Multicenter Osteoarthritis Study (MOST)

See also: UC San Francisco MOST Website

The Objective

A multicenter prospective observational study of risk factors for the development and progression of knee osteoarthritis and knee pain that will help better understand how to prevent and treat knee osteoarthritis, one of the most common causes of disability in adults.

MOST Team (Faculty)

Michael C. Nevitt, Ph.D., M.P.H.
Professor, Epidemiology and Biostatistics
PI, Osteoarthritis Initiative Coordinating Center
UC San Francisco
SF Coordinating Center
OAI Coordinating Center
Dept. of Epidemiology and Biostatistics
mnevitt@psg.ucsf.edu

Barton Wise, M.D., M.Sc.
Co-Study Investigator

Assistant Professor, Medicine

Center for Musculoskeletal Health

UC Davis

barton.wise@ucdmc.ucdavis.edu

MOST Coordinating Center

• UC San Francisco Department of Epidemiology and Biostatistics
  San Francisco Coordinating Center
  Principal Investigator: Michael Nevitt, Ph.D.
  Project Director: Jean Hietpas, M.S.W., O.T.R.

Radiograph Reading and Analysis Center

• Boston University Clinical Epidemiology Research and Training Unit
  Principal Investigator: David Felson, M.D., M.P.H.

Clinical Centers

• University of Alabama at Birmingham Department of Preventive Medicine
  Principal Investigator: Cora E. Lewis, M.D., M.S.P.H.

• University of Iowa College of Public Health
  Principal Investigator: James Torner, Ph.D.

RESEARCH:

Background

Osteoarthritis (OA) is the most common form of arthritis and the major cause of activity limitation and physical disability in older people. More than half of those over the age of 65 have radiological evidence of osteoarthritis in at least one joint. By 2030, approximately 20 percent of Americans (about 70 million people) will have passed their 65th birthday and will be at increased risk for the disease. Today, 39 million people (13 percent of the U.S. population) are 65 and older, and more than half have developed OA.

The Multicenter Osteoarthritis Study (MOST) is a longitudinal, prospective, observational study of knee OA in older Americans with OA disease or at increased risk of developing it. The study is comprised of two clinical centers, a data coordinating center, and an analysis center.

MOST enrolled 3,026 study participants and has conducted five follow-up contacts at 15, 30, 60, 72, and 84 months. At each time point, clinical assessments were conducted and radiological data (x-ray and MRI) collected, as well as other measures and instruments, with the exception of the 72-month follow-up, which was a Telephone Interview only.

Specific AIMS

The overall aims of MOST are to identify novel and modifiable biomechanical factors (including physical activity-related factors), bone and joint structural factors (including those assessed by MRI of the knee), and nutritional factors that affect the occurrence and progression of OA-related knee symptoms and radiographic knee OA. Additionally, MOST investigators aim to determine whether risk factors for new disease differ from those for OA progression. The MOST cohort has been followed through 84 months with three investigative themes: mechanical risk factors, causes of knee symptoms and pain, and the long term disease trajectory of knee OA.

To achieve these aims, we recruited a community-based sample of 3,026 (101% of our goal) men and women aged 50 to 79 and drawn from the general population but selected so as to be likely to either have preexisting OA or be at high risk as indicated by weight, knee symptoms, or a history of knee injuries or operations. Approximately 15% of the cohort are African Americans and 60% are women. Baseline exams began in 2003 and included an assessment of risk factors and disease characteristics, knee radiographs and knee MRIs, and a musculoskeletal examination to identify knee symptoms that do not emanate from the knee or hip joint. Knee MRIs were acquired with a 1.0 T dedicated extremity MR scanner (GE Healthcare).

Significance

This rich database will provide valuable information to help identify and define modifiable biomechanical, bone and structural, nutritional, and other risk factors for new disease and progression of existing disease.

OUTREACH:

Collaboration
To collaborate with MOST investigators, submit a Collaboration Request Form and attached Analysis Plan Proposal to MOSTOnline@psg.ucsf.edu

Collaboration Request Form (PDF)
MOST Guidelines For Publications Using Public Use Datasets (PDF)
 
Published Articles
List of MOST Published Articles (PDF)