{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:31:11Z","timestamp":1790836271571,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T00:00:00Z","timestamp":1674604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to delineate phenotypes in hand osteoarthritis (HOA) based on cardinal symptoms (pain, functional limitation, stiffness, and aesthetic discomfort).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>With data from the Digital Cohort Design (DIGICOD), we performed a hierarchical agglomerative clustering analysis based on Australian\/Canadian Osteoarthritis Hand Index (AUSCAN) subscores for pain, physical function, stiffness, and visual analog scale for aesthetic discomfort. Kruskal\u2010Wallis and post hoc analyses were used to assess differences between clusters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 389 patients, we identified 5 clusters: cluster 1 (n\u00a0=\u00a088) and cluster 2 (n\u00a0=\u00a091) featured low and mild symptoms; cluster 3 (n\u00a0=\u00a080) featured isolated aesthetic discomfort; cluster 4 (n\u00a0=\u00a042) featured a high level of pain, stiffness, and functional limitation; and cluster 5 (n\u00a0=\u00a088) had the same features as cluster 4 but with high aesthetic discomfort. For clusters 4 and 5, AUSCAN pain score was &gt;41 of 100, representing only one\u2010third of our patients. Aesthetic discomfort (clusters 3 and 5) was significantly associated with erosive HOA and a higher number of nodes. The highly symptomatic cluster 5 was associated but not significantly with metabolic syndrome, and body mass index and C\u2010reactive protein level did not differ among clusters. Symptom intensity was significantly associated with joint destruction as well as with physical and psychological burden. Patients\u2019 main expectations differed among clusters, and function improvement was the most frequent expectation overall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The identification of distinct clinical clusters based on HOA cardinal symptoms suggests previously undescribed subtypes of this condition, warranting further study of biological characteristics of such clusters, and opening a path toward phenotype\u2010based personalized medicine in HOA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25047","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T05:34:48Z","timestamp":1666244088000},"page":"1494-1502","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Identification of Symptom Phenotypes of Hand Osteoarthritis Using Hierarchical Clustering: Results From the DIGICOD Cohort"],"prefix":"10.1002","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7473-7636","authenticated-orcid":false,"given":"Marie","family":"Binvignat","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Saint\u2010Antoine Hospital, Centre de Recherche Saint\u2010Antoine, Paris Inserm UMRS 938, Sorbonne Universit\u00e9, Assistance Publique\u2013H\u00f4pitaux de Paris, Paris, France, Immunology, Immunopathology, Immunotherapy I3 Lab, Inserm URMS 959, Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital, Paris, France, and Bakar Computational Health Science Institute University of California  San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Pires","sequence":"additional","affiliation":[{"name":"Immunology, Immunopathology, Immunotherapy I3 Lab, Inserm URMS 959 Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital  Paris 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