patient-centered outcomes; optimal duration, intensity, and frequency of nonsurgical interventions; whether the comparative effectiveness of nonsurgical interventions varies by socioeconomic factors; when and how to transition from nonsurgical to surgical interventions; effective ways to engage patients in self-management and promote long-term behavior change; standardized screening tools that improve early diagnosis; biomechanical strategies that improve symptoms; mechanisms for promoting and delivering coordinated, longitudinal care; and comparative effectiveness of nonsurgical therapies. Searches of PubMed and ClinicalTrials.gov showed many recent and ongoing studies addressing comparative effectiveness of nonsurgical interventions; relatively few of these evaluated treatments across categories (for example, drug therapy vs. weight management) or combined categories of treatment. Few studies addressed other high-priority evidence gaps.
Overview of prioritization process.
Adapted from reference 19. ESG = Evidence Synthesis Group; PCORI = Patient-Centered Outcomes Research Institute.
Italicized text indicates top-tier gaps. ADLs = activities of daily living; FRN = future research need; OA = osteoarthritis.
Appendix Table. Final Ranking of Future Research Needs for Alternative Strategies for OA*
Table. Top-Ranked Research Priorities and Recommended Study Designs or Suggested Analyses to Address Them
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Gierisch JM, Myers ER, Schmit KM, McCrory DC, Coeytaux RR, Crowley MJ, et al. Prioritization of Patient-Centered Comparative Effectiveness Research for Osteoarthritis. Ann Intern Med. 2014;160:836–841. doi: 10.7326/M14-0318
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Published: Ann Intern Med. 2014;160(12):836-841.
Osteoarthritis, Research and Reporting Methods, Rheumatology.
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