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Statistical approaches to evaluating the effect of risk factors on the pain of knee osteoarthritis in longitudinal studies
Current Opinion in Rheumatology, 08/17/09

Zhang Y et al. – Findings suggest that compared to cross-sectional studies, longitudinal studies allow investigators to assess the effect of change in a risk factor of interest on change in risk of knee pain or change in pain severity.

Methods

Main objectives of this study were to:
- Describe the commonly used measures of knee pain in longitudinal studies, and
- Review various analytic approaches in evaluating the effect of a risk factor on each type of pain measure

Results

In longitudinal epidemiologic studies of knee pain, the most commonly used measures for pain are:
- Frequent knee pain, and
- Activity-related pain severity

Various analytic approaches to evaluate the effect of a risk factor on each type of pain measure are:

Generalized estimating equations model and the mixed-effects linear regression model for pain severity assessed as a continuous outcome variable
Mixed-effects logistic regression model and conditional logistic regression model for pain exacerbation measured as a dichotomous outcome variable, and
A mixed-effects regression model, stratified proportional odds model, and a multistate transition model for pain severity measured as an ordinal outcome variable

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