Rheumatology Medical News about JIA;composite disease activity score

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Development and validation of a composite disease activity score for juvenile idiopathic arthritis
Arthritis Care and Research , 05/12/09

Consolaro A et al. – Study reports that the Juvenile Arthritis Disease Activity Score (JADAS) is a valid instrument for assessment of disease activity in juvenile idiopathic arthritis (JIA) and is potentially applicable in standard clinical care, observational studies, and clinical trials.

Methods

Aim was to develop and validate a composite disease activity score for JIA, the JADAS
JADAS includes 4 measures:
1. Physician global assessment of disease activity
2. Parent/patient global assessment of well-being
3. Active joint count, and
4. Erythrocyte sedimentation rate (ESR)
These variables are part of the ACR Pediatric 30 (Pedi 30), Pedi 50, and Pedi 70 criteria for improvement
Validation analyses conducted on >4,500 pts; included assessment of construct validity, discriminant validity, and responsiveness to change
3 versions of the JADAS were tested based on 71-joint, 27-joint, or 10-joint counts
Statistical performances of the JADAS were compared with:
- 2 rheumatoid arthritis composite scores
- Disease Activity Score in 28 joints (DAS28) and
- Clinical Disease Activity Index (CDAI)

Results

JADAS demonstrated:
- good construct validity, yielding strong correlations with JIA activity measures not included in the score and
- moderate correlations with the Childhood Health Assessment Questionnaire
Correlations obtained for 3 JADAS versions were comparable, but superior to those yielded by DAS28 and CDAI
The AUC of the JADAS predicted long-term disease outcome, measured as radiographic progression over 3 yrs
JADAS discriminated well between ACR Pedi 30, Pedi 50, and Pedi 70 response
It revealed strong responsiveness to clinical change

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