Osteoarthritis (OA) and its related disability impose an enormous burden on persons with OA, their families and society. OA affects nearly 21 million people in the US, with annual treatment costs exceeding $33 billion or 0.33% of the US gross domestic product. The prevalence of knee OA is rising rapidly due to the growing obesity epidemic in the US as well as to incresing life expectancy. These sobering facts led the US Center for Disease Control and Prevention (CDC) to propose prevention and management of OA as a health priority in Healthy People 2010. Clinicians and policy makers face critical questions related to prevention, treatment and monitoring of knee OA. In this application, we propose to build a comprehensive computer simulation model of knee OA to evaluate the health and economic effects of four major developments in OA prevention and management: the formidable challenge posed by the growing obesity epidemic, the anticipated availability of disease modifying drugs;the use of technologies such as MRI and serum or urine biomarkers to monitor disease progression;and utilization of total knee replacement (TKR) for advanced knee OA. We have assembled a multidisciplinary team of internationally renowned rheumatologists, epidemiologists, biostatisticians, decision analysts and experts in health economics to propose """"""""Knee OA: setting priorities for care, policy, research."""""""" Our proposed study will use innovative methods of decision analysis modeling to summarize state of the art data from various research studies and translate them into estimates of the long- term gains in quality-adjusted life expectancy and lifetime costs for people with knee OA. This application is motivated by several recent reports from the World Health Organization (WHO) and the CDC, which identified both OA prevention and treatment as important public health priorities. The broad objective guiding our research is to optimize quality of life and resource allocation in the prevention and treatment of knee OA. This project responds directly to the NIH Roadmap Initiative with one of its main objectives to use multidisciplinary expertise to accelerate translation of fundamental discovery into effective prevention and new treatment strategies. This study will provide guidance to clinicians and policy makers on efforts to reduce pain and disability, and to improve quality of life for people with knee osteoarthritis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR053112-04
Application #
7674659
Study Section
Health Services Organization and Delivery Study Section (HSOD)
Program Officer
Lester, Gayle E
Project Start
2006-09-01
Project End
2011-08-31
Budget Start
2009-09-01
Budget End
2010-08-31
Support Year
4
Fiscal Year
2009
Total Cost
$641,055
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
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Hunter, David J; Nevitt, Michael; Losina, Elena et al. (2014) Biomarkers for osteoarthritis: current position and steps towards further validation. Best Pract Res Clin Rheumatol 28:61-71
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Losina, E; Dervan, E E; Daigle, M E et al. (2013) Studies of pain management in osteoarthritis: bedside to policy. Osteoarthritis Cartilage 21:1264-71
Daigle, Meghan E; Weinstein, Alexander M; Katz, Jeffrey N et al. (2012) The cost-effectiveness of total joint arthroplasty: a systematic review of published literature. Best Pract Res Clin Rheumatol 26:649-58
Losina, Elena; Thornhill, Thomas S; Rome, Benjamin N et al. (2012) The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic. J Bone Joint Surg Am 94:201-7

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