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Many approaches exist for characterising radiographic knee OA, including machine learning (ML).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aims<\/jats:title>\n                <jats:p>To examine Kellgren and Lawrence (K&amp;L) scores from ML and expert observation, minimum joint space and osteophyte in relation to pain and function.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Participants from the Hertfordshire Cohort Study, comprising individuals born in Hertfordshire from 1931 to 1939, were analysed. Radiographs were assessed by clinicians and ML (convolutional neural networks) for K&amp;L scoring. Medial minimum joint space and osteophyte area were ascertained using the knee OA computer-aided diagnosis (KOACAD) program. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was administered. Receiver operating characteristic analysis was implemented for minimum joint space, osteophyte, and observer- and ML-derived K&amp;L scores in relation to pain (WOMAC pain score\u2009&gt;\u20090) and impaired function (WOMAC function score\u2009&gt;\u20090).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>359 participants (aged 71\u201380) were analysed. Among both sexes, discriminative capacity regarding pain and function was fairly high for observer-derived K&amp;L scores [area under curve (AUC): 0.65 (95% CI 0.57, 0.72) to 0.70 (0.63, 0.77)]; results were similar among women for ML-derived K&amp;L scores. Discriminative capacity was moderate among men for minimum joint space in relation to pain [0.60 (0.51, 0.67)] and function [0.62 (0.54, 0.69)]. AUC\u2009&lt;\u20090.60 for other sex-specific associations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>Observer-derived K&amp;L scores had higher discriminative capacity regarding pain and function compared to minimum joint space and osteophyte. Among women, discriminative capacity was similar for observer- and ML-derived K&amp;L scores.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>ML as an adjunct to expert observation for K&amp;L scoring may be beneficial due to the efficiency and objectivity of ML.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40520-023-02428-5","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T02:02:15Z","timestamp":1684461735000},"page":"1449-1457","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Machine learning as an adjunct to expert observation in classification of radiographic knee osteoarthritis: findings from the Hertfordshire Cohort Study"],"prefix":"10.1007","volume":"35","author":[{"given":"Leo D.","family":"Westbury","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5463-2255","authenticated-orcid":false,"given":"Nicholas R.","family":"Fuggle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diogo","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Oka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6555-5782","authenticated-orcid":false,"given":"Noriko","family":"Yoshimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriyuki","family":"Oe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sasan","family":"Mahmoodi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-140X","authenticated-orcid":false,"given":"Mahesan","family":"Niranjan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3048-4961","authenticated-orcid":false,"given":"Elaine M.","family":"Dennison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-0709","authenticated-orcid":false,"given":"Cyrus","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"key":"2428_CR1","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/j.semarthrit.2019.04.008","volume":"49","author":"O Bruy\u00e8re","year":"2019","unstructured":"Bruy\u00e8re O, Honvo G, Veronese N et al (2019) An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). 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EMD reports personal fees and honoraria (outside the submitted work) from UCB, Pfizer, Lilly and Viatris. NRF has received travel bursaries from Pfizer and Eli Lilly. The remaining authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964, as revised in 2000. The baseline Hertfordshire Cohort Study had ethical approval from the Hertfordshire and Bedfordshire Local Research Ethics Committee and the follow-up had ethical approval from the East and North Hertfordshire Ethical Committees.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants provided written informed consent to participate in the study and for their health records to be accessed in the future.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}