{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T22:02:33Z","timestamp":1766181753002,"version":"3.37.3"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["89890"],"award-info":[{"award-number":["89890"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["89997"],"award-info":[{"award-number":["89997"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006538","name":"Canadian Arthritis Network","doi-asserted-by":"publisher","award":["01-MNO-09N"],"award-info":[{"award-number":["01-MNO-09N"]}],"id":[{"id":"10.13039\/501100006538","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000142","name":"The Arthritis Society","doi-asserted-by":"crossref","award":["TAS04\/0063"],"award-info":[{"award-number":["TAS04\/0063"]}],"id":[{"id":"10.13039\/501100000142","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000142","name":"The Arthritis Society","doi-asserted-by":"crossref","award":["INS-12-027"],"award-info":[{"award-number":["INS-12-027"]}],"id":[{"id":"10.13039\/501100000142","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To develop a whole-joint, unidimensional, irreversible, and fine-grained MRI knee osteoarthritis (OA) severity score, based on cartilage, osteophytes and meniscus (OA-COM), and to predict progression across different severity states using OA-COM as outcome and clinical variables as predictors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Population-based knee pain cohort aged 40\u201379 was assessed at baseline and 7-year follow-up. OA-COM score was defined as the sum of MRI scores for cartilage, osteophytes and menisci, measured at 6, 8 and 6 sites, total score 0\u201354. To anchor severity levels, we fit cross-sectional logistic models using OA-COM to predict Kellgren-Lawrence (KL) grades in subsets at or one point below each grade. OA-COM threshold scores were selected on sensitivity, specificity, positive and negative predictive value. We developed longitudinal logistic models for OA-COM progression over each threshold over 7 years. Potential predictors included age, sex, BMI, malalignment, physical exam effusion, quadriceps weakness, and crepitus, selected on area under the receiver operating characteristic curve (AUC) and Akaike\u2019s Information Criterion (AIC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Optimal OA-COM thresholds were 12, 18, 24 and 30, for KL grades 1 to 4. Significant predictors of progression (depending on threshold) included physical exam effusion, malalignment and female sex, with other selected predictors age, BMI and crepitus.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>OA-COM (0\u201354 range) is a whole-joint, unidimensional, irreversible, and fine-grained MRI OA severity score reflecting cartilage, osteophytes and menisci. OA-COM scores 12, 18, 24 and 30 are equivalent to KL grades 1 to 4, while offering fine-grained differentiation of states between KL grades, and within pre-radiographic disease (KL = 0) or late-stage disease (KL = 4). In modeling, several clinical variables predicted progression across different states over 7 years.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0258451","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T19:12:44Z","timestamp":1634238764000},"page":"e0258451","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["A whole-joint, unidimensional, irreversible, and fine-grained MRI knee osteoarthritis severity score, based on cartilage, osteophytes and meniscus (OA-COM)"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-278X","authenticated-orcid":true,"given":"Eric 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A.","family":"Kopec","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Singer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anona","family":"Thorne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolanda","family":"Cibere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"issue":"1","key":"pone.0258451.ref001","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1002\/art.23176","article-title":"Estimates of the prevalence of arthritis and other rheumatic conditions in the United States","volume":"58","author":"RC Lawrence","year":"2008","journal-title":"Arthritis Rheum"},{"issue":"8","key":"pone.0258451.ref002","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1002\/art.1780300811","article-title":"THE PREVALENCE OF KNEE OSTEOARTHRITIS IN THE ELDERLY\u2014THE FRAMINGHAM OSTEOARTHRITIS STUDY","volume":"30","author":"DT Felson","year":"1987","journal-title":"Arthritis Rheum"},{"journal-title":"The impact of arthritis in Canada: today and over the next 30 years","year":"2016","author":"Arthritis Alliance of Canada","key":"pone.0258451.ref003"},{"issue":"4","key":"pone.0258451.ref004","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1136\/ard.16.4.494","article-title":"RADIOLOGICAL ASSESSMENT OF OSTEO-ARTHROSIS","volume":"16","author":"JH Kellgren","year":"1957","journal-title":"Ann Rheum Dis"},{"issue":"3","key":"pone.0258451.ref005","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.joca.2003.11.003","article-title":"Whole-organ magnetic resonance imaging score 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