MSK Calculator FAQ

beplay体育怎么下载与关节炎与伦敦帝国学院合作开发了肌肉骨骼计算器，该工具旨在产生肌肉骨骼（MSK）条件的患病率估计值（即有多少人患有状况）。

在这个阶段估计可供osteoarthritis of the hip and knee (general (i.e. total)/severe), back pain (general (i.e. total)/severe) and rheumatoid arthritis for England and Scotland. Estimates for Wales and high risk of fragility fractures for all countries are expected to be available soon. Prevalence estimates for Northern Ireland are not possible due to a lack of local risk factor data.

数据可在地方政府（LA），临床调试小组（CCG）或卫生委员会（HB）级别上获得数据。

Location	Osteoarthritis (hip/knee)	Back pain	Rheumatoid arthritis	High risk of fragility fracture
England	YES - LA, CCG	YES - LA, CCG	是的-CCG	NO - TBC
Scotland	是的-LA，HB	是的-LA，HB	YES - HB	NO - TBC
Wales	NO - TBC	NO - TBC	NO - TBC	NO - TBC
Northern Ireland	NO - N/A	NO - N/A	NO - N/A	NO - N/A

在开发肌肉骨骼计算器之前，没有关于这些常见MSK条件的人数的局部估计。通过不衡量这些条件，当地规划者在计划服务时很难考虑到他们的危险，并冒险忽略了条件。医疗保健系统中的许多权力，尤其是公共卫生，都在地方一级，因此允许在此级别产生估计值尤为重要。地方当局可能会对MSK风险因素（例如体育活动）产生影响，并且一般实践可以通过发现和准确记录新的疾病病例来改善诊断。

提供的数据是估计值，因为目前不可能访问确定有多少人患有MSK条件所需的健康数据记录。MSK条件的大多数治疗方法都发生在初级保健中，并且NHS并未始终如一地收集该数据。肌肉骨骼计算器得出的数字和百分比基于统计模型。beplay体育怎么下载与关节炎正在竞选有关可提供肌肉骨骼疾病的更多数据。

England

Condition	Source of numerator	Description of source	分母的来源
Osteoarthritis (hip/knee)	The English Longitudinal Study of Ageing (ELSA) Wave 1 (2000/01) – Wave 5 (2010/11)	艾尔莎（Elsa）是对50岁及其年轻伴侣的大型多中心和多学科研究，居住在英格兰的私人家庭中。 This survey was chosen because the sample used in ELSA was designed to be nationally representative and osteoarthritis is most common in those aged over 45 years of age. The survey uses patient-reported doctor diagnosed disease criteria; it includes questions concerning limitations with activities of daily living allowing us to differentiate disease severity.	ONS mid-year population estimates for 2012. People aged 45 and over only.
Back pain	Health Survey for England (HSE) 2011	HSE是对成年人和儿童的年度调查，是国家和地区级别的整个人口的代表，旨在衡量与健康和健康相关的行为。 This survey was chosen because it contains several questions around pain or discomfort and specifically chronic pain, which allows us to differentiate disease severity.	ONS mid-year population estimates for 2012. People of all ages.
Rheumatoid arthritis	Clinical Practice Research Datalink (CPRD)-extracted 23/01/15	The CPRD is governmental, not-for-profit research service that provides anonymised primary care records for public health research. 由于可用于确定可能情况的数据广度，包括临床，开处方和测试数据，因此选择了该数据库。	ONS mid-year population estimates for 2015. 16岁及以上的人。
High risk of fragility fracture	TBC	TBC	TBC

Scotland

Condition	Source of numerator	Description of source	分母的来源
Osteoarthritis (hip/knee)	Scottish Health Survey (SHeS) 2012-14	SHE是对成人和儿童的年度调查，可定期提供有关公众与健康与健康相关行为方面的信息。 This survey was chosen because it contains the relevant health questions and additional risk factor statistics needed to estimate the prevalence of these conditions, which cannot be obtained from other sources.	General Practice workforce and practice population statistics 01.04.2016 People aged 45 and over only.
Back pain	Scottish Health Survey (SHeS) 2012-14	Same as above	General Practice workforce and practice population statistics 01.04.2016 People aged over 18 years.
Rheumatoid arthritis	Scottish Health Survey (SHeS) 2012-14	Same as above	General Practice workforce and practice population statistics 01.04.2016 18岁及以上的人。1
High risk of fragility fracture	TBC	TBC	TBC

¹Note –population estimates at health board level for RA do not always match those for Back Pain. This is not an error but a consequence of missing local data. The RA MSK Calculator model uses deprivation as a risk factor for RA, however missing deprivation scores were identified for six GP practices and were therefore not included in the model. This accounts for a total population difference of 37,576 people. This discrepancy does not affect Local Authority estimates.

