CASK (Clinical Assessment of the Knee)

Chief Investigator:

Study Co-ordinator:

Dr Rosie Lacey

Funder name / reference number: Medical Research Council Programme Grant (G9900220), Arthritis Research UK Programme Grant (18174), North Staffordshire Primary Care Research Consortium
UKCRN Study portfolio: 3101 (36 and 54 month Follow up), 6083 ( 6 year Follow up)
Year 2002-2010

Study design

Prospective observational cohort. Adults aged 50 years and over at time of baseline survey (2002-2003); responded to NorStOP Health Survey; self-reported knee pain in 12 months prior to NorStOP Health Survey; consented to further contact; responded to NorStOP Regional Pains Survey; attended research clinic  (2002 – 2003) for clinical interview and knee assessment, lower extremity function tests, digital photography of the hands and knees, plain x-ray of the hands and knees, anthropometric measurement and brief self complete questionnaire. Postal questionnaire follow-up at 18 months, three years and 54 months.  Postal questionnaire and clinical assessment follow-up at six years.

Primary objective

Clinical Assessment Study of the Knee 

Phase 1: 2001-2008

1) To determine the medium-term course of knee pain and knee osteoarthritis in community-dwelling adults and its relation to primary health care use.

2) To determine the prevalence of, and relationship between, clinical signs and symptoms, knee function, and radiographic osteoarthritis in a population sample of older people with knee pain or problems.

3) To determine the prognostic usefulness of clinical history, knee assessment, digital imaging, radiographic severity, and lower limb function in determining outcome in older people with knee pain or problems.

Phase 2:2008-2013

Theme 1: Peripheral joint pain and limitations in activity and participation: the dynamics of long-term progression

  • To describe the long-term (6-year) trajectories of knee pain in community-dwelling adults aged 50 years and over and their relation to activity limitation and participation restriction.
  • To develop prognostic models to help clinicians and patients predict the future clinical course of pain and associated activity limitation and participation restriction.
  • To test longitudinal explanatory models based on the dynamic relationship between changes in pain and limitations and key time-dependent and time-independent personal, environmental, and comorbid health factors.
  • Theme 2: Phenotypic expression of peripheral joint osteoarthritis
  • To describe the patterns of occurrence and co-occurrence of defined OA subtypes at the knee, hand, and foot and their progression over time.
  • To determine the long-term outcome of different OA subgroups, by linking phenotypic characterization to the long-term pain and functional trajectories outlined in Theme 1.
  • Theme 3: Modelling the outcomes of care
  • To identify which phenotypes are presented to primary care and diagnosed in this setting.
  • To describe the patterns of self-care and primary health care use for defined OA subtypes.
  • To model the effects of care on the outcome of severe knee, hand, and foot pain.
  • Theme 4. Patient preferences and clinical decision-making 
  • To elicit patient and practitioner preferences for composite health states and the relative importance patients attach to different aspects of health and functioning.
  • To identify the relative importance of characteristics of the patient, their problem, the practitioner and the health and social context, in determining whether peripheral joint problems are raised and addressed in the primary care consultation.