Patients with trochanteric pain syndrome always have peritrochanteric T2 abnormalities and are significantly more likely to have abductor tendinopathy on magnetic resonance imaging (MRI). However, although the absence of peritrochanteric T2 MR abnormalities makes trochanteric pain syndrome unlikely, detection of these abnormalities on MRI is a poor predictor of trochanteric pain syndrome as these findings are present in a high percentage of patients without trochanteric pain.
Large-scale computer experiments are becoming increasingly important in
science. A multi-step procedure is introduced to statisticians for modeling
such experiments, which builds an accurate interpolator in multiple steps. In
practice, the procedure shows substantial improvements in overall accuracy, but
its theoretical properties are not well established. We introduce the terms
nominal and numeric error and decompose the overall error of an interpolator
into nominal and numeric portions. Bounds on the numeric and nominal error are
developed to show theoretically that substantial gains in overall accuracy can
be attained with the multi-step approach.Comment: Published in at http://dx.doi.org/10.1214/11-AOS929 the Annals of
Statistics (http://www.imstat.org/aos/) by the Institute of Mathematical
Statistics (http://www.imstat.org
BackgroundDespite the high prevalence and global impact of knee osteoarthritis (KOA), current treatments are palliative. No disease modifying anti-osteoarthritic drug (DMOAD) has been approved. We recently demonstrated significant involvement of uric acid and activation of the innate immune response in osteoarthritis (OA) pathology and progression, suggesting that traditional gout therapy may be beneficial for OA. We therefore assess colchicine, an existing commercially available agent for gout, for a new therapeutic application in KOA.Methods/DesignCOLKOA is a double-blind, placebo-controlled, randomized trial comparing a 16-week treatment with standard daily dose oral colchicine to placebo for KOA. A total of 120 participants with symptomatic KOA will be recruited from a single center in Singapore. The primary end point is 30% improvement in total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at week 16. Secondary end points include improvement in pain, physical function, and quality of life and change in serum, urine and synovial fluid biomarkers of cartilage metabolism and inflammation. A magnetic resonance imaging (MRI) substudy will be conducted in 20 participants to evaluate change in synovitis. Logistic regression will be used to compare changes between groups in an intention-to-treat analysis.DiscussionThe COLKOA trial is designed to evaluate whether commercially available colchicine is effective for improving signs and symptoms of KOA, and reducing synovial fluid, serum and urine inflammatory and biochemical joint degradation biomarkers. These biomarkers should provide insights into the underlying mechanism of therapeutic response. This trial will potentially provide data to support a new treatment option for KOA.Trial registrationThe trial has been registered at clinicaltrials.gov as NCT02176460. Date of registration: 26 June 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0726-x) contains supplementary material, which is available to authorized users.
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