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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.

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Pediatric Department, Vaasan keskussairaala, Vaasa, Finland.
Department of Pediatrics, South Karelia Central Hospital, Lappeenranta, Finland.
Poison Information Center, University of Helsinki Hospital, Helsinki, Finland.
Hospital for Children and Adolescents, University of Helsinki Hospital for Children and Adolescents, Helsinki, Finland.
Department of Pediatrics, Turku University Hospital, Turku, Finland.
Department of Pediatrics, Satakunta Central Hospital, Pori, Finland.
Department of Pediatrics, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
Department of Paediatrics, Oulu University Hospital, Oulu, Finland.
Medical Research Center Oulu, Oulu University Hospital and PEDEGO Research Unit, University of Oulu, Oulu, Finland.
Department of Pediatrics, Päijät-Häme Central Hospital, Lahti, Finland.
Department of Pediatrics, Central Finland Hospital District, Jyvaskyla, Finland.
Department of Biostatistics, University of Turku, Turku, Finland.



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.


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.


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.


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.


disease activity; juvenile idiopathic arthritis; outcomes research

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