Preliminary definition of improvement in juvenile arthritis

✍ Scribed by Edward H. Giannini; Nicolino Ruperto; Angelo Ravelli; Daniel J. Lovell; David T. Felson; Alberto Martini

• Book ID: 102750958
• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 794 KB
• Volume: 40
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780400703

✦ Synopsis

Objective. To identify a core set of outcome variables for the assessment of children with juvenile arthritis (JA), to use the core set to develop a definition of improvement to determine whether individual patients demonstrate clinically important improvement, and to promote this definition as a single efficacy measure in JA clinical trials.

Methods. A core set of outcome variables was established using a combination of statistical and consensus formation techniques. Variables in the core set consisted of 1) physician global assessment of disease activity; 2) parent/patient assessment of overall wellbeing; 3) functional ability; 4) number of joints with active arthritis; 5) number of joints with limited range of motion; and 6) erythrocyte sedimentation rate. To establish a definition of improvement using this core set, 21 pediatric rheumatologists from 14 countries met, and, using consensus formation techniques, scored each of 72 patient profiles as improved or not improved. Using the physicians' consensus as the gold standard, the chi-square, sensitivity, and specificity were calculated for each of 240 possible definitions of improve-