The controversial role of wellbeing assessment in juvenile idiopathic arthritis

Santaniello, Stefania; Ravelli, Angelo

doi:10.1016/s2665-9913(20)30383-0

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…[32][33][34] Needless to say that in the assessment of parent-reported and patient-reported pain particular attention should be paid to rule out pain unrelated to disease activity, such as mechanical pain secondary to structural joint damage or pain amplifications symptoms, which are frequent in paediatric rheumatic illnesses, especially in adolescent girl and in patients with long-standing disease. 35 However, to patients, remission means no pain, regardless of its cause. Thus, for the treatment of the overall disease across the multidisciplinary team and the understanding of the overall impact of disease, pain amplification and pain secondary to joint damage could be considered in remission criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, considerable concern has been raised by the observations of persistent pain in some children with JIA despite adequate treatment with biological medications and good disease control 32–34. Needless to say that in the assessment of parent-reported and patient-reported pain particular attention should be paid to rule out pain unrelated to disease activity, such as mechanical pain secondary to structural joint damage or pain amplifications symptoms, which are frequent in paediatric rheumatic illnesses, especially in adolescent girl and in patients with long-standing disease 35. However, to patients, remission means no pain, regardless of its cause.…”

Section: Discussionmentioning

confidence: 99%

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Drivers of non-zero physician global scores during periods of inactive disease in juvenile idiopathic arthritis

et al. 2022

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ObjectiveTo investigate the frequency in which the physician provides a global assessment of disease activity (PhGA) >0 and an active joint count (AJC)=0 in children with juvenile idiopathic arthritis (JIA) and search for determinants of divergence between the two measures.MethodsData were extracted from a multinational cross-sectional dataset of 9966 patients who had JIA by International League of Associations for Rheumatology criteria, were recruited between 2011 and 2016, and had both PhGA and AJC recorded by the caring paediatric rheumatologist at the study visit. Determinants of discordance between PhGA>0 and AJC=0 were searched for by multivariable logistic regression and dominance analyses.ResultsThe PhGA was scored >0 in 1647 (32.3%) of 5103 patients who had an AJC of 0. Independent associations with discordant assessment were identified for tender or restricted joint count >0, history of enthesitis, presence of active uveitis or systemic features, enthesitis-related or systemic arthritis, increased acute phase reactants, pain visual analogue scale (VAS)>0, and impaired physical or psychosocial well-being. In dominance analysis, tender joint count accounted for 35.43% of PhGA variance, followed by pain VAS>0 (17.72%), restricted joint count >0 (16.14%) and physical health score >0 (11.42%).ConclusionWe found that many paediatric rheumatologists did not mark a score of 0 for patients who they found not to have active joints. The presence of pain in joints not meeting the definition of active joint used in JIA was the main determinant of this phenomenon.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Drivers of non-zero physician global scores during periods of inactive disease in juvenile idiopathic arthritis

et al. 2022

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Is the parent global assessment a reliable quality of life measure in juvenile idiopathic arthritis?

2022

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Development and initial validation of parent and child versions of the Juvenile Arthritis Disease Activity Score

Naddei,

Ridella,

Bovis

et al. 2024

Rheumatology

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Objective To develop parent- and child-centered versions of the Juvenile Arthritis Disease Activity Score (JADAS) and to provide preliminary evidence of their validity. Methods Validation analyses were conducted on two large multinational datasets of patients with juvenile idiopathic arthritis (JIA) and included assessment of construct validity, internal consistency and structure, discriminative validity, responsiveness to change, and predictive validity. Results The parJADAS and patJADAS include four parent/patient-reported outcomes, each measured on a 0–10 scale: assessment of overall disease activity; rating of pain intensity; assessment of activity of joint disease; duration of morning stiffness. Both scores are calculated as the simple linear sum of the scores of their 4 components, which yields for both of them a global score of 0–40. The parJADAS and patJADAS demonstrated good construct validity, yielding high correlations with other JIA composite disease activity measures and moderate correlations with physician global rating and joint counts. Internal consistency was satisfactory, with Cronbach’ s alpha > 0.80, and exploratory factor analysis showed that both indices are monodimensional. Both instruments discriminated well between different disease states, with discriminative ability being not affected by the presence of damage, proved able to predict important disease outcomes, and showed fair responsiveness to clinically important change, with standardized response mean of 0.71. Conclusion Both parJADAS and patJADAS were found to possess good measurement properties and to serve as surrogate of physicians’ evaluations. Regular home completion of the two instruments through digital technologies offers a suitable and pragmatic approach to deliver remote symptom monitoring and telehealth.

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The controversial role of wellbeing assessment in juvenile idiopathic arthritis

Cited by 3 publications

References 7 publications

Drivers of non-zero physician global scores during periods of inactive disease in juvenile idiopathic arthritis

Drivers of non-zero physician global scores during periods of inactive disease in juvenile idiopathic arthritis

Is the parent global assessment a reliable quality of life measure in juvenile idiopathic arthritis?

Development and initial validation of parent and child versions of the Juvenile Arthritis Disease Activity Score

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