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RMD Open. 2019 Apr 24;5(1):e000888. doi: 10.1136/rmdopen-2018-000888. eCollection 2019.

Validating 10-joint juvenile arthritis disease activity score cut-offs for disease activity levels in non-systemic juvenile idiopathic arthritis.

Author information

1
Pediatric Department, Vaasan keskussairaala, Vaasa, Finland.
2
Department of Pediatrics, South Karelia Central Hospital, Lappeenranta, Finland.
3
Poison Information Center, University of Helsinki Hospital, Helsinki, Finland.
4
Hospital for Children and Adolescents, University of Helsinki Hospital for Children and Adolescents, Helsinki, Finland.
5
Department of Pediatrics, Turku University Hospital, Turku, Finland.
6
Department of Pediatrics, Satakunta Central Hospital, Pori, Finland.
7
Department of Pediatrics, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
8
Department of Paediatrics, Oulu University Hospital, Oulu, Finland.
9
Medical Research Center Oulu, Oulu University Hospital and PEDEGO Research Unit, University of Oulu, Oulu, Finland.
10
Department of Pediatrics, Päijät-Häme Central Hospital, Lahti, Finland.
11
Department of Pediatrics, Central Finland Hospital District, Jyvaskyla, Finland.
12
Department of Biostatistics, University of Turku, Turku, Finland.

Abstract

Objectives:

To validate cut-offs of the Juvenile Arthritis Disease Activity Score 10 (JADAS10) and clinical JADAS10 (cJADAS10) and to compare them with other patient cohorts.

Methods:

In a national multicentre study, cross-sectional data on recent visits of 337 non-systemic patients with juvenile idiopathic arthritis (JIA) were collected from nine paediatric outpatient units. The cut-offs were tested with receiver operating characteristic curve-based methods, and too high, too low and correct classification rates (CCRs) were calculated.

Results:

Our earlier presented JADAS10 cut-offs seemed feasible based on the CCRs, but the cut-off values between low disease activity (LDA) and moderate disease activity (MDA) were adjusted. When JADAS10 cut-offs for clinically inactive disease (CID) were increased to 1.5 for patients with oligoarticular disease and 2.7 for patients with polyarticular disease, as recently suggested in a large multinational register study, altogether 11 patients classified as CID by the cut-off had one active joint. We suggest JADAS10 cut-off values for oligoarticular/polyarticular disease to be in CID: 0.0-0.5/0.0-0.7, LDA: 0.6-3.8/0.8-5.1 and MDA: >3.8/5.1. Suitable cJADAS10 cut-offs are the same as JADAS10 cut-offs in oligoarticular disease. In polyarticular disease, cJADAS10 cut-offs are 0-0.7 for CID, 0.8-5.0 for LDA and >5.0 for MDA.

Conclusion:

International consensus on JADAS cut-off values is needed, and such a cut-off for CID should preferably exclude patients with active joints in the CID group.

KEYWORDS:

disease activity; juvenile idiopathic arthritis; outcomes research

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