Evidence mapPaperPMID 39400996Full record

Trial reportArthritis care & research2025

Disparities Between Rural and Urban Communities: Response to 18 Months of Diet and Exercise Versus Control for Knee Osteoarthritis and Overweight or Obesity.

Stephen P Messier, Megan G Monroe, Leigh F Callahan, Shannon L Mihalko, Daniel P Beavers, Kate Queen, Gary D Miller, Elena Losina, Jeffrey N Katz, Richard F Loeser and 3 more

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Arthritis care & research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Rurality and Delayed Diagnosis of Giant Cell Arteritis-A Single-Center Experience.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Stephen P MessierWake Forest University, Winston-Salem, North Carolina.ORCID 0000-0002-7033-8459
Megan G MonroeWake Forest University, Winston-Salem, North Carolina.
Leigh F CallahanUniversity of North Carolina at Chapel Hill.
Shannon L MihalkoWake Forest University, Winston-Salem, North Carolina.
Daniel P BeaversWake Forest University, Winston-Salem, North Carolina.
Kate QueenHaywood Regional Medical Center, Clyde, North Carolina.
Gary D MillerWake Forest University, Winston-Salem, North Carolina.
Elena LosinaBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Jeffrey N KatzBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0003-2104-4670
Richard F LoeserUniversity of North Carolina at Chapel Hill.ORCID 0000-0003-2832-6144
Paul DeVitaEast Carolina University, Greenville, North Carolina.
David J HunterSydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-3197-752X
Sara A QuandtWake Forest University, Winston-Salem, North Carolina.

Funding

Weight Loss and Exercise for Communities with Arthritis in North Carolina (WE-CAN)U01AR068658 · NIAMS · WAKE FOREST UNIVERSITY · PI CALLAHAN, LEIGH FLEMING, MESSIER, STEPHEN P · 2015 to 2017
$3.6M
NIAMS NIH HHS U01 AR068658NIH HHS 1 U01 AR068658-01
6 · The paper itself

Abstract

objectiveThe study objective was to determine whether the clinical response of older adults with knee osteoarthritis and overweight or obesity to 18 months of diet and exercise (D + E) or attention control (C) interventions differed between participants from rural versus urban communities.

methodsParticipants were 823 older adults (mean age, 64.6 years; 77% women) with knee osteoarthritis and overweight or obesity who resided in rural (n = 410) and urban (n = 413) counties in North Carolina. All were enrolled in the Weight Loss and Exercise for Communities with Arthritis in North Carolina clinical trial that randomly assigned participants to either 18 months of D + E or C interventions. General linear models were used to examine differences in clinical outcomes between rural and urban groups after adjusting for covariates.

resultsThe rural group had significant differences (P < 0.05) at baseline in clinical outcomes, education, comorbidities, medication use, and income compared with the urban dwellers. After adjusting for baseline differences, the group (rural or urban) by treatment (D + E or C) interactions for Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) pain (rural: D + E - C = -0.63, 95% confidence interval [CI] -1.31 to 0.06; urban: D + E - C= -0.29, 95% CI -0.99 to 0.41; P = 0.50) and WOMAC function (rural: D + E - C = -4.60, 95% CI -6.89 to -2.31; urban: D + E - C = -1.38, 95% CI -3.73 to 0.94; P = 0.054) indicated that the groups responded similarly to the interventions.

conclusionAmong participants with knee osteoarthritis and overweight or obesity, D + E compared to C led to similar pain outcomes in rural and urban dwellers that favored D + E. The possibility that there may be greater differential efficacy in functional outcomes among rural participants needs further study.

Indexed as

Exercise TherapyObesityOsteoarthritis, KneeAgedDiet, ReducingFemaleHealth Status DisparitiesHumansMaleMiddle AgedNorth CarolinaOverweightRural HealthTime FactorsTreatment OutcomeUrban Health

Identifiers

PMID39400996
PMCPMC11684979

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.