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The design and execution of prevention trials for OA have methodological issues that are distinct from trials designed to impact prevalent disease. Disease definitions and their precise and sensitive measurement, identification of high-risk populations, the nature of the intervention (pharmaceutical, nutraceutical, behavioral) and its potential pleiotropic impacts on other organ systems are critical to consider. Because prevention trials may be prolonged, close attention to concomitant life changes and co-morbidities, adherence and participant retention in the trial is of primary importance, as is recognition of the potential for "preventive misconception" and "behavioral disinhibition" to affect the ability of the trial to show an effect of the intervention under study. None of these potential pitfalls precludes a successful and scientifically rigorous process and outcome. As technology improves the means to measure and predict the OA process and its clinical consequences, it will be increasingly possible to screen individuals for high-risk phenotypes, combining clinical factors with information from imaging, genetic, metabolic and other biomarkers and to impact this high-risk condition to avoid or delay OA both structurally and symptomatically.

Original publication

DOI

10.1016/j.joca.2010.10.031

Type

Journal article

Journal

Osteoarthritis and cartilage

Publication Date

05/2011

Volume

19

Pages

500 - 508

Addresses

Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC 27599-7280, USA. joanne_jordan@med.unc.edu

Keywords

Humans, Osteoarthritis, Osteoarthritis, Knee, Knee Injuries, Risk Reduction Behavior, Research Design, Ethics, Research, Adult, Middle Aged, Female, Male, Overweight, Clinical Trials as Topic, Young Adult