BASELINE C-SCORE ON WEIGHT-BEARING CT PREDICTS 2-YEAR WORSENING OF KNEE PAIN IN WOMEN
Bibliographic record
Abstract
INTRODUCTION The B-score is a statistical score derived from non-weight-bearing MRI to assess femoral bone shape and its relationship with knee OA. However, CT scans may offer a more reliable and robust evaluations of bone shape, as they not only provide clearer differentiation between bone and soft tissue but also eliminate distortion artefact that can occur with MRI. OBJECTIVE To investigate a new “C-score” for femoral bone shape derived from CT as a predictive imaging biomarker for worsening knee pain in men and women with or at risk for knee osteoarthritis. METHODS This study included 649 knees from 389 participants (219 women) with a mean±SD age of 63.8±9.6 years and BMI of 28.5±5.0 kg/m². C-scores were calculated from baseline weight-bearing CT (WBCT) imaging of the knee joint: 0.37 mm voxels, FOV 30 × 20 cm, 120 kVp, 5.0 mA on a LineUp scanner, Curvebeam LLC, Warrington, PA. All distal femurs were segmented using Stradview to produce a surface mesh. A canonical distal femur mesh was registered using wxRegSurf to each individual femur to build the study population shape model. Each knee's C-score was derived from the distance along the vector for femur shape between the average KL0/1 and KL2/3/4 shapes from the study population using a custom script in MATLAB. A single unit of the C-score was standardized as 1SD along this vector for the KL0/1 population (Figure 1). Generalized estimating equations adjusted for age, sex, BMI and presence of up to 2 knees per participant were used to assess associations between baseline C-score and 2-year minimally clinically important worsening (MCIW) of the Western Ontario McMaster’s University Osteoarthritis Scale (WOMAC) pain subscore (2 points). MCIW is defined as the smallest difference on a pain scale that either patients perceive as worsening or requires change in treatment. RESULTS 186 knees demonstrated pain worsening (32.71% women and 23.2% men). 98 knees had MCIW of pain (19.0% women and 9.8% men). C-scores ranged from -2.64 to +3.34 in women and -3.96 to +2.83 in men, with mean±SD values of 0.16±1.06 and -0.52±1.01 respectively (p-value for difference between sexes p=0.0003). Women without MCIW pain had a mean C-score of +0.31, while those with worsening pain had a mean C-score of +0.72. Men had mean C-scores of -0.03 and -0.01, respectively. In fully adjusted models, baseline C-score predicted 2-year MCIW pain (OR: 1.27, 95% CI: 1.00–1.62, p=0.047). In sex-stratified models, the odds ratios for 2-year MCIW pain in women and men were 1.49 (95% CI: 1.10–2.01, p=0.0159) and 1.01 (95% CI: 0.70–1.47, p=0.95), respectively. CONCLUSION Higher C-scores in women were significantly associated with worsening knee pain over 2 years, suggesting the C-score as a potential predictive biomarker for knee pain progression.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".