Development of Explainable Machine Learning Models to Predict Outcomes After Platelet-Rich Plasma Injections for Knee Osteoarthritis Article Swipe
YOU?
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· 2025
· Open Access
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· DOI: https://doi.org/10.1177/23259671251349743
Background: Platelet-rich plasma (PRP) has been increasingly used to treat knee osteoarthritis, but its efficacy remains unclear due to the variability of outcomes. Machine learning (ML) can improve the ability to predict responses to PRP treatment by identifying specific baseline characteristics of patients who may have greater clinical improvements. Purpose: To develop and evaluate an ML model predicting clinical outcomes after PRP injection for knee osteoarthritis. Study design: Cohort study (prognosis); Level of evidence, 2. Methods: This retrospective study utilized patient demographics and patient-reported outcome measures (PROMs) from 191 patients who received PRP injections for knee osteoarthritis. Patients were randomly split into a training set (80%) and a testing set (20%). The primary outcome was predicting the achievement of the minimal clinically important difference at 6 months after treatment, defined as a ≥10-point increase in the Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) and a ≥20% decrease in the numeric pain rating scale for knee pain score. Ten preinjection variables, including demographics and baseline PROMs, were evaluated. Multiple ML algorithms were developed and evaluated on sensitivity, accuracy, precision, area under the receiver operating characteristic curve (AUC)-ROC, and F 1 score. Feature importance and partial dependency plots were used to explore predictor relationships with the primary outcome. Results: The Explainable Boosting Machine (EBM) algorithm was determined to be the best algorithm due to its greater explainability (AUC-ROC, 0.81 [95% CI, 0.65-0.94]; F 1 score, 0.75 [95% CI, 0.57-0.88]; accuracy, 0.74 [95% CI, 0.59-0.90]; sensitivity, 0.71 [95% CI, 0.50-0.90]; precision, 0.79 [95% CI, 0.59-0.96]). The baseline PROMIS (Patient-Reported Outcomes Measurement Information System) Mental score (the higher, the better) and the KOOS JR score (the lower, the better) were the most influential predictors. By excluding the baseline PROMIS health scores, the model's performance significantly deteriorated (AUC-ROC, 0.51 [95% CI, 0.32-0.7]). Conclusion: ML models effectively predicted a clinically meaningful improvement at 6 months after PRP injection for knee osteoarthritis. The EBM was the algorithm with the best performance, with the PROMIS Mental and Physical scores and the KOOS Jr score being the most influential predictors. Additional independent studies are needed to externally validate this model.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1177/23259671251349743
- https://journals.sagepub.com/doi/pdf/10.1177/23259671251349743
- OA Status
- gold
- Cited By
- 1
- References
- 24
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4413039241
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4413039241Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1177/23259671251349743Digital Object Identifier
- Title
-
Development of Explainable Machine Learning Models to Predict Outcomes After Platelet-Rich Plasma Injections for Knee OsteoarthritisWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-08-01Full publication date if available
- Authors
-
Felix C. Oettl, Antonio Ibarra, Mark Alan Fontana, Ophelie Loblack, Mert Marcel Dagli, Miguel Otero, Jessica Andres Bergos, Brian Halpern, Scott A. RodeoList of authors in order
- Landing page
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https://doi.org/10.1177/23259671251349743Publisher landing page
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https://journals.sagepub.com/doi/pdf/10.1177/23259671251349743Direct link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://journals.sagepub.com/doi/pdf/10.1177/23259671251349743Direct OA link when available
- Concepts
-
Medicine, Osteoarthritis, Platelet-rich plasma, Platelet, Physical therapy, Surgery, Physical medicine and rehabilitation, Internal medicine, Pathology, Alternative medicineTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1Per-year citation counts (last 5 years)
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24Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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