An interpretable and trustworthy AI framework for large-scale longitudinal structure-pain association studies using data from the Osteoarthritis Initiative (OAI)

Computer Science > Artificial Intelligence [Submitted on 3 Jun 2026] An interpretable and trustworthy AI framework for large-scale longitudinal structure-pain association studies using data from the Osteoarthritis Initiative (OAI) Jincheng Yu, Haoyang Li, Yiwen Liu, Shen Liu, Rachel Yuanbao Chen, C. Kent Kwoh, Hongxu Ding, Xiaoxiao Sun Purpose: To develop an interpretable and trustworthy AI framework that combines deep learning based MRI Osteoarthritis Knee Score (MOAKS) prediction with interpretable statistical modeling to study structure-pain relationships at scale using data from the Osteoarthritis Initiative (OAI). Materials and Methods: We first developed a deep learning framework to predict MOAKS features directly from knee MRIs and incorporated conformal prediction to provide prediction uncertainty quantification. This uncertainty-aware strategy enables explicit filtering of model outputs, retaining only high-confidence MOAKS predictions at the knee level. Second, we applied a longitudinal latent class mixed model (LCMM) to examine associations between key structural abnormalities and four complementary knee pain measurements. Results: Among the three MRI-defined abnormalities (i.e., bone marrow lesions (BML), cartilage loss (CART), and meniscal extrusion (ME)), our framework substantially improved the Matthews correlation coefficient (MCC) and some other metrics. For example, MCC increased from 0.69 to 0.91 for BML, from 0.45 to 0.80 for CART, and from 0.59 to 0.89 for ME. Using these high-confidence predictions, we expanded the sample size to 2,175 knees for the LCMM analysis. Two distinct pain trajectories were identified (rapid and stable pain progression). The estimated odds ratios (95% CI) for the rapid progression group were 1.62 (1.12-2.35) for BML, 1.83 (1.24-2.70) for CART loss, and 2.50 (1.75-3.57) for ME. Conclusion: These results highlight the importance of these structural abnormalities as risk factors for pain and functional progression in osteoarthritis. Subjects: Artificial Intelligence (cs.AI) Cite as: arXiv:2606.05357 [cs.AI]   (or arXiv:2606.05357v1 [cs.AI] for this version)   https://doi.org/10.48550/arXiv.2606.05357 Focus to learn more Submission history From: Jincheng Yu [view email] [v1] Wed, 3 Jun 2026 18:59:38 UTC (771 KB) Access Paper: view license Current browse context: cs.AI < prev   |   next > new | recent | 2026-06 Change to browse by: cs References & Citations NASA ADS Google Scholar Semantic Scholar Export BibTeX Citation Bookmark Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer (What is the Explorer?) Connected Papers Toggle Connected Papers (What is Connected Papers?) Litmaps Toggle Litmaps (What is Litmaps?) scite.ai Toggle scite Smart Citations (What are Smart Citations?) Code, Data, Media Demos Related Papers About arXivLabs Which authors of this paper are endorsers? | Disable MathJax (What is MathJax?)