title: Is self-reported improvement in osteoarthritis pain and disability reflected in objective measures?
abstract: OBJECTIVE
  To determine if self-reported improvements in pain and function correlate with improvement in objective measures of disease in osteoarthritis (OA).
  
  
  METHODS
  Individuals with disabling hip/knee OA were assessed 7 years apart by questionnaire [sociodemographics, body mass index, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores] and physical [range of motion (ROM), disease activity based on joint stress pain, erythema, warmth, effusion] and radiographic examination of the hips and knees (Kellgren-Lawrence grade). Changes over time were expressed as improved, unchanged, or worse based on a priori criteria.
  
  
  RESULTS
  Of 69 eligible patients, 43 (64%) with a mean age of 76.3 years participated; 77% were female. For WOMAC scores, 25% and 19% reported improved pain and function, respectively. For joint ROM, disease activity, and radiographic grade, 0% to 30% of participants were improved. However, improvements in WOMAC scores were not associated with improvements in any of the other measures (r < 0.24 for all).
  
  
  CONCLUSIONS
  One-quarter of participants reported significant improvements in WOMAC pain and disability after 7 years' followup. However, these improvements were not associated with similar improvements in joint ROM, disease activity, or radiographic grade. Greater understanding of the determinants of self-reported improvements in arthritis status, in particular the role of adaptation, is warranted.
authors.affiliation: Department of Health Policy, Management and Evaluation, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sindhu R
authors.initials: SR
authors.lastname: Johnson
authors.forename: Alison
authors.initials: A
authors.lastname: Archibald
authors.forename: Aileen M
authors.initials: AM
authors.lastname: Davis
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Badley
authors.forename: James G
authors.initials: JG
authors.lastname: Wright
authors.forename: Gillian A
authors.initials: GA
authors.lastname: Hawker
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D018771:Arthralgia / Q000209:etiology / Q000503:physiopathology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012649:Self Concept; D012720:Severity of Illness Index; D017211:Treatment Failure