肌肉骨骼计算器的数字和百分比是基于统计模型的估计值。用于开发这些模型的方法的摘要如下：

• Identify risk factors: A literature review was conducted via the MedLine database and supplemental references provided by Versus Arthritis to identify risk factors and comorbidities (if applicable) associated with an outcome (i.e. osteoarthritis of the hip/knee).
• Choose data source: Several existing data sources were analysed (i.e. HSE, ELSA, GLS, CPRD) to identify which dataset best records the outcome in question (i.e. osteoarthritis of the hip/knee). The final data source was selected based on its data qualities (i.e. validity, completeness, timeliness etc.). For example, ELSA is more specific than HSE or GLS, because it allows a specific type of arthritis to be recorded, which was an important reason for selecting it when examining outcomes (i.e. osteoarthritis of the hip/knee)
• 数据映射：文献综述中确定的风险因素和合并症（如果适用）在数据集中绘制了以确定1.）丢失数据的比例2.）需要多次插补以弥补丢失的数据和3.）在回归模型中包含风险因素数据。
• Regression modelling and validation: Baseline characteristics and regression analysis was conducted via Stata 11 to identify the relationship between risk factors and comorbidities (if applicable) available in the dataset and the outcome variable (i.e. osteoarthritis of the hip/knee). Sensitivity and specificity were calculated using the area under the ROC curve to validate results.
• Synthetic estimation: application of the model to small population data: Derived Odds Ratios from regression modelling were then used to estimate prevalence of the condition in small population subgroups (i.e. General Practice and Middle Layer Super Output Area (MLSOA) populations) using local population breakdowns for each risk factor where available.

肌肉骨骼计算器的数字和百分比是基于统计模型的估计值。However, the data sources used to produce these models and estimates are designed to give a representative picture for the whole of England. National bodies routinely use survey data: for example, ELSA is jointly funded by UK government departments and the National Institute on Aging (USA) and “helps the government plan health care services and pensions systems to accurately meet the needs of older people”.

进行了科学文献综述，以确定关键的风险因素，以增加/减少开发有关条件的机会。例如，肥胖和膝盖骨关节炎之间存在明确的联系。然后分析调查中有关这些风险因素的问题的答案。例如，某人对体重（BMI）的回答用于检查膝盖肥胖与骨关节炎之间的关系。

As with all datasets, some data was missing, in which specific statistical techniques were used that take into account missing data.

Osteoarthritis (hip/knee)	Back pain	Rheumatoid arthritis
Age group Sex Socioeconomic factors 教育 BMI Smoking status 休闲体育锻炼 Membership at gym/sports club	Age group Sex Socioeconomic factors 教育 BMI Smoking status	Age Gender 酒精 BMI Smoking 剥夺（IMD） Ethnicity

There is no simple test for conditions like osteoarthritis or back pain, diagnoses vary greatly between individual GPs and across general practices. GPs often use symptom labels such as 'knee pain' rather than a diagnostic label of osteoarthritis and by the time someone has a GP appointment, their back pain may have subsided.

因此，肌肉骨骼计算器将两个主要组定义为髋或膝盖的骨关节炎。报告的受访者报告说，他们患有医生诊断的骨关节炎和/或报告髋关节或膝盖疼痛的受访者。

Similarly, the Musculoskeletal Calculator defined someone as having back pain as survey respondents who said they are 1. currently troubled by pain or discomfort, 2. the pain or discomfort lasted for more than three months, and 3. the site of the pain was identified as “back pain”.

Total includes all cases of osteoarthritis of the hip or knee or back pain. Severe includes cases that would require special attention, and additional resources, from healthcare providers and commissioners.

严重的骨关​​节炎（臀部/膝盖）and back pain are defined as follows:

Condition	Definition
严重的骨关​​节炎（臀部/膝盖）	This severity of osteoarthritis was determined using two survey questions: “大多数时候的疼痛严重程度” 'Difficulty walking ¼ mile unaided'. Respondents were deemed to have 'severe' osteoarthritis if their answers included any one of the following statements: They have severe pain most of the time (as opposed to 'mild' or 'moderate'). They're unable to walk ¼ mile unaided (as opposed to 'no', 'some' or 'much difficulty'). 他们以前由于关节炎而经过髋关节或膝盖置换。
Back pain	背部疼痛的严重程度是使用基于GCPS 2.0版的慢性疼痛等级确定的： Grade 0 - no pain problem Grade I – Low intensity, low interference II级 - 高强度 Grade III – Moderate interference (limiting) Grade IV – Severely interference (limiting) 如果受访者为II，III或IV的慢性疼痛级得分，则认为他们的腰痛严重。

beplay体育怎么下载与关节炎is constantly seeking to make sure that the needs of people with musculoskeletal conditions are considered when decisions are made about the healthcare system. You can learn more about what we’re asking politicians to do by reading our manifesto.

如果您想了解更多信息，则可以访问和下载以下技术文档。如果您还有其他疑问，请联系data@versusarthlitis.org

• Osteoarthritis technical document(PDF, 1.7 MB)
• Back pain technical document（PDF，2.3 MB）
• Rheumatoid arthritis technical document（PDF，2.5 MB）