Development of radiographic classification criteria for hand osteoarthritis: a methodological report (Phase 2)

Ida K. Haugen*, David Felson, Abhishek Abhishek, Francis Berenbaum, John James Edwards, Gabriel Herrero Beaumont, Merete Hermann-Eriksen, Catherine L. Hill, Mariko Ishimori, Helgi Jonsson, Teemu Karjalainen, Ying Ying Leung, Emmanuel Maheu, Christian D. Mallen, Rikke Helene Moe, Roberta Ramonda, Valentin Ritschl, Tanja A. Stamm, Zoltan Szekanecz, Florus J. van der GiesenMarco J.P.F. Ritt, Ruth Wittoek, Ingvild Kjeken, Nina Osteras, Lotte A. van de Stadt, Martin Englund, Krysia S. Dziedzic, M. Marshall, Sita Bierma-Zeinstra, Paul Hansen, Elsie Greibrokk, Wilma Smeets, Margreet Kloppenburg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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ObjectivesIn Phase 1 of developing new hand osteoarthritis (OA) classification criteria, features associated with hand OA were identified in a population with hand complaints. Radiographic findings could better discriminate patients with hand OA and controls than clinical examination findings. The objective of Phase 2 was to achieve consensus on the features and their weights to be included in three radiographic criteria sets of overall hand OA, interphalangeal OA and thumb base OA.MethodsMultidisciplinary, international expert panels were convened. Patient vignettes were used to identify important features consistent with hand OA. A consensus-based decision analysis approach implemented using 1000minds software was applied to identify the most important features and their relative importance influencing the likelihood of symptoms being due to hand OA. Analyses were repeated for interphalangeal and thumb base OA. The reliability and validity of the proposed criteria sets were tested.ResultsThe experts agreed that the criteria sets should be applied in a population with pain, aching or stiffness in hand joint(s) not explained by another disease or acute injury. In this setting, five additional criteria were considered important: age, morning stiffness, radiographic osteophytes, radiographic joint space narrowing and concordance between symptoms and radiographic findings. The reliability and validity were very good.ConclusionRadiographic features were considered critical when determining whether a patient had symptoms due to hand OA. The consensus-based decision analysis approach in Phase 2 complemented the data-driven results from Phase 1, which will form the basis of the final classification criteria sets.

Original languageEnglish
Article numbere002024
JournalRMD Open
Issue number1
Publication statusPublished - 4 Feb 2022

Bibliographical note

Funding Information:
Funding The project on the development of new classification criteria for hand OA is funded by EULAR. The EULAR executive committee has not been involved in the study design, analyses or interpretation of results.

Funding Information:
Competing interests IKH reports personal fees from Abbvie and Novartis, and research grants from Pfizer and IMI-APPROACH (both paid to the institution), all outside of the submitted work. FB reports being CEO of 4MOVING BIOTECH, received personal fees from 4P PHARMA, Boehringer, Bone Therapeutics, CellProthera, Galapagos, GSK, Lilly, Merck Sereno, MSD, Novartis, Pfizer, Servier and Peptinov, and research grant from TRB Chemedica and IMI-APPROACH (paid to the institution), all outside the submitted work. GHB reports personal fees from Pfizer, Sobi, Fresenius, Mylan, Tedec Meiji, Novartis, Sandoz and Faes, outside of the submitted work. EM reports personal fees from Expanscience, Mylan-Meda, TRB Chemedica, Pierre Fabre, Celgene and Fidia, and non-financial support from Pfizer, outside the submitted work. CDM and JJE report a research grant from BMS, outside the submitted work. RR reports personal fees from Abbvie, Celgene, Novartis, Pfizer and Lilly, outside of the submitted work. TAS reports personal fees from Sanofi, AbbVie, Roche and Takeda, outside of the submitted work. ZS reports personal fees from AbbVie, Roche, Pfizer, Berlin Chemie, UCB and Bristol-Myers, outside of the submitted work. RW reports personal fees from Abbvie, Galapagos, UCB, Bristol Myers Squib and Tilman, and grants from Amgen, outside the submitted work. ME reports serving on an advisory board for Pfizer (tanezumab) and research grant from IMI-APPROACH (paid to the institution), outside of the submitted work. SB-Z reports personal fees from Infirst healthcare, Pfizer and Osteoarthritis and Cartilage, outside the submitted work. PH is a co-inventor of the 1000minds software used in this study. MK reports personal fees from Abbvie, Pfizer, Levicept, GlaxoSmithKline, Merck-Serono, Kiniksa, Flexion, Galapagos, Jansen, CHDR, Novartis and UCB, and research grants from Pfizer, IMI-APPROACH (all paid to the institution), and royalties from Wolters Kluwer and Springer Verlag, all outside the submitted work. YYL reports grants from National Medical Research Council of Singapore, and personal fees from Abbvie, DKSH, Janssen, Novartis and Pfizer, all outside the submitted work.

Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Other keywords

  • epidemiology
  • health care
  • osteoarthritis
  • outcome assessment
  • Radiography
  • Reproducibility of Results
  • Hand/diagnostic imaging
  • Humans
  • Osteoarthritis/diagnostic imaging


